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  • Open Access

    ARTICLE

    Intrauterine growth restriction is not associated with decreased exercise capacity in adolescents with congenital heart disease

    Andrew D. Spearman1, Rohit S. Loomba2, Michael Danduran1, Joshua Kovach1

    Congenital Heart Disease, Vol.13, No.3, pp. 369-376, 2018, DOI:10.1111/chd.12577

    Abstract Objective: Multiple studies demonstrate the association of intrauterine growth restriction (IUGR) with impaired aerobic fitness in adolescents and adults. To our knowledge, there are no studies including individuals with the history of both IUGR and congenital heart disease (CHD). Thus, we sought to evaluate the impact of IUGR on exercise capacity in adolescents with CHD.
    Study Design: We conducted a retrospective chart review of patients <18 years of age who underwent cardiopulmonary exercise testing (CPET) between August 1, 2003 and July 1, 2016. Individuals with birth weight <10th percentile for gestational age were defined as IUGR. Patients… More >

  • Open Access

    ARTICLE

    Quality of life and sexual well-being in patients with a Fontan circulation: An explorative pilot study with a mixed method design

    Djoeke Wolff1, Henricus B. M. van de Wiel2, Mirthe E. de Muinck Keizer1, Joost P. van Melle3, Petronella G. Pieper3, Rolf M. F. Berger1, Tjark Ebels4, Willebrord C. M. Weijmar Schultz5

    Congenital Heart Disease, Vol.13, No.2, pp. 319-326, 2018, DOI:10.1111/chd.12576

    Abstract Objective: To get an impression of the quality of life (QOL) and sexual well-being in the Fontan population, and to generate hypotheses for future research.
    Methods: For this cross-sectional pilot study, questionnaires regarding health-related QOL, sexual function and fertility/pregnancy were completed by 21 patients with a Fontan circulation >16 years old, followed at the University Medical Center Groningen, the Netherlands. Semi-structured qualitative interviews were conducted in 8 patients.
    Results: Fontan patients scored significantly lower on general health than their healthy peers (t (19)=-3.0, P = .008), whereas their scores on other QOL domains and sexual well-being were comparable… More >

  • Open Access

    ARTICLE

    Optimizing patient care and outcomes through the congenital heart center of the 21st century

    Jeffery B. Anderson1, Devyani Chowdhury2, Jean A. Connor3, Curt J. Daniels4, Craig E. Fleishman5, Michael Gaies6, Jeffrey Jacobs7,8, John Kugler9, Nicolas Madsen1, Robert H. Beekman6, Stacey Lihn10, Kay Stewart-Huey11, Robert Vincent11, Robert Campbell11

    Congenital Heart Disease, Vol.13, No.2, pp. 167-180, 2018, DOI:10.1111/chd.12575

    Abstract Pediatric cardiovascular services are responding to the dynamic changes in the medical environment, including the business of medicine. The opportunity to advance our pediatric cardiology field through collaboration is now realized, permitting us to define meaningful quality metrics and establish national benchmarks through multicenter efforts. In March 2016, the American College of Cardiology hosted the first Adult Congenital/Pediatric Cardiology Section Congenital Heart Community Day. This was an open participation meeting for clinicians, administrators, patients/parents to propose metrics that optimize patient care and outcomes for a state-of-the-art congenital heart center of the 21st century. Care center… More >

  • Open Access

    ARTICLE

    Subclinical hypothyroidism: A common finding in adult patients with cyanotic congenital heart disease

    Peter Bak1, Cristel S. Hjortshøj2, Peter Gæde3, Lars Idorn4, Lars Søndergaard2, Annette S. Jensen2

    Congenital Heart Disease, Vol.13, No.2, pp. 263-270, 2018, DOI:10.1111/chd.12565

    Abstract Objective: Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time.
    Methods: First, 90 clinically stable cyanotic congenital heart disease patients were examined with blood… More >

  • Open Access

    ARTICLE

    Home-based interval training increases endurance capacity in adults with complex congenital heart disease

    Camilla Sandberg1,2, Magnus Hedström1, Karin Wadell2, Mikael Dellborg3, Anders Ahnfelt3, Anna-Klara Zetterström4, Amanda Öhrn4, Bengt Johansson1

    Congenital Heart Disease, Vol.13, No.2, pp. 254-262, 2018, DOI:10.1111/chd.12562

    Abstract Objective: The beneficial effects of exercise training in acquired heart failure and coronary artery disease are well known and have been implemented in current treatment guidelines. Knowledge on appropriate exercise training regimes for adults with congenital heart disease is limited, thus further studies are needed. The aim of this study was to examine the effect of home-based interval exercise training on maximal endurance capacity and peak exercise capacity.
    Design: Randomized controlled trial.
    Methods: Twenty-six adults with complex congenital heart disease were recruited from specialized units for adult congenital heart disease. Patients were randomized to either an intervention group—12… More >

  • Open Access

    ARTICLE

    Physical activity perceptions and behaviors among young adults with congenital heart disease: A mixed-methods study

    Adam McKillop1, Brian W. McCrindle1,2, Gina Dimitropoulos3, Adrienne H. Kovacs3

    Congenital Heart Disease, Vol.13, No.2, pp. 232-240, 2018, DOI:10.1111/chd.12553

    Abstract Objective: A physically active lifestyle can help maintain positive physical and psychosocial health outcomes among adults with congenital heart disease (CHD). This study explored the physical activity perceptions and behaviors among young adults with CHD.
    Design: This was a cross-sectional, mixed-methods study that included objectively measured physical activity assessment (accelerometer), individual semistructured interviews, and psychosocial questionnaires.
    Results: Fifteen participants (67% male; 21 ± 3 years old) with moderate (n = 10) or complex (n = 5) CHD were recruited from an outpatient adult CHD clinic. Participants accumulated 26 ± 16 minutes of moderate-to-vigorous physical activity per day, and… More >

  • Open Access

    ARTICLE

    Age is not a good predictor of irreversibility of pulmonary hypertension in congenital cardiac malformations with left-to-right shunt

    Amir-Reza Hosseinpour1, Marie-Hélène Perez2, David Longchamp2, Jacques Cotting2, Nicole Sekarski3, Michel Hurni1, René Prêtre1, Stefano Di Bernardo3

    Congenital Heart Disease, Vol.13, No.2, pp. 210-216, 2018, DOI:10.1111/chd.12545

    Abstract Objective: Congenital cardiac malformations with high pulmonary blood flow and pressure due to left-to-right shunts are usually repaired in early infancy for both the benefits of early relief of heart failure and the fear that the concomitant pulmonary hypertension may become irreversible unless these defects are corrected at an early age. Age, however, has been a poor predictor of irreversibility of pulmonary hypertension in our experience, which is presented here.
    Design: A retrospective observational study. We defined “late” as age ≥2 years. We examined clinical, echocardiographic, and hemodynamic data from all patients aged ≥2 years with such… More >

  • Open Access

    ARTICLE

    The 745.5 issue in code-based, adult congenital heart disease population studies: Relevance to current and future ICD-9-CM and ICD-10-CM studies

    Fred H. Rodriguez III1,2,3,4, Georges Ephrem1,2, Jennifer F. Gerardin1,2, Cheryl Raskind-Hood5, Carol Hogue5, Wendy Book1,2

    Congenital Heart Disease, Vol.13, No.1, pp. 59-64, 2018, DOI:10.1111/chd.12563

    Abstract Objective: Although the ICD-9-CM code 745.5 is widely used to indicate the presence of a secundum atrial septal defect (ASD), it is also used for patent foramen ovale (PFO) which is a normal variant and for “rule-out” congenital heart disease (CHD). The ICD-10-CM code Q21.1 perpetuates this issue. The objective of this study was to assess whether code 745.5 in isolation or in combination with unspecified CHD codes 746.9 or 746.89 miscodes for CHD, and if true CHD positives decrease with age.
    Design: Echocardiograms of patients with an ICD-9-CM code of 745.5 in isolation or in combination… More >

  • Open Access

    ARTICLE

    Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

    Yumi Shiina1, Tomoaki Murakami2, Noriko Matsumoto3, Daisuke Okamura4, Yuta Takahashi4, Yosuke Nishihata1, Nobuyuki Komiyama1, Koichiro Niwa1

    Congenital Heart Disease, Vol.13, No.1, pp. 79-84, 2018, DOI:10.1111/chd.12555

    Abstract Objectives: To assess body composition and relationships among body composition, appetiterelated hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD).
    Patients: This prospective study enrolled 46 consecutive adult patients with CHD and 12 agematched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls.
    Design: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and… More >

  • Open Access

    ARTICLE

    Toward standardization of care: The feeding readiness assessment after congenital cardiac surgery

    Daniel E. Ehrmann1, Matthew Mulvahill2, Shaunda Harendt1,3, Jessica Church1, Amy Stimmler1, Piyagarnt Vichayavilas1,4, Sanja Batz1,5, Jennifer Rodgers1,5, Michael DiMaria1, James Jaggers1, Cindy Barrett1, Jon Kaufman1

    Congenital Heart Disease, Vol.13, No.1, pp. 31-37, 2018, DOI:10.1111/chd.12550

    Abstract Background: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care.
    Methods: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center. A systematic feeding readiness assessment (FRA) was utilized to score infant feeding skills. FRA scores were assigned immediately prior to surgery and 1, 2, and… More >

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