Predictive factors for long-term prognosis in adults with cyanotic congenital heart disease — Japanese multi-center study
| Autor: | Shigeyuki Echigo, Hisanori Sakazaki, Teiji Akagi, Makoto Nakazawa, Koichiro Niwa |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Heart Defects Congenital Male medicine.medical_specialty Pediatrics Adolescent Cross-sectional study Hypoxemia Japan Risk Factors Epidemiology medicine Humans Child Survival rate Cyanosis Proportional hazards model business.industry Incidence (epidemiology) Infant Middle Aged Prognosis medicine.disease Hospitalization Survival Rate Cross-Sectional Studies Child Preschool Heart failure Atrioventricular canal Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 120:72-78 |
| ISSN: | 0167-5273 |
| Popis: | Objective Adults with cyanotic congenital heart disease (CCHD) are associated with a significant incidence of morbid events and premature deaths that may be predicted during childhood. We aimed to identify predictive factors related to long-term prognosis through a Japanese multi-center cross-sectional study. Methods Data were collected from 253 adults with CCHD (126 men; age 28 (18 to 56) years) from 15 participating centers between 1998 and 2003. Laboratory data such as cardiothoracic ratio (CTR), percutaneous oxygen saturation (SpO 2 ), hematocrit levels (Ht) and platelet counts (Pl-c) at the age of 15 years were collected for predictive factor analysis for death and cardiovascular and systematic events. Predictive factors were determined by multivariate Cox regression analysis. Results After a mean follow-up of 21 (0–42) years, 23 patients died with a median age of 29 (18–54) years (heart failure in 8, sudden in 6 and systematic complications in 9). Survival since 18 years of age was 91% and 84% at 10 and 20 years, respectively. Significant predictive factor for death was Pl-c 9 /l and for renal failure ( n =7) was Ht>65%. 162 patients were hospitalized and predictors for hospitalization due to heart failure ( n =45) were common atrioventricular canal CTR>60% and Pl-c 9 /l and that due to arrhythmias ( n =44) were systematic right ventricle and CTR>60%. Conclusions This multi-center study provides an objective basis of assessing the long-term prognosis in patients with CCHD. These data are useful in making decisions regarding medical management and in favorably altering the non-operative course of the disease. |
| Databáze: | OpenAIRE |
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