1
|
Ma F, Li P, Zhang S, Shi W, Wang J, Ma Q, Zhao M, Nie Z, Xiao H, Chen X, Xie X. Decreased lipid levels in adult with congenital heart disease: a systematic review and Meta-analysis. BMC Cardiovasc Disord 2023; 23:523. [PMID: 37891491 PMCID: PMC10612202 DOI: 10.1186/s12872-023-03455-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Metabolic disorders were a health problem for many adults with congenital heart disease, however, the differences in metabolic syndrome-related metabolite levels in adults with congenital heart disease compared to the healthy population were unknown. METHODS We collected 18 studies reporting metabolic syndrome-associated metabolite levels in patients with congenital heart disease. Data from different studies were combined under a random-effects model using Cohen's d values. RESULTS The results found that the levels of total cholesterol (Cohen's d -0.68, 95% CI: -0.91 to -0.45), high-density lipoprotein cholesterol (Cohen's d -0.63, 95% CI: -0.89 to -0.37), and low-density lipoprotein cholesterol (Cohen's d -0.32, 95% CI: -0.54 to -0.10) were significantly lower in congenital heart disease patients compared with controls. Congenital heart disease patients also had a lower body mass index (Cohen's d -0.27, 95% CI: -0.42 to -0.12) compared with controls. On the contrary, congenital heart disease patients had higher levels of hemoglobin A1c (Cohen's d 0.93, 95% CI: 0.17 to 1.70) than controls. Meanwhile, there were no significant differences in triglyceride (Cohen's d 0.07, 95% CI: -0.09 to 0.23), blood glucose (Cohen's d -0.12, 95% CI: -0.94 to 0.70) levels, systolic (Cohen's d 0.07, 95% CI: -0.30 to 0.45) and diastolic blood pressure (Cohen's d -0.10, 95% CI: -0.39 to 0.19) between congenital heart disease patients and controls. CONCLUSIONS The lipid levels in patients with congenital heart disease were significantly lower than those in the control group. These data will help in the health management of patients with congenital heart disease and guide clinicians. PROSPERO REGISTRATION NUMBER CRD42022228156.
Collapse
Affiliation(s)
- Fengdie Ma
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Peiqiang Li
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
| | - Shasha Zhang
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Wenjing Shi
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Wang
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Qinglong Ma
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Meie Zhao
- The first people's hospital of Lanzhou city, Lanzhou, Gansu, China
| | - Ziyan Nie
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Handan Xiao
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Xinyi Chen
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaodong Xie
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
| |
Collapse
|
2
|
Yamamura K, Nagata H, Sakamoto I, Tsutsui H, Ohga S. Transition in cardiology 1: Pediatric patients with congenital heart disease to adulthood. Pediatr Int 2022; 64:e15096. [PMID: 34905265 DOI: 10.1111/ped.15096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 01/06/2023]
Abstract
With advances in medical care, the majority of infants and children with chronic diseases are now able to reach adulthood. However, many of them still need special health care because of their original diseases, sequelae, and complications. The transition from the child health care system to the adult health care system is a crucial step for these patients. The goal of transitional care is to maximize the lifelong function and potential of these patients by uninterruptedly providing appropriate health-care services. To achieve this goal, we should (i) coordinate the transfer to adequate medical institutions and departments for adults, (ii) educate patients to improve self-management, and (iii) support the transition to social and welfare services for adults. Transitional care in pediatric cardiology has been a step ahead of such care in other diseases because of the relatively high incidence and the long history of adult congenital heart disease. Education of the patients to establish autonomy reduces dropping out and unexpected hospitalizations and it is the most important part of transitional care. To achieve this goal, we should provide explanations to pediatric patients according to their age and level of understanding from their first visit, rather than waiting until they reach a certain age. Tools for education and readiness checks are also being developed. To achieve a situation in which pediatric patients with chronic disease can take care of their own health and fully utilize their abilities at the growing step, transitional care plays a crucial role not only in pediatric cardiology but also in other subspecialties.
Collapse
Affiliation(s)
- Kenichiro Yamamura
- Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hazumu Nagata
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
3
|
Niwa K. The Japanese Society of Adult Congenital Heart Disease. “A rapidly growing society”. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
4
|
Niwa K. Metabolic syndrome and coronary artery disease in adults with congenital heart disease. Cardiovasc Diagn Ther 2021; 11:563-576. [PMID: 33968634 DOI: 10.21037/cdt-20-781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In adults with congenital heart disease (ACHD), conditions acquired with aging, such as metabolic syndrome, hypertension, diabetes mellitus, and obesity, can negatively influence the original cardiovascular disease. Metabolic syndrome has a higher prevalence in ACHD than in the general population. In contrast, coronary artery disease shows a similar prevalence in adults with acyanotic CHD and the general population, while adults with cyanotic CHD, even after repair, have an even lower incidence of coronary artery disease than the general population/adults with acyanotic CHD. However, even in those with cyanotic CHD, coronary artery disease can develop when they have risk factors such as obesity, dyslipidemia, hypertension, diabetes mellitus, smoking habit, or limited exercise. The prevalence of risk factors for cardiovascular disease is similar between ACHD and the general population, but an increased risk of coronary atherosclerosis has been observed for congenital coronary artery anomalies, dextro-transposition of the great arteries after arterial switch operation, Ross procedure, and coarctation of the aorta. Aortopathy may be an additional risk factor for cardiovascular disease. As ACHD have other abnormalities that may make the heart more vulnerable to both the development of atherosclerosis and adverse cardiovascular sequelae, regular evaluation of their cardiovascular disease risk status is recommended. Metabolic syndrome is more common among ACHD than in the general population, and may therefore increase the future incidence of atherosclerotic coronary artery disease even in ACHD. Thus, ACHD should be screened for metabolic syndrome to eliminate risk factors for atherosclerotic coronary artery disease.
Collapse
Affiliation(s)
- Koichiro Niwa
- Department of Cardiology, Cardiovascular Center, St Luke's International Hospital, Tokyo 104-8560, Japan
| |
Collapse
|
5
|
Lee SY, Kim GB, Kwon HW, Song MK, Bae EJ, Cho S, Kwak JG, Lim HG, Kim WH, Lee JR. Changes of hospitalization trend in the pediatric cardiology division of a single center by increasing adult with congenital heart disease. BMC Cardiovasc Disord 2020; 20:227. [PMID: 32414329 PMCID: PMC7229598 DOI: 10.1186/s12872-020-01511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background As a result of advances in pediatric care and diagnostic testing, there is a growing population of adults with congenital heart disease (ACHD). The purpose of this study was to better define the epidemiology and changes in the trend of hospitalizations for ACHD in Korean society. Methods We reviewed outpatient and inpatient data from 2005 to 2017 to identify patient ≥18 years of age admitted for acute care with a congenital heart disease (CHD) diagnosis in the pediatric cardiology division. We tried to analyze changes of hospitalization trend for ACHD. Results The ratio of outpatients with ACHD increased 286.5%, from 11.1% (1748/15,682) in 2005 to 31.8% (7795/24,532) in 2017. The number of ACHD hospitalizations increased 360.7%, from 8.9% (37/414) in 2005 to 32.1% (226/705) in 2017. The average patient age increased from 24.3 years in 2005 to 27.4 in 2017. The main diagnosis for admission of ACHD is heart failure, arrhythmia and Fontan-related complications. The annual ICU admission percentage was around 5% and mean length of intensive care unit (ICU) stay was 8.4 ± 14.6 days. Mean personal hospital charges by admission of ACHD increased to around two times from 2005 to 2017. (from $2578.1 to $3697.0). Total annual hospital charges by ACHD markedly increased ten times (from $95,389.7 to $831,834.2). Conclusions The number of hospital cares for ACHD dramatically increased more than five times from 2005 to 2017. We need preparations for efficient healthcare for adults with CHD such as a multi-dimensional approach, effective communication, and professional training.
Collapse
Affiliation(s)
- Sang-Yun Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Gi-Beom Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Hye-Won Kwon
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Mi-Kyoung Song
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sungkyu Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Gun Kwak
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hong-Gook Lim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Woong-Han Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Ryul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
6
|
Niwa K. Metabolic Syndrome in Adult Congenital Heart Disease. Korean Circ J 2019; 49:691-708. [PMID: 31347322 PMCID: PMC6675699 DOI: 10.4070/kcj.2019.0187] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 12/18/2022] Open
Abstract
In adult congenital heart disease (ACHD), residua and sequellae after initial repair develop late complications such as cardiac failure, arrhythmias, thrombosis, aortopathy, pulmonary hypertension and others. Acquired lesions with aging such as hypertension, diabetes mellitus, obesity can be negative influence on original cardiovascular disease (CVD). Also, atherosclerosis may pose an additional health problem to ACHD when they grow older and reach the age at which atherosclerosis becomes clinically relevant. In spite of the theoretical risk of atherosclerosis in ACHD due to above mentioned factors, cyanotic ACHDs even after repair are noted to have minimal incidence of coronary artery disease (CAD). Acyanotic ACHD has similar prevalence of CAD as the general population. However, even in cyanotic ACHD, CAD can develop when they have several risk factors for CAD. The prevalence of risk factor is similar between ACHD and the general population. Risk of premature atherosclerotic CVD in ACHD is based, 3 principal mechanisms: lesions with coronary artery abnormalities, obstructive lesions of left ventricle and aorta such as coarctation of the aorta and aortopathy. Coronary artery abnormalities are directly affected or altered surgically, such as arterial switch in transposition patients, may confer greater risk for premature atherosclerotic CAD. Metabolic syndrome is more common among ACHD than in the general population, and possibly increases the incidence of atherosclerotic CAD even in ACHD in future. Thus, ACHD should be screened for metabolic syndrome and eliminating risk factors for atherosclerotic CAD.
Collapse
Affiliation(s)
- Koichiro Niwa
- Cardiovascular Center, Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
| |
Collapse
|
7
|
Pediatric heart transplantation: long-term outcomes. Indian J Thorac Cardiovasc Surg 2019; 36:175-189. [PMID: 33061202 DOI: 10.1007/s12055-019-00820-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/26/2022] Open
Abstract
Pediatric heart transplant has become the standard of care for end-stage heart disease in children throughout the world. The number of transplants has grown dramatically since the first transplant was performed, and over the last two decades, outcomes have consistently improved with progression in knowledge enhancing the clinical course and outcomes of these patients. Short-term outcomes in the most recent era have been excellent resulting in a renewed focus towards medium- and long-term outcomes. This article will review the most up-to-date literature on overall heart transplantation outcomes and specific long-term outcomes including rejection, cardiac allograft vasculopathy, graft failure, infection, renal dysfunction, malignancy, and the need for re-transplantation. The article also explores the post-transplantation outcomes of special populations, including Fontan patients, ABO-incompatible recipients, sensitized recipients, extracorporeal membrane oxygenation, and ventricular assist devices. The article concludes with a look at transition from pediatric to adult care and medication adherence, which are becoming major issues related to long-term outcomes as post-transplant survival increases.
Collapse
|
8
|
Helm PC, Kempert S, Körten MA, Lesch W, Specht K, Bauer UMM. Congenital heart disease patients' and parents' perception of disease-specific knowledge: Health and impairments in everyday life. CONGENIT HEART DIS 2018; 13:377-383. [DOI: 10.1111/chd.12581] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/09/2017] [Accepted: 12/19/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Paul C. Helm
- National Register for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
| | - Sebastian Kempert
- Institute for Educational Studies, Humboldt University of Berlin; Berlin Germany
| | - Marc-André Körten
- National Register for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
| | - Wiebke Lesch
- Competence Network for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
| | - Katharina Specht
- Competence Network for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
| | - Ulrike M. M. Bauer
- National Register for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
- Competence Network for Congenital Heart Defects, DZHK (German Center for Cardiovascular Research); Berlin Germany
| |
Collapse
|
9
|
Abstract
As the most prevalent form of birth defect in humans worldwide, congenital heart disease (CHD) is responsible for substantial morbidity and is still the leading cause of birth defect-related demises. Increasing evidence demonstrates that genetic defects play an important role in the pathogenesis of CHD, and mutations in multiple genes, especially in those coding for cardiac core transcription factors, have been causally linked to various CHDs. Nevertheless, CHD is a genetically heterogeneous disease and the genetic determinants underpinning CHD in an overwhelming majority of patients remain elusive. In the current study, genomic DNA was extracted from venous blood samples of 165 unrelated patients with CHD, and the coding exons and splicing junction sites of the HAND1 gene, which encodes a basic helix-loop-helix transcription factor essential for cardiovascular development, were sequenced. As a result, a novel heterozygous mutation, p.R118C, was identified in a patient with tetralogy of Fallot (TOF). The missense mutation, which was absent in 600 referential chromosomes, altered the amino acid that was completely conserved evolutionarily. Biological assays with a dual-luciferase reporter assay system revealed that the R118C-mutant HAND1 protein had significantly reduced transcriptional activity when compared with its wild-type counterpart. Furthermore, the mutation significantly decreased the synergistic activation of a downstream target gene between HAND1 and GATA4, another cardiac core transcription factor associated with TOF. To our knowledge, this is the first report on the association of a HAND1 loss-of-function mutation with enhanced susceptibility to TOF in humans. The findings provide novel insight into the molecular etiology underlying TOF, suggesting potential implications for the improved prophylactic and therapeutic strategies for TOF.
Collapse
|
10
|
Transitioning from pediatric to adult care after thoracic transplantation. J Heart Lung Transplant 2017; 36:823-829. [PMID: 28342709 DOI: 10.1016/j.healun.2017.02.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 01/24/2017] [Accepted: 02/24/2017] [Indexed: 11/23/2022] Open
Abstract
With improving outcomes after thoracic transplantation, more children are surviving to adulthood and requiring specialized adult care. A systematic and effective program is essential to transition these patients from a pediatric to adult health care setting. In this review, we discuss the concept of transition and the factors leading to an effective transfer to an adult care provider, including administrative support, patient/provider preparation, and the navigation of potential barriers. Notably, there is a paucity of data for many details of transition, making this a significant opportunity for future research.
Collapse
|
11
|
Li L, Wang J, Liu XY, Liu H, Shi HY, Yang XX, Li N, Li YJ, Huang RT, Xue S, Qiu XB, Yang YQ. HAND1 loss-of-function mutation contributes to congenital double outlet right ventricle. Int J Mol Med 2017; 39:711-718. [DOI: 10.3892/ijmm.2017.2865] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/05/2017] [Indexed: 11/06/2022] Open
|
12
|
Biglino G, Layton S, Leaver LK, Wray J. Fortune favours the brave: composite first-person narrative of adolescents with congenital heart disease. BMJ Paediatr Open 2017; 1:e000186. [PMID: 29637173 PMCID: PMC5862190 DOI: 10.1136/bmjpo-2017-000186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND An interdisciplinary framework including a narrative element could allow addressing lack of awareness or excessive anxieties and teasing out divergences between patients' health status and their expectations. This could be particularly relevant for adolescents with congenital heart disease (CHD). OBJECTIVE To develop a collective narrative ensuing from a creative activity involving adolescents with CHD, in order to explore their health perceptions and expectations. DESIGN Artist-led workshop process supported by a multidisciplinary team. SETTING AND PARTICIPANTS Young people with CHD (n=5, age 17-18 years, two men) were involved in the creative process, which encouraged them, over two sessions, to elaborate imagery relating to their uniqueness as individuals and their hearts. On top of creative activities (including self-portraits, embossing, body mapping and creative writing), participants were also shown their hearts in the form of cardiovascular MRIs and three-dimensional (3D) models manufactured by means of 3D printing. METHODS A composite first-person narrative approach was adopted to handle the emerged phenomenological descriptions and creative outputs, in order to shape a unified story. RESULTS The composite first-person narrative highlighted themes central to the patients, including their interpretation of medical references, their resilience and their awareness of anatomical complexity. DISCUSSION AND CONCLUSIONS Exploring the narrative of adolescents with CHD can offer unique insight into the way they view their hearts at a crucial stage of their care. An artist-led creative workshop supported by a multidisciplinary team can be a valuable approach to collect such narratives from patients and begin exploring them.
Collapse
Affiliation(s)
- Giovanni Biglino
- Bristol Heart Institute, Bristol Medical School, University of Bristol, Bristol, UK.,Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Sofie Layton
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Lindsay-Kay Leaver
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Jo Wray
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| |
Collapse
|
13
|
Biglino G, Koniordou D, Gasparini M, Capelli C, Leaver LK, Khambadkone S, Schievano S, Taylor AM, Wray J. Piloting the Use of Patient-Specific Cardiac Models as a Novel Tool to Facilitate Communication During Cinical Consultations. Pediatr Cardiol 2017; 38:813-818. [PMID: 28214968 PMCID: PMC5388703 DOI: 10.1007/s00246-017-1586-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 02/02/2017] [Indexed: 12/03/2022]
Abstract
This pilot study aimed to assess the impact of using patient-specific three-dimensional (3D) models of congenital heart disease (CHD) during consultations with adolescent patients. Adolescent CHD patients (n = 20, age 15-18 years, 15 male) were asked to complete two questionnaires during a cardiology transition clinic at a specialist centre. The first questionnaire was completed just before routine consultation with the cardiologist, the second just after the consultation. During the consultation, each patient was presented with a 3D full heart model realised from their medical imaging data. The model was used by the cardiologist to point to main features of the CHD. Outcome measures included rating of health status, confidence in explaining their condition to others, name and features of their CHD (as a surrogate for CHD knowledge), impact of CHD on their lifestyle, satisfaction with previous/current visits, positive/negative features of the 3D model, and open-ended feedback. Significant improvements were registered in confidence in explaining their condition to others (p = 0.008), knowledge of CHD (p < 0.001) and patients' satisfaction (p = 0.005). Descriptions of CHD and impact on lifestyle were more eloquent after seeing a 3D model. The majority of participants reported that models helped their understanding and improved their visit, with a non-negligible 30% of participants indicating that the model made them feel more anxious about their condition. Content analysis of open-ended feedback revealed an overall positive attitude of the participants toward 3D models. Clinical translation of 3D models of CHD for communication purposes warrants further exploration in larger studies.
Collapse
Affiliation(s)
- Giovanni Biglino
- Bristol Heart Institute, School of Clinical Sciences, Bristol Royal Infirmary, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK. .,Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
| | - Despina Koniordou
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Claudio Capelli
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK ,Institute of Cardiovascular Science, University College London, London, UK
| | - Lindsay-Kay Leaver
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Sachin Khambadkone
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Silvia Schievano
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK ,Institute of Cardiovascular Science, University College London, London, UK
| | - Andrew M. Taylor
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK ,Institute of Cardiovascular Science, University College London, London, UK
| | - Jo Wray
- Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| |
Collapse
|
14
|
Abstract
Interprofessional collaboration in health has become essential to providing high-quality care, decreased costs, and improved outcomes. Patient-centered care requires synthesis of all the components of primary and specialty medicine to address patient needs. For individuals living with chronic diseases, this model is even more critical to obtain better health outcomes. Studies have shown shown that oral health and systemic disease are correlated as it relates to disease development and progression. Thus, inclusion of oral health in many of the existing and new collaborative models could result in better management of chronic illnesses and improve overall health outcomes.
Collapse
|
15
|
Postoperative residua and sequelae in adults with repaired tetralogy of Fallot. Gen Thorac Cardiovasc Surg 2016; 64:373-9. [DOI: 10.1007/s11748-016-0651-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/06/2016] [Indexed: 02/06/2023]
|