Δημοσιεύσεις

Hospitalisations for heart failure predict mortality in pulmonary hypertension related to congenital heart disease.

By 1 Οκτωβρίου 2018 10 Απριλίου, 2019 No Comments

Δημοσίευση στις 2018/10/1 στο PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30269081

Ntiloudi D, Apostolopoulou S, Vasiliadis K, Frogoudaki A, Tzifa A, Ntellos C, Brili S, Manginas A, Pitsis A, Kolios M0, Karvounis H, Tsioufis C, Goudevenos J0, Rammos S, Giannakoulas G; CHALLENGE investigators.

Abstract

OBJECTIVE:

Despite the progress in the management of patients with adult congenital heart disease (ACHD), a significant proportion of patients still develop pulmonary hypertension (PH). We aimed to highlight the rate of the complications in PH-ACHD and the predicting factors of cumulative mortality risk in this population.

METHODS:

Data were obtained from the cohort of the national registry of ACHD in Greece from February 2012 until January 2018.

RESULTS:

Overall, 65 patients receiving PH-specific therapy were included (mean age 46.1±14.4 years, 64.6% females). Heavily symptomatic (New York Heart Association (NYHA) class III/IV) were 53.8% of patients. The majority received monotherapy, while combination therapy was administered in 41.5% of patients. Cardiac arrhythmia was reported in 30.8%, endocarditis in 1.5%, stroke in 4.6%, pulmonary arterial thrombosis in 6.2%, haemoptysis in 3.1% and hospitalisation due to heart failure (HF) in 23.1%. Over a median follow-up of 3 years (range 1-6), 12 (18.5%) patients died. On univariate Cox regression analysis history of HF hospitalisation emerged as a strong predictor of mortality (HR 8.91, 95% CI 2.64 to 30.02, p<0.001), which remained significant after adjustment for age and for NYHA functional class.

CONCLUSIONS:

Long-term complications are common among patients with PH-ACHD. Hospitalisations for HF predict mortality and should be considered in the risk stratification of this population.

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