Increased inflammatory markers in adult patients born with an atrial septal defect

Schram, Anne-Sif Lund; Sellmer, Anna; Nyboe, Camilla; Sillesen, Martin; Hjortdal, Vibeke E.

doi:10.3389/fcvm.2022.925314

Cited by 4 publications

(3 citation statements)

References 40 publications

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“…Some of the same mechanisms are found to be affected in patients with CHD. [42][43][44][45][46][47] As many of the above-mentioned factors are potentially more disturbed in complex CHD both prenatal with desaturated blood in the developing brain 48,49 and postnatal with early, difficult, and long-lasting surgeries, it is not surprising that it is in this patient group that we found an increased risk for attention deficit hyperactivity disorder. The advancements in the treatment and clinical care of complex CHD have led to a decrease in postoperative brain injuries, injuries which are possible contributors to neurodevelopmental co-morbidities.…”

Section: Discussionmentioning

confidence: 73%

Psychiatric co-morbidity in children and adolescents with CHDs: a systematic review

et al. 2023

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The population of long-term survivors with CHDs is increasing due to better diagnostics and treatment. This has revealed many co-morbidities including different neurocognitive difficulties. However, the prevalence of psychiatric disorders among children and adolescents and the specific types of disorders they may experience are unclear. We systematically reviewed the existing literature, where psychiatric diagnoses or psychiatric symptoms were investigated in children and adolescents (age: 2–18 aged) with CHDs and compared them with a heart-healthy control group or normative data. The searches were done in the three databases PubMed, psychINFO, and Embase. We included 20 articles reporting on 8035 unique patients with CHDs. Fourteen articles repoted on psychological symptoms, four reported on psychiatric diagnoses, and two reported on both symptoms and diagnoses. We found that children and adolescents with a CHD had a higher prevalence of attention deficit hyperactivity disorder (ranging between 1.4 and 9 times higher) and autism (ranging between 1.8 and 5 times higher) than controls, but inconsistent results regarding depression and anxiety.

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Section: Discussionmentioning

confidence: 73%

Psychiatric co-morbidity in children and adolescents with CHDs: a systematic review

et al. 2023

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“…In Autism Spectrum Disorder, where difficulties in social skills play a large and important part, genetics, immunological dysregulation, metabolic disturbances, and early brain injury (both developmental and structural lesions) are suggested etiological pathways (31). Some of the same mechanisms are found to be affected in patients with CHD (35)(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Self- and proxy-reported impaired social interaction in young adults with simple congenital heart defects

Lau-Jensen,

Asschenfeldt,

Evald

et al. 2023

Front. Pediatr.

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BackgroundSimple Congenital Heart Defects such as septal defects constitute a large proportion of Congenital Heart Defects. New research has demonstrated more co-morbidities than previously thought. In particular, co-morbidities involving neurocognitive, psychiatric, and social difficulties have been described. Neurocognitive and psychiatric morbidities affect social interaction. Social interaction is important in everyday social life (education, work life, family life). In this study, we investigated social interaction through self- and proxy-answered Social Responsiveness Scale 2 (SRS-2) in young adults with simple Congenital Heart Defects and compared their social interaction profile to healthy matched controls.MethodsWe included a total of 80 patients with either atrial or ventricular septal defect (age 26.6 years) and 38 heart-healthy, age, sex, and ISCED educational matched controls (age: 25.3 years). A close relative proxy from each participant took part in the study as well. All participants answered the Social Responsiveness Scale 2 (SRS-2) (n = 225). Our primary and secondary outcomes were the SRS-2 Total score and the SRS-2 sub-scores.ResultsIn the Congenital Heart Defects group, 31.3% had a Total score above 60 compared to 7.9% in the control group (p = 0.005, RR = 3.96). The participants with a septal defect had a higher Total score (52.5 vs. 45.5, p = 0.004), a higher Social Cognition sub-score (55.0 vs. 47.0, p = 0.0004), and a higher Social Motivation sub-score (50.0 vs. 45.0, p = 0.003) than the heart-healthy participants. We found no difference between the two groups regarding the sub-scores of Social Awareness and Social Communication. A multiple linear regression model showed that the variable that explained most of the variation in Total Score was having a previously diagnosed psychiatric disorder.ConclusionWe found that young adults with atrial or ventricular septal defects have a fourfold increased risk of social interaction difficulties compared to heart-healthy peers. They have a social interaction profile, with difficulties in social cognition and social motivation, and preserved social awareness and social communication. Psychiatric morbidity explained most of the variation in social interaction problems. As social difficulties and psychiatric morbidities are intertwined, social interaction difficulties could be an indication of already underlying psychiatric morbidities or a risk factor for future psychiatric morbidity.

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“…Speculatively, in small-scale clinical studies, an alteration in inflammatory response has been found at baseline in children with congenital heart disease (CHD) [ 50 , 51 ]. Moreover, an immune contribution to the CHD development has been suggested [ 52 ], as well as compensatory remodeling mechanism caused by changes in the cytokine profile. Children born with an atrial septal defect (ASD) undergo cardiac remodeling to compensate for the flow of blood from the left to the right atrium.…”

Section: Discussionmentioning

confidence: 99%

The Patent Ductus Arteriosus in Extremely Preterm Neonates Is More than a Hemodynamic Challenge: New Molecular Insights

et al. 2022

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Complications to preterm birth are numerous, including the presence of a patent ductus arteriosus (PDA). The biological understanding of the PDA is sparse and treatment remains controversial. Herein, we speculate whether the PDA is more than a cardiovascular imbalance, and may be a marker in response to immature core molecular and physiological processes driven by biological systems, such as inflammation. To achieve a new biological understanding of the PDA, we performed echocardiography and collected plasma samples on day 3 of life in 53 consecutively born neonates with a gestational age at birth below 28 completed weeks. The proteome of these samples was analyzed by mass spectrometry (nanoLC-MS/MS) and immunoassay of 17 cytokines and chemokines. We found differences in 21 proteins and 8 cytokines between neonates with a large PDA (>1.5 mm) compared to neonates without a PDA. Amongst others, we found increased levels of angiotensinogen, periostin, pro-inflammatory associations, including interleukin (IL)-1β and IL-8, and anti-inflammatory associations, including IL-1RA and IL-10. Levels of complement factors C8 and carboxypeptidases were decreased. Our findings associate the PDA with the renin-angiotensin-aldosterone system and immune- and complement systems, indicating that PDA goes beyond the persistence of a fetal circulatory connection of the great vessels.

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Increased inflammatory markers in adult patients born with an atrial septal defect

Cited by 4 publications

References 40 publications

Psychiatric co-morbidity in children and adolescents with CHDs: a systematic review

Psychiatric co-morbidity in children and adolescents with CHDs: a systematic review

Self- and proxy-reported impaired social interaction in young adults with simple congenital heart defects

The Patent Ductus Arteriosus in Extremely Preterm Neonates Is More than a Hemodynamic Challenge: New Molecular Insights

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