Prevalence of Congenital Heart Disease Amongst Schoolchildren in Southwest China

Assessing the Frequency of Congenital Heart Diseases Among Children in Eastern Afghanistan

Background

Congenital heart disease (CHD), characterized by anatomical and functional abnormalities of the heart, can impair an individual's quality of life and, if not treated with appropriate interventions, it can result in early death. Morbidity and mortality from CHD are greatly reduced by early diagnosis and timely therapy. Therefore, this study aimed to determine the frequency of various forms of CHD among affected children in Eastern Afghanistan considering age, gender, and region of distribution (countryside and city).

Patients and Methods

A retrospective hospital-based study was conducted on 1323 patients with a confirmed diagnosis of CHD who were referred for echocardiography to public and private hospitals in Jalalabad City, Afghanistan, from July 2018 to June 2022. Patients from day one of life till 18 years were included. The study participants were chosen using a non-probability convenience sampling technique, and the data were analyzed using the statistical package for social sciences (SPSS) version 27.0.

Results

In this study, males comprised 60.4% of the participants, while females made up 39.6%. More than three-quarters (86.4%) of the diagnoses were in children below 1 year of age. 86.5% of them were patients with acyanotic, and 13.5% had cyanotic CHD. The most common acyanotic heart disease was patent ductus arteriosus (PDA; 252.6%), followed by ventricular septal defect (VSD; 18.4%) and atrial septal defect (ASD; 8.5%). The most frequent cyanotic heart disease was Tetralogy of Fallot (TOF). 79.9% of the total cases were patients with simple CDH lesions, and 20.1% had complex CHD lesions. In addition, participants from rural areas had a higher (78.9%) frequency of CHD compared to those from urban areas (21.1%).

Conclusion

The study concluded that over 85% of CHD-diagnosed cases were under 1 year of age, with PDA, VSD, ASD, and TOF being the most commonly diagnosed acyanotic and cyanotic lesions. Participants from rural residence had a higher frequency of CHD compared to those from urban residence. Additionally, our study found that more males were affected by CHD compared to females. In order to avoid serious complications, reduce mortality, and improve quality of life, early identification and correction of disease is crucial.

A comparison of quality of life between older adults living in high and low altitude areas

Background

High altitude is known to have a significant impact on human physiology and health, therefore, understanding its relationship with quality of life is an important research area. This study compared the quality of life (QOL) in older adults living in high and low altitude areas, and examined the independent correlates of QOL in those living in a high altitude area.

Methods

Older adults living in three public nursing homes in Xining (high altitude area) and one public nursing home in Guangzhou (low altitude area) were recruited. The WHOQOL-BREF was used to measure the QOL.

Results

644 older adults (male: 39.1%) were included, with 207 living in high altitude and 437 living in low altitude areas. After controlling for the covariates, older adults living in the high altitude area had higher QOL in terms of physical (P = 0.035) and social domains (P = 0.002), but had lower QOL in psychological (P = 0.009) domain compared to their counterparts living in the low altitude area. For older adults living in the high altitude area, smoking status was associated with higher social QOL (P = 0.021), good financial status was associated with higher physical QOL (P = 0.035), and fair or good health status was associated with higher physical (p < 0.001) and psychological QOL (P = 0.046), while more severe depressive symptoms were associated with lower QOL.

Conclusion

Appropriate interventions and support to improve depressive symptoms and both financial and health status should be developed for older adults living in high altitude areas to improve their QOL.

NOTCH2, ATIC, MRI1, SLC6A13, ATP13A2 Genetic Variations are Associated with Ventricular Septal Defect in the Chinese Tibetan Population Through Whole-Exome Sequencing

Background

Ventricular septal defect (VSD) is the most common congenital cardiac abnormality in children and the second most common in adults. This study aimed to explore the potentially causative genes in VSD patients in the Chinese Tibetan population, and to provide a theoretical basis for the genetic mechanism of VSD.

Methods

Peripheral venous blood was collected from 20 VSD subjects, and whole-genome DNA was extracted. High-throughput sequencing was performed on qualified DNA samples using whole-exome sequencing (WES) technology. After filtering, detecting, and annotating qualified data, single nucleotide variations (SNVs) and insertion-deletion (InDel) markers were analyzed, and data processing software such as GATK, SIFT, Polyphen, and MutationTaster were used for comparative evaluation and prediction of pathogenic deleterious variants associated with VSD.

Results

A total of 4793 variant loci, including 4168 SNVs, 557 InDels and 68 unknown loci and 2566 variant genes were obtained from 20 VSD subjects through bioinformatics analysis. According to the screening of the prediction software and database, the occurrence of VSD was predicted to be associated with five inherited pathogenic gene mutations, all of which were missense mutations, including NOTCH2 (c.1396C >A:p.Gln466Lys), ATIC (c.235C >T:p.Arg79Cys), MRI1 (c.629G >A:p.Arg210Gln), SLC6A13 (c.1138G >A:p.Gly380Arg), ATP13A2 (c.1363C >T:p.Arg455Trp).

Conclusion

This study demonstrated that NOTCH2, ATIC, MRI1, SLC6A13, ATP13A2 gene variants were potentially associated with VSD in Chinese Tibetan population.

Prevalence of congenital heart disease among school children in Qinghai Province

Objectives

This study aimed to investigate the prevalence of congenital heart disease (CHD) among school children in Qinghai province, a high-altitude region in China.

Methods

A cross-sectional study was conducted among school-aged children in 2019. All subjects completed a survey with a structure questionnaire and underwent CHD screening. CHD was screened by standard physical examination and further confirmed by echocardiography. Multivariate logistic regression were used to estimate the association of CHD prevalence with gender, nationality, and altitude.

Results

A total of 43,562 children aged 3–19 years participated in the study. The mean (SD) age was 11.2 (3.3) years. 49.7% were boys, and 80.0% were of Tibetan. CHD was identified in 293 children, with an overall prevalence of 6.73 ‰. Among them, 239 were unrecognized CHD, yielding a prevalence of 5.49 ‰. Atrial septal defect accounted for 51.9% of the CHD, followed by patent ductus arteriosus (31.1%), ventricular septal defect (9.9%). The CHD prevalence was significantly higher in female (8 ‰), Han race (18 ‰), children lived in Qumalai county (13 ‰), and children lived in a higher altitude (13 ‰). Female had greater prevalence of total CHD, atrial septal defect, and patent ductus arteriosus, but insignificant difference was observed in ventricular septal defect prvalence than male. In multivariable logistic regression analyses, female (OR, 1.48; 95% CI, 1.17–1.87, P = 0.001), Han population (OR, 3.28; 95% CI, 1.67–6.42, P = 0.001), and higher altitudes (OR, 2.28; 95% CI, 1.74–3.00, P < 0.001) were shown to be independently association with CHD prevalence.

Conclusions

The prevalence of CHD in Qinghai province was 6.73 ‰. Altitude elevation, female, and Han population were independently association with CHD prevalence.

Postnatal Expression Profile of MicroRNAs Associated with Cardiovascular Diseases in 3- to 11-Year-Old Preterm-Born Children

(1) Background: Preterm-born children have an increased cardiovascular risk with the first clinical manifestation during childhood and/or adolescence. (2) Methods: The occurrence of overweight/obesity, prehypertension/hypertension, valve problems or heart defects, and postnatal microRNA expression profiles were examined in preterm-born children at the age of 3 to 11 years descending from preterm prelabor rupture of membranes (PPROM) and spontaneous preterm birth (PTB) pregnancies. The whole peripheral blood gene expression of 29 selected microRNAs associated with cardiovascular diseases was the subject of our interest. (3) Results: Nearly one-third of preterm-born children (32.43%) had valve problems and/or heart defects. The occurrence of systolic and diastolic prehypertension/hypertension was also inconsiderable in a group of preterm-born children (27.03% and 18.92%). The vast majority of children descending from either PPROM (85.45%) or PTB pregnancies (85.71%) had also significantly altered microRNA expression profiles at 90.0% specificity. (4) Conclusions: Postnatal microRNA expression profiles were significantly influenced by antenatal and early postnatal factors (gestational age at delivery, birth weight of newborns, and condition of newborns at the moment of birth). These findings may contribute to the explanation of increased cardiovascular risk in preterm-born children. These findings strongly support the belief that preterm-born children should be dispensarized for a long time to have access to specialized medical care.