Congenital Heart Disease: Advances in Clinical Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 28 May 2024 | Viewed by 523

Special Issue Editor


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Guest Editor
Department of Cardiology, Complejo Hospitalario Universitario Insular-Materno Infantil, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Interests: congenital heart disease; pulmonary arterial hypertension; complexity; cyanosis
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Special Issue Information

Dear Colleagues,

In recent decades, there have been important advances in patients with congenital heart diseases that have allowed many of them to reach adulthood. In fact, currently 85% of neonates with congenital heart disease survive into adult life. These advances include genetic factors recognized as playing an important role in cardiovascular malformations, the detection of congenital heart disease using fetal echocardiography, anesthetic management, noninvasive imaging options, including cardiac magnetic resonance (CMR) imaging, cardiac computed tomography (CT), and nuclear scintigraphy, cardiovascular surgery, percutaneous interventions, intensive care, as well as improvements in pharmacotherapy. Also, the diagnosis and management of late complications in adult congenital heart disease patients is of paramount importance as residual and sequelae may progress in terms of severity with age, inducing late complications, such as arrhythmias, cardiac failure, renal and liver disease, thromboembolism, aortopathy, cyanosis, pulmonary arterial hypertension, infective endocarditis, or mental health and psychological problems due to the need to cope with stress, anxiety, or depression. In addition to this, we find that there are challenges faced by the parents of patients with congenital heart disease. The goal of this Special Issue is to provide a very contemporary and practical approach to congenital heart disease patients, from childhood to adulthood, through original research and review articles with the aim of updating the advances in clinical diagnosis and management in the field of congenital heart disease.

Dr. Efrén Martínez-Quintana
Guest Editor

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Keywords

  • congenital heart disease
  • fetal
  • childhood
  • adults
  • genetic
  • imaging
  • surgery
  • percutaneous
  • complications
  • psychological

Published Papers (1 paper)

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12 pages, 456 KiB  
Article
C-Reactive Protein and Long-Term Prognosis in Adult Patients with Congenital Heart Disease
by Efrén Martínez-Quintana, María Alcántara-Castellano, Marta Isabel García-Suárez and Fayna Rodríguez-González
J. Clin. Med. 2024, 13(8), 2199; https://doi.org/10.3390/jcm13082199 - 11 Apr 2024
Viewed by 329
Abstract
Background/Objectives: Prognostic biomarkers may provide information about the patient’s cardiovascular outcomes. However, there are doubts regarding how high-sensitivity C-reactive protein (hs-CRP) impacts patients with congenital heart disease (CHD). The main objective is to evaluate whether high hs-CRP levels predict a worse prognosis [...] Read more.
Background/Objectives: Prognostic biomarkers may provide information about the patient’s cardiovascular outcomes. However, there are doubts regarding how high-sensitivity C-reactive protein (hs-CRP) impacts patients with congenital heart disease (CHD). The main objective is to evaluate whether high hs-CRP levels predict a worse prognosis in patients with CHD. Methods: Observational and prospective cohort study. Adult CHD patients and controls were matched for age and sex. Results: In total, 434 CHD patients (cases) and 820 controls were studied. The median age in the CHD patients was 30 (18–62) years and 256 (59%) were male. A total of 51%, 30%, and 19% of patients with CHD had mild, moderate, and great complexity defects, respectively. The body mass index [1.07 (1.01–1.13), p = 0.022)], diabetes mellitus [3.57 (1.07–11.97), p = 0.039], high NT-pro-BNP levels [1.00 (1.00–1.01), p = 0.021], and low serum iron concentrations [0.98 (0.97–0.99), p = 0.001] predicted high hs-CRP levels (≥0.3 mg/dL) in patients with CHD. During a follow-up time of 6.81 (1.17–10.46) years, major cardiovascular events (MACE) occurred in 40 CHD patients, showing the Kaplan–Meier test demonstrated a worse outcome among patients with hs-CRP levels above 0.3 mg/dL (p = 0.012). Also, hs-CRP showed statistical significance in the univariate Cox regression survival analysis. However, after adjusting for other variables, this significance was lost and the remaining predictors of MACE were age [HR 1.03 (1.01–1.06), p = 0.001], great complexity defects [HR 2.46 (1.07–5.69), p = 0.035], and an NT pro-BNP cutoff value for heart failure > 125 pg/mL [HR 7.73 (2.54–23.5), p < 0.001]. Conclusions: Hs-CRP obtained statistical significance in the univariate survival analysis. However, this significance was lost in the multivariate analysis in favor of age, CHD complexity, and heart failure. Full article
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