38 research outputs found
Ventricular function, myocardial delayed enhancement and patient-reported quality of life in adolescents and adults with repaired tetralogy of Fallot
INTRODUCTION: In patients with repaired tetralogy of Fallot (TOF), right ventricular myocardial delayed enhancement (MDE) and diastolic dysfunction are common, and have been associated with decreased exercise capacity and increased arrhythmia. Predictors of quality of life (QOL) have not been reported in this population.
PURPOSE: We assessed the hypothesis that a greater degree of MDE in adolescents and adults with repaired TOF would correlate with diastolic dysfunction and decreased QOL
Ventricular function, myocardial delayed enhancement and patient-reported quality of life in adolescents and adults with repaired tetralogy of Fallot
INTRODUCTION: In patients with repaired tetralogy of Fallot (TOF), right ventricular myocardial delayed enhancement (MDE) and diastolic dysfunction are common, and have been associated with decreased exercise capacity and increased arrhythmia. Predictors of quality of life (QOL) have not been reported in this population.
PURPOSE: We assessed the hypothesis that a greater degree of MDE in adolescents and adults with repaired TOF would correlate with diastolic dysfunction and decreased QOL
COVID-19-Related Thrombotic and Bleeding Events in Adults With Congenital Heart Disease.
BACKGROUND
Altered coagulation is a striking feature of COVID-19. Adult patients with congenital heart disease (ACHD) are prone to thromboembolic (TE) and bleeding complications.
OBJECTIVES
The purpose of this study was to investigate the prevalence and risk factors for COVID-19 TE/bleeding complications in ACHD patients.
METHODS
COVID-19-positive ACHD patients were included between May 2020 and November 2021. TE events included ischemic cerebrovascular accident, systemic and pulmonary embolism, deep venous thrombosis, myocardial infarction, and intracardiac thrombosis. Major bleeding included cases with hemoglobin drop >2 g/dl, involvement of critical sites, or fatal bleeding. Severe infection was defined as need for intensive care unit, endotracheal intubation, renal replacement therapy, extracorporeal membrane oxygenation, or death. Patients with TE/bleeding were compared to those without events. Factors associated with TE/bleeding were determined using logistic regression.
RESULTS
Of 1,988 patients (age 32 [IQR: 25-42] years, 47% male, 59 ACHD centers), 30 (1.5%) had significant TE/bleeding: 12 TE events, 12 major bleeds, and 6 with both TE and bleeding. Patients with TE/bleeding had higher in-hospital mortality compared to the remainder cohort (33% vs 1.7%; P < 0.0001) and were in more advanced physiological stage (P = 0.032) and NYHA functional class (P = 0.01), had lower baseline oxygen saturation (P = 0.0001), and more frequently had a history of atrial arrhythmia (P < 0.0001), previous hospitalization for heart failure (P < 0.0007), and were more likely hospitalized for COVID-19 (P < 0.0001). By multivariable logistic regression, prior anticoagulation (OR: 4.92; 95% CI: 2-11.76; P = 0.0003), cardiac injury (OR: 5.34; 95% CI: 1.98-14.76; P = 0.0009), and severe COVID-19 (OR: 17.39; 95% CI: 6.67-45.32; P < 0.0001) were independently associated with increased risk of TE/bleeding complications.
CONCLUSIONS
ACHD patients with TE/bleeding during COVID-19 infection have a higher in-hospital mortality from the illness. Risk of coagulation disorders is related to severe COVID-19, cardiac injury during infection, and use of anticoagulants