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Lynn MM, Salemi JL, Meath CJ, Dolgner SJ, Morris SA, Sexson Tejtel SK, Lopez KN. Lesion-specific mortality due to congenital heart disease in U.S. adults from 1999 to 2017. Birth Defects Res 2022; 114:725-745. [PMID: 35593518 DOI: 10.1002/bdr2.2044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/12/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adults with congenital heart disease (ACHD) comprise an increasing proportion of individuals living with CHD in the United States (US) although little is known regarding lesion or age-specific mortality in the modern era. Our study aimed to describe current era ACHD mortality rates by age and CHD lesion and provide temporal mortality rate trends for the last two decades. METHODS We conducted a 19-year analysis (1999-2017) of publicly available, de-identified Multiple Cause of Death data compiled and produced by the National Center for Health Statistics. Age and lesion-specific mortality rates were calculated using joinpoint regression. RESULTS ACHD mortality rates decreased by an average of 2%-4% per year for all adults. CHD lesions resulting in the highest ACHD-related mortality varied by age. Unlike the other lesions, mortality attributed to single ventricle physiology failed to improve in early adulthood (average of 1.6% increase per year). In decedents age 65 years or older, simpler forms of CHD like shunt lesions became more prominent contributors, accounting for 46% of deaths. CONCLUSION Rates of mortality due to ACHD have declined significantly for adults with CHD, however, continued mortality due to single ventricle physiology remains an area requiring improved strategies to increase survival.
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Affiliation(s)
- Melodie M Lynn
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA
| | - Jason L Salemi
- College of Public Health, University of South Florida, Tampa, Florida, USA.,Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | | | - Stephen J Dolgner
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA.,Adult Congenital Heart Disease Program, Texas Children's Hospital, Houston, Texas, USA
| | - Shaine A Morris
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA
| | - S Kristen Sexson Tejtel
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA
| | - Keila N Lopez
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA
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Fink DL, Machluf Y, Farkash R, Weisz G, Pirogovsky A, Tal O, Dagan D, Chaiter Y. Cardiac anomalies and associated comorbidities in a large adolescent population. Int J Adolesc Med Health 2017; 31:ijamh-2017-0020. [PMID: 28614051 DOI: 10.1515/ijamh-2017-0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/12/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine the prevalence, secular trends and associations of heart disease in a large unscreened, otherwise basically healthy, adolescent population. SUBJECTS AND METHODS Cross-sectional study of the cardiac status of 113,694 adolescents from the northern district of Israel, who completed the profiling process between the ages of 16 and 19, including all essential measures over a 22-year period. Results of imaging were categorized as either isolated valvar or structural abnormalities, and their clinically significant subgroups defined prospectively. The findings were correlated with the socio-demographic and anthropometric data and non-cardiac health conditions. RESULTS Of those sent for echocardiography, 1257 (0.93% of the total population) had isolated valvar disease and 216 (0.19%) had structural abnormalities, with 20% of both groups considered significant. Females had lower prevalence of heart disease. There was peak prevalence in the second 5-year period. Tall subjects or a past history of rheumatic fever had more valvar abnormalities. Thin subjects or those with skeletal anomalies had more structural abnormalities. Significant valvar and structural anomalies were more common in subjects with learning disorders, endocrine disorders and diabetes mellitus. Fewer valvar abnormalities were diagnosed in obese subjects. Heart disease was more common in those with non-solid tumors. CONCLUSION Appreciable numbers of potentially healthy adolescents were found to have heart disease. There appeared to be an association with body size, skeletal abnormalities and relatively common medical disorders, the cause of which remains to be determined in prospective studies that could change the way common adolescent disease should be followed.
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Affiliation(s)
- Daniel Lyon Fink
- Shaare Zedek Medical Center, Jerusalem, Israel
- Medical Corps, Israel Defense Forces (IDF), Tel Aviv, Israel
| | - Yossy Machluf
- Medical Corps, Israel Defense Forces (IDF), Tel Aviv, Israel
| | | | - Giora Weisz
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Avinoam Pirogovsky
- Medical Corps, Israel Defense Forces (IDF), Tel Aviv, Israel
- Schneider Children Medical Center, Petah Tikva, Israel
| | - Orna Tal
- Assaf Harofeh Medical Center, Tzrifin, Israel
| | - David Dagan
- Medical Corps, Israel Defense Forces (IDF), Tel Aviv, Israel
| | - Yoram Chaiter
- Head of Quality Assurance and Control of Medical Committees, Medical Corps (IDF), Epidemiologist, Pinsker 72 street, Haifa 32712, Israel, Phone: +972-4-8320751; +972-50-5510044
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