Document Detail


Survival implications: hypertrophic cardiomyopathy in Noonan syndrome.
MedLine Citation:
PMID:  21269411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To understand relationships and survival implications between structural heart disease and hypertrophic cardiomyopathy in Noonan syndrome (Noonan syndrome-HCM), we reviewed the clinical course of 138 children with Noonan syndrome diagnosed with cardiovascular abnormalities and compared survival with the 30 children with Noonan syndrome-HCM with 120 contemporaneous children with nonsyndromic HCM.
METHODS: Study cohorts represent consecutive cases diagnosed at our institution 1966 through 2006. Outcomes were modeled using multiphase parametric techniques followed by multivariable regression with bagging.
RESULTS: Cardiac abnormalities in Noonan syndrome: Cardiac abnormalities in the 138 Noonan syndrome children included pulmonary valve dysplasia (52%), hypertrophic cardiomyopathy (22%), atrial septal defect (20%), ventricular septal defect (10%), mitral valve dysplasia (6%), coarctation (3%), and Fallot's tetralogy (2%). Need for surgery was high but not different from children with structural defects coexisting with HCM. Overall, late survival in children with Noonan syndrome and cardiac defects was good (91 ± 3% at 15 years), although significantly worse for those with Noonan syndrome-HCM (P < .01). Noonan syndrome-HCM vs. nonsyndromic HCM: In the 30 children with Noonan syndrome-HCM, structural cardiac malformations coexisted in 18 (57%). The incidence of structural cardiac malformations in nonsyndromic HCM was instead 3/120 (2.5%, P < .001). Risk-adjusted late survival was significantly worse for Noonan syndrome-HCM than for nonsyndromic HCM (P= .02).
CONCLUSIONS: Noonan syndrome-HCM frequently coexists with structural cardiac malformations, whereas nonsyndromic HCM does not; their natural histories may therefore be different. Late survival is significantly worse for Noonan syndrome-HCM than nonsyndromic HCM.
Authors:
Edward J Hickey; Rohit Mehta; Maryam Elmi; Kentaro Asoh; Brian W McCrindle; William G Williams; Cedric Manlhiot; Lee Benson
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  6     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-05-09     Revised Date:  2011-09-07    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Copyright Information:
© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.
Affiliation:
Department of Pediatrics, University of Toronto School of Medicine, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cardiomyopathy, Hypertrophic / mortality*,  surgery
Chi-Square Distribution
Child
Child, Preschool
Heart Defects, Congenital / mortality*,  surgery
Humans
Incidence
Infant
Kaplan-Meier Estimate
Logistic Models
Noonan Syndrome / mortality*,  surgery
Ontario
Prognosis
Risk Assessment
Risk Factors
Survival Rate
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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