End-stage heart failure in congenitally corrected transposition of the great arteries: a multicentre study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
van Dissel Alexandra C, Opotowsky Alexander R, Burchill Luke J, Aboulhosn Jamil, Grewal Jasmine, Lubert Adam M, Antonova Petra, Shah Sangeeta, Cotts Timothy, John Anitha S, Kay William Aaron, DeZorzi Christopher, Magalski Anthony, Han Frank, Baker David, Kay Joseph, Yeung Elizabeth, Vonder Muhll Isabelle, Pylypchuk Stephen, Kuo Marissa C, Nicolarsen Jeremy, Sarubbi Berardo, Fusco Flavia, Jameson Susan M, Cramer Jonathan, Gupta Tripti, Gallego Pastora, O'Donnell Clare, Hannah Jane, Dellborg Mikael, Kauling Robert M, Ginde Salil, Krieger Eric V, Rodriguez Fred, Dehghani Payam, Kutty Shelby, Wong Joshua, Wilson William M, Rodriguez-Monserrate Carla P, Roos-Hesselink Jolien, Celermajer David S, Khairy Paul, Broberg Craig S
Аннотация
METHODS: This multicentre, retrospective cohort study included adults with ccTGA seen at a congenital heart disease centre. Clinical data from initial and most recent visits were obtained. The composite primary outcome was mechanical circulatory support, heart transplantation, or death.
RESULTS: From 558 patients (48% female, age at first visit 36 ± 14.2 years, median follow-up 8.7 years), the event rate of the primary outcome was 15.4 per 1000 person-years (11 mechanical circulatory support implantations, 12 transplantations, and 52 deaths). Patients experiencing the primary outcome were older and more likely to have a history of atrial arrhythmia. The primary outcome was highest in those with both moderate/severe right ventricular (RV) dysfunction and tricuspid regurgitation (n = 110, 31 events) and uncommon in those with mild/less RV dysfunction and tricuspid regurgitation (n = 181, 13 events, P < .001). Outcomes were not different based on anatomic complexity and history of tricuspid valve surgery or of subpulmonic obstruction. New CHF admission or ventricular arrhythmia was associated with the primary outcome. Individuals who underwent childhood surgery had more adverse outcomes than age- and sex-matched controls. Multivariable Cox regression analysis identified older age, prior CHF admission, and severe RV dysfunction as independent predictors for the primary outcome.
CONCLUSIONS: Patients with ccTGA have variable deterioration to end-stage heart failure or death over time, commonly between their fifth and sixth decades. Predictors include arrhythmic and CHF events and severe RV dysfunction but not anatomy or need for tricuspid valve surgery.