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  • 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 samples (thyroid-stimulating hormone,… 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 weeks of… 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 reported a… 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 malformations referred to… 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 with unspecified CHD… 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 tumor necrosis… 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 3 weeks after… More >

  • Open Access

    ARTICLE

    Short-term outcomes following implementation of a dedicated young adult congenital heart disease transition program

    Sumeet S. Vaikunth1,2, Roberta G. Williams3, Merujan Y. Uzunyan4, Han Tun5, Cheryl Barton3, Philip M. Chang5

    Congenital Heart Disease, Vol.13, No.1, pp. 85-91, 2018, DOI:10.1111/chd.12549

    Abstract Objective: Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease.
    Design, Setting, and Patients: We performed a retrospective analysis of all 73 patients seen in a dedicated young adult congenital heart disease transition clinic from January 2012 to December… More >

  • Open Access

    ARTICLE

    Stress and quality of life among parents of children with congenital heart disease referred for psychological services

    Astrida Kaugars1, Clarissa Shields2, Cheryl Brosig3

    Congenital Heart Disease, Vol.13, No.1, pp. 72-78, 2018, DOI:10.1111/chd.12547

    Abstract Objective: The study examined parent stress and health-related quality of life (HRQOL) among families of children with congenital heart disease (CHD) referred for psychological services.
    Methods: Parents of 54 children (85% boys) aged 3 to 13 (Mage = 7.48, SD = 2.38) completed measures to assess parenting stress (Parenting Stress Index – Short Form; Pediatric Inventory for Parents) and the PedsQL Family Impact Module. Medical information was retrieved from medical record review.
    Results: Half of parents of children with single ventricle anatomy had clinically significant levels of parenting stress. Parents of children with single ventricle anatomy reported more frequent illnessrelated… More >

  • Open Access

    ARTICLE

    Determinants of platelet count in pediatric patients with congenital cyanotic heart disease: Role of immature platelet fraction

    Randa M. Matter1, Iman A. Ragab1, Alaa M. Roushdy2, Ahmed G. Ahmed1, Hanan H. Aly1, Eman A. Ismail3

    Congenital Heart Disease, Vol.13, No.1, pp. 118-123, 2018, DOI:10.1111/chd.12530

    Abstract Objectives: Congenital heart defects are common noninfectious causes of mortality in children. Bleeding and thrombosis are both limiting factors in the management of such patients. We assessed the frequency of thrombocytopenia in pediatric patients with congenital cyanotic heart disease (CCHD) and evaluated determinants of platelet count including immature platelet fraction (IPF) and their role in the pathogenesis of thrombocytopenia.
    Methods: Forty-six children and adolescents with CCHD during pre-catheter visits were studied; median age was 20.5 months. Complete blood count including IPF as a marker of platelet production and reticulated hemoglobin content (RET-He) as a marker of red cell production and… More >

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