1. Hospitalisations for heart failure predict mortality in pulmonary hypertension related to congenital heart disease.
- Author
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Ntiloudi, Despoina, Apostolopoulou, Sotiria, Vasiliadis, Konstantinos, Frogoudaki, Alexandra, Tzifa, Aphrodite, Ntellos, Christos, Brili, Styliani, Manginas, Athanasios, Pitsis, Antonios, Kolios, Marios, Karvounis, Haralambos, Tsioufis, Costas, Goudevenos, John, Rammos, Spyridon, Giannakoulas, George, and CHALLENGE investigators
- Subjects
CONGENITAL heart disease ,HEART failure ,PULMONARY hypertension ,ATRIAL septal defects ,MEDICAL care ,PATENT ductus arteriosus ,ALDOSTERONE antagonists ,ARRHYTHMIA treatment ,HEART failure treatment ,PULMONARY hypertension treatment ,PULMONARY hypertension diagnosis ,CARDIOVASCULAR agents ,STROKE treatment ,ARRHYTHMIA ,COMPARATIVE studies ,HOSPITAL care ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,MORTALITY ,PROGNOSIS ,RESEARCH ,RISK assessment ,STROKE ,EVALUATION research ,ACQUISITION of data ,DISEASE complications ,THERAPEUTICS - 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. [ABSTRACT FROM AUTHOR]- Published
- 2019
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