Neurocognitive function and health-related quality of life in adolescents and young adults with CHD with pulmonary valve dysfunction.

Autor:	Zampi JD; Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA., Heinrich KP; Department of Psychology, University of Michigan, Ann Arbor, MI, USA., Bergersen L; Division of Pediatric Cardiology, Boston Children's Hospital, Boston, MA, USA., Goldstein BH; UPMC Children's Hospital of Pittsburgh and Department of Pediatrics, Heart Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Batlivala SP; Cincinnati Children's Hospital Heart Institute, Cincinnati, OH, USA., Fuller S; Division of Cardiac Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Glatz AC; Division of Pediatric Cardiology, St. Louis Children's and Washington University Heart Center, St. Louis, MO, USA., O'Byrne ML; Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Marino B; Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA., Afton K; Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA., Lowery R; Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA., Yu S; Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA., Goldberg CS; Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2024 May; Vol. 34 (5), pp. 1018-1025. Date of Electronic Publication: 2023 Nov 30.
DOI:	10.1017/S1047951123003979
Abstrakt:	Background: Neurocognitive impairment and quality of life are two important long-term challenges for patients with complex CHD. The impact of re-interventions during adolescence and young adulthood on neurocognition and quality of life is not well understood. Methods: In this prospective longitudinal multi-institutional study, patients 13-30 years old with severe CHD referred for surgical or transcatheter pulmonary valve replacement were enrolled. Clinical characteristics were collected, and executive function and quality of life were assessed prior to the planned pulmonary re-intervention. These results were compared to normative data and were compared between treatment strategies. Results: Among 68 patients enrolled from 2016 to 2020, a nearly equal proportion were referred for surgical and transcatheter pulmonary valve replacement (53% versus 47%). Tetralogy of Fallot was the most common diagnosis (59%) and pulmonary re-intervention indications included stenosis (25%), insufficiency (40%), and mixed disease (35%). There were no substantial differences between patients referred for surgical and transcatheter therapy. Executive functioning deficits were evident in 19-31% of patients and quality of life was universally lower compared to normative sample data. However, measures of executive function and quality of life did not differ between the surgical and transcatheter patients. Conclusion: In this patient group, impairments in neurocognitive function and quality of life are common and can be significant. Given similar baseline characteristics, comparing changes in neurocognitive outcomes and quality of life after surgical versus transcatheter pulmonary valve replacement will offer unique insights into how treatment approaches impact these important long-term patient outcomes.
Databáze:	MEDLINE
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