NULL
Section
All sections
Countries | Regions
Countries | Regions
Article Types
Article Types
Year
Volume
Issue
Pages
IMR Press / RCM / Volume 24 / Issue 3 / DOI: 10.31083/j.rcm2403085
23
75
Views
Journal Browser
Volume | Year
Issue
Announcements
Open Access Original Research
Predictors of Developing Heart Failure in Adults with Congenital Heart Defects
Kambiz Norozi1,2,3,4,*,†
Show Less
1 Department of Pediatrics, Pediatric Cardiology, Western University, London, ON N6A 3K7, Canada
2 Department of Pediatric Cardiology, Intensive Care Medicine and Neonatology, University Medical Center, 37075 Goettingen, Germany
3 Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, Germany
4 Children Health Research Institute, London, ON N6A 5W9, Canada
5 Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany
*Correspondence: Kambiz.norozi@lhsc.on.ca (Kambiz Norozi)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(3), 85; https://doi.org/10.31083/j.rcm2403085
Submitted: 26 November 2022 | Revised: 16 January 2023 | Accepted: 30 January 2023 | Published: 8 March 2023
This is an open access article under the CC BY 4.0 license.
Abstract

Background: The population of adults with congenital heart defects (ACHD) is growing. The leading cause of premature death in these patients is heart failure (HF). However, there is still limited information on the predictive factors for HF in ACHD patients. Objectives: This study re-examined a group of patients with repaired or palliated congenital heart defects (CHD) that were initially studied in 2003. A follow-up period of 15 years has allowed us to identify and evaluate predictors for the development of HF in ACHD. Methods: All patients with repaired or palliated CHD who participated in the initial study (n = 364) were invited for a follow-up examination. The effects of maximum oxygen uptake (VO${}_{\text{2max}}$) during exercise stress testing, the cardiac biomarker N-terminal pro brain natriuretic peptide (NT-proBNP), and QRS complex on the development of HF during the follow-up period were investigated. Results: From May 2017 to April 2019, 249 of the initial 364 (68%) patients participated in the follow-up study. Of these, 21% were found to have mild CHD, 60% had moderate CHD, and 19% had complex CHD. Significant predictors for the development of HF were: NT-proBNP level $>$1.7 times the upper normal limit, VO${}_{\text{2max}}$ $<$73% of predicted values, and QRS complex duration $>$120 ms. Combination of these three parameters resulted in the highest area-under-the-curve of 0.75, with a sensitivity of 75% and specificity of 63% for predicting the development of HF. Conclusions: In this cohort of ACHD patients, the combination of VO${}_{\text{2max\%}}$, NT-proBNP, and QRS duration was predictive of HF development over a 15-year follow-up period. Enhanced surveillance of these parameters in patients with ACHD may be beneficial for the prevention of HF and early intervention.

Keywords