PP-371 Noncardiac Comorbidities of Congenital Heart Disease in Adults

Lummert, Eckart; Hauser, Michael; Vigl, Matthaeus; Pujol, C.; Braun, Sophie; Zachoval, R.; Fischereder, Michael; Engelhardt, A.; Mebus, Siegrun; Eicken, Andreas; Ewert, Peter; Kaemmerer, Harald

doi:10.1016/j.amjcard.2014.01.283

Cited by 7 publications

(7 citation statements)

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“…Additionally, acquired cardiac and non-cardiac comorbidities can adversely affect the outcome of the CHD. Vice versa course and treatment of comorbidities can be decisively modified by the CHD (20,21).…”

Section: Development Of Congenital Cardiology Epidemiologymentioning

confidence: 99%

“…Also operative scars and large artificial patches may be other additional factors. Acquired comorbidities gain importance with increasing age, aggravating the natural/unnatural course of the CHD (20). Coronary artery disease, arterial hypertension, peripheral arterial disease, metabolic disorders (e.g., diabetes mellitus, hyperlipidemia), cerebrovascular diseases, chronic obstructive pulmonary disease, myocarditis, or other organ involvement (e.g., liver, kidney) may negatively impact the prognosis and long-term outcome.…”

Section: Heart Failurementioning

confidence: 99%

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Improving medical care and prevention in adults with congenital heart disease—reflections on a global problem—part I: development of congenital cardiology, epidemiology, clinical aspects, heart failure, cardiac arrhythmia

Neidenbach

Niwa

Oto

et al. 2018

Cardiovasc. Diagn. Ther

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Today most patients with congenital heart defects (CHD) survive into adulthood. Unfortunately, despite relevant residua and sequels, follow-up care of adults with congenital heart disease (ACHD) is not performed in specialized and/or certified physicians or centres. Major problems in the long-term course encompass heart failure, cardiac arrhythmias, heart valve disorders, pulmonary vascular disease, infective endocarditis, aortopathy and non-cardiac comorbidities. Many of them manifest themselves differently from acquired heart disease and therapy regimens from general cardiology cannot be transferred directly to CHD. It should be noted that even simple, postoperative heart defects that were until recently considered to be harmless can lead to problems with age, a fact that had not been expected so far. The treatment of ACHD has many special features and requires special expertise. Thereby, it is important that treatment regimens from acquired heart disease are not necessarily transmitted to CHD. While primary care physicians have the important and responsible task to set the course for adequate diagnosis and treatment early and to refer patients to appropriate care in specialized ACHD-facilities, they should actively encourage ACHD to pursue follow-up care in specialized facilities who can provide responsible and advanced advice. This medical update emphasizes the current data on epidemiology, heart failure and cardiac arrhythmia in ACHD.

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Section: Development Of Congenital Cardiology Epidemiologymentioning

confidence: 99%

Section: Heart Failurementioning

confidence: 99%

Improving medical care and prevention in adults with congenital heart disease—reflections on a global problem—part I: development of congenital cardiology, epidemiology, clinical aspects, heart failure, cardiac arrhythmia

Neidenbach

Niwa

Oto

et al. 2018

Cardiovasc. Diagn. Ther

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“…Acquired co-morbidities, which occur frequently and have a lasting and unfavorable effect on the natural course of a CHD, are of particular relevance within a rehabilitation program for ACHD (53)(54)(55). In addition to acquired cardiovascular diseases (arterial hypertension, coronary heart disease, valvular diseases, endocarditis), this occurrence concerns the involvement of other organ systems, especially the lungs, pulmonary vessels, kidney, blood, coagulation system, central nervous system and metabolic disorders (diabetes mellitus, hyperlipidemia, hyperuricemia).…”

Section: Health Maintenance and Preventionmentioning

confidence: 99%

Lessons from the short- and mid-term outcome of medical rehabilitation in adults with congenital heart disease

Freilinger¹,

Andric²,

Andonian³

et al. 2021

Cardiovasc Diagn Ther

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Background: The number of adults with congenital heart disease (ACHD) is steadily increasing. Over their life-time, many of the affected patients require medical rehabilitation after interventional or surgical treatment of residua, sequels or complications of their congenital heart defect (CHD). However, up to now only scarce data exist about indication, performance and outcomes of cardiac rehabilitation in ACHD. Methods:The course and outcome of rehabilitation after previous interventional or surgical treatment in ACHD was analyzed in a retrospective cohort study.Results: Two hundred and five ACHD {54% female; mean age 34±12 [16-68] years} with mild (23.9%), moderate (35.1%) or severe CHD (41.0%), of whom 32% had complex CHD, 21% right-ventricular outflow tract obstructions, 20% pre-tricuspid shunts, 18% left heart or aortic anomalies, 9% post-tricuspid shunts and 2% other congenital cardiac anomalies were included into analysis. The main indications for rehabilitation were a preceding surgical (92%) or interventional (3%) treatment of the underlying CHD immediately before rehabilitation. During rehabilitation, no severe complications occurred. The number of patients in function class I/II increased from 189 to 200 and decreased in class III/IV from 16 to 5. Cardiac medication could be reduced or stopped after rehabilitation in 194 patients, with the exception of ACEinhibitors. There was an improvement in cardiovascular risk factors. While before medical treatment 77% (n=157) patients were capable of working, the number increased to 82% [168] at the end of rehabilitation.Throughout a follow-up 9.3% (n=19) of patients needed further cardiac interventions. Conclusions:The current study provided for the first time comprehensive data on the course of rehabilitation in a large cohort of ACHD after surgical or interventional treatment. The overall outcome of ACHD after rehabilitation was uneventful and favorable. Further research is required to assess the clinical long-term outcome, the impact of rehabilitation on the quality of life, disease coping and employment. The results of this study can serve as a benchmark for the development of specific rehabilitation programs in ACHD.

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“…Die erforderlichen Kontrollintervalle werden von der Art des Herzfehlers, dem klinischen Zustand sowie dem durchgeführten Eingriff bestimmt [4]. Hinzu kommt, dass bei den Betroffenen mit zunehmendem Alter mit immer mehr Komorbiditäten gerechnet werden muss [13,14]. Diese beeinflussen einerseits den natürlichen Verlauf des jeweiligen Herzfehlers, andererseits wird aber die Zusatzerkrankung durch den Herzfehler beeinflusst und tritt nicht immer in typischer Weise auf.…”

Section: Korrektur Bzw Reparatur Angeborener Herzfehlerunclassified