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AbstractBackground:CHD influences many aspects of life in affected individuals. Puberty, a major aspect of development, is a concern for patients and families.Objectives:We investigated pubertal status in children and adolescents with CHD.Methods:Patients with CHD aged 6–18 were enrolled. Cardiac diagnoses were confirmed using history, examination, and paraclinical tools including echocardiography. An endocrinologist determined pubertal stages, and the second Tanner stages for pubarche (P2), thelarche (B2), and gonadarche (G2) were considered as the pubertal onset. A study with a large sample size on pubertal onset in a normal population was used for comparison.Results:Totally, 451 patients (228 girls and 223 boys) at a median (10th–90th percentile) age of 10.79 (8.02–14.28) years for the girls and 10.72 (8.05–14.03) years for the boys were enrolled. The median (10th–90th percentile) ages at B2 and P2 in the girls with CHD were 10.77 (9.55–12.68) and 10.53 (9.39–12.28) years, respectively, which were higher than the median ages of 9.74 (8.23–11.94) and 10.49 (8.86–12.17) years in the normal girls.The median (10th–90th percentile) ages at G2 and P2 in the boys with CHD were 11.04 (8.85–13.23) and 11.88 (9.78–13.46) years, correspondingly, which were higher than the median ages of 9.01 (6.00–11.84) and 10.34 (6.84–13.10) years in the normal boys.Conclusions:Pubertal onset could be delayed in children with CHD when compared with the normal population.

Despite the occurrence of adverse events after coronary artery bypass, the degree of social integration can be increased following this operation. This study addresses the predictive power of risk factors as well as clinical status in determining long-term social functioning and rate of return to work following isolated bypass surgery. A prospective cohort study was conducted in 178 patients who underwent isolated bypass surgery between 2004 and 2007. Information on work status and social relationships was obtained 1–2 days before surgery and during a mean follow-up of 29.4 ± 1.1 months. The proportion of patients who engaged in social activities at 2, 3, and 4 years of follow-up was 0.3, 0.6, and just over 0.8, respectively, and the proportion who had returned to work at these time points was 0.2, 0.45, and 0.63, respectively. Social activity after surgery was less in patients with left ventricular dysfunction, cerebrovascular disease, and higher New York Heart Association functional class. The rate of return to work was lower for men and for patients with left ventricular dysfunction, diabetes, cerebrovascular disease, and those who were hospitalized for more than 14 days.

Objective— Improving the quality of life (QoL) in patients with coronary artery disease (CAD) requires the determination of the risk factors that have an impact on physical functioning and mental health. The present study sought to determine the risk factors influencing QoL in patients with CAD and to assess the relationship between preoperative QoL and early outcome of CABG.Methods and results— The SF-36 questionnaire was completed through interviews with 275 consecutive patients who underwent isolated CABG in the Tehran Heart Centre between May and-09-2006. The present study measured the two scores of physical and psychological component summary scores and assessed their relationships with preoperative characteristics and postoperative complications. The mean scores of physical and psychological components were 65.78 ± 24.13 and 67.72 ± 20.55, respectively. Diabetes mellitus (P= 0.007), family history of CAD (P= 0.032), low education level (P= 0.015), high Euroscore (P= 0.022), and high functional class (P< 0.001) were the main predictors for the low physical score of QoL. In addition, female gender was associated with a low QoL psychological score (P< 0.001). However, the elderly patients had a higher psychological score in comparison with the younger ones (P= 0.032). No relationship between the studied postoperative complications and preoperative psychological and physical scores was found.Conclusions— Female gender and lower age show specific influences on the patients’ mental health. Our findings also indicate a major direct influence of general risk factors for CAD and education level on CAD patients’ physical functioning before CABG. Nonetheless, preoperative QoL does not influence the postoperative complications.