المؤلفون: Francisco Javier Ruperti‐Repilado, Fabian Tran, Philip Haaf, Pedro Lopez‐Ayala, Matthias Greutmann, Markus Schwerzmann, Judith Bouchardy, Harald Gabriel, Dominik Stambach, Tobias Rutz, Juerg Schwitter, Kerstin Wustmann, Michael Freese, Christian Mueller, Daniel Tobler

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 10 (2024)

مصطلحات موضوعية: adult congenital heart disease, high‐sensitivity cardiac troponin T, risk stratification, systemic right ventricle, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background The determinants and prognostic value of high‐sensitivity cardiac troponin T (hs‐cTnT) among patients with a systemic right ventricle are largely unknown. Methods and Results Ninety‐eight patients from the randomized controlled SERVE (Effect of Phosphodiesterase‐5 Inhibition With Tadalafil on Systemic Right Ventricular Size and Function) trial were included. The correlation between baseline hs‐cTnT concentrations and biventricular volumes and function quantified by cardiac magnetic resonance or cardiac multirow detector computed tomography was assessed by adjusted linear regression models. The prognostic value of hs‐cTnT was assessed by adjusted Cox proportional hazards models, survival analysis, and concordance statistics. The primary outcome was time to the composite of clinically relevant arrhythmia, hospitalization for heart failure, or all‐cause death. Median age was 39 (interquartile range, 32–48) years, and 32% were women. Median hs‐cTnT concentration was 7 (interquartile range, 4–11) ng/L. Coefficients of determination for the relationship between hs‐cTnT concentrations and right ventricular end‐systolic volume index and right ventricular ejection fraction (RVEF) were +0.368 (P=0.046) and −0.381 (P=0.018), respectively. The sex‐ and age‐adjusted hazard ratio for the primary outcome of hs‐cTnT at 2 and 4 times the reference level (5 ng/L) were 2.89 (95% CI, 1.14–7.29) and 4.42 (95% CI, 1.21–16.15), respectively. The prognostic performance quantified by the concordance statistics for age‐ and sex‐adjusted models based on hs‐cTnT, right ventricular ejection fraction, and peak oxygen uptake predicted were comparable: 0.71% (95% CI, 0.61–0.82), 0.72% (95% CI, 0.59–0.84), and 0.71% (95% CI, 0.59–0.83), respectively. Conclusions Hs‐cTnT concentration was significantly correlated with right ventricular ejection fraction and right ventricular end‐systolic volume index in patients with a systemic right ventricle. The prognostic accuracy of hs‐cTnT was comparable to that of right ventricular ejection fraction and peak oxygen uptake predicted. Registration URL: https://www.clinicaltrials.govTest; Unique identifier: NCT03049540.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/503119601f8647c288529bd02906f148Test

المؤلفون: Corina Thomet, Philip Moons, Markus Schwerzmann, Fabienne Schwitz

المصدر: BMC Health Services Research, Vol 23, Iss 1, Pp 1-11 (2023)

مصطلحات موضوعية: Heart defects, Congenital, Cardiac care facilities, Transition to adult care, Quality indicators, Health care, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Quality indicators are crucial in evaluating and comparing the quality of healthcare services. In the case of congenital heart disease, transition programmes for adolescents have been recommended to ensure uninterrupted healthcare and lifelong care. It is necessary to establish quality indicators in order to facilitate the evaluation of programme quality and to allow comparison between different centres. The objective of this study is therefore to develop a set of quality indicators for the transition of adolescents with congenital heart disease. Methods The RAND/UCLA appropriateness method was employed in a four-step process to develop a set of quality indicators. First, a literature search was conducted on the dimensions of transitional care, based on which a preliminary set of quality indicators was developed. Second, experts were contacted, and an expert panel was established. Third, the panel members were asked to rate the appropriateness of the quality indicators in a two-round process. Finally, in the fourth step, we evaluated the data by measuring the median and Disagreement Index. Results The expert panel consisted of 16 members, congenital cardiologists, nurses, transition experts, patients and research experts. The preliminary set of quality indicators comprised 16 items, categorized in process and structure criteria. Based on the panel’s feedback, the set was refined to 12 quality indicators, which were rated as relevant and feasible. Conclusions This study represents the first attempt to develop quality indicators for transitional care services for adolescents with congenital heart disease. The set of 12 quality indicators was developed based on existing evidence and expert opinion. Further testing is needed to assess the feasibility of these quality indicators in daily practice. If successfully implemented, these quality indicators could allow comparison and facilitate benchmarking of transitional care services for adolescents with congenital heart disease.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6963Test

الوصول الحر: https://doaj.org/article/741fb6f1466441c8b9c1c697d8940ce0Test

المؤلفون: Markus Schwerzmann, Matthias Greutmann, Daniel Tobler, Kerstin Wustmann, Andrea Papa, Clement Nussbaumer, Eleni Goulouti, Fabienne Schwitz

المصدر: Open Heart, Vol 11, Iss 1 (2024)

مصطلحات موضوعية: Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Objective Residual sequelae after surgical repair of tetralogy of Fallot (rTOF) affect clinical outcome. We investigated the prognostic impact of right ventricular (RV) dyssynchrony in adults with rTOF years after the surgical repair.Methods Patients from the Swiss Adult Congenital HEart disease Registry were included. NT-proBNP levels, echocardiography, exercise testing and MRI data were collected. An offline strain analysis to quantify RV-ventricular and interventricular dyssynchrony was performed. The standard deviation of the time-to-peak shortening (TTP) of six RV segments defined the RV Dyssynchrony Index (RVDI). Maximal difference of TTP between RV and left ventricular segments defined the interventricular shortening delay (IVSD). Predictors of a composite adverse event (arrhythmias, hospitalisation for heart failure and death) were identified by multivariate Cox regression analysis. Their median values were used to create a risk score.Results Out of 285 included patients (mean age 34±14 years), 33 patients (12%) experienced an adverse event during a mean follow-up of 48±21 months. No correlation was found between RVDI, IVSD and clinical events. NT-proBNP, right atrial area and peak heart rate were independent predictors of outcomes. After 4 years-follow-up, no adverse events occurred in patients at low risk (score=0 points), while an adverse event occurred in 62% of patients at high risk (score=3 points, p

وصف الملف: electronic resource

العلاقة: https://openheart.bmj.com/content/11/1/e002583.fullTest; https://doaj.org/toc/2053-3624Test

الوصول الحر: https://doaj.org/article/34234b09af5c4b66aad2ff7d2624aeeeTest

المؤلفون: Mariama Touray, MD, Magalie Ladouceur, MD, PhD, Judith Bouchardy, MD, PD MER, Markus Schwerzmann, Prof. MD, Matthias Greutmann, Prof. PD MD, Daniel Tobler, Prof. MD, Reto Engel, MD, Harald Gabriel, Prof. MD, Etienne Pruvot, Prof. MD, Coralie Blanche, MD, Nicole Sekarski, Prof. MD, Tobias Rutz, MD, PD MER

المصدر: CJC Pediatric and Congenital Heart Disease, Vol 1, Iss 6, Pp 263-269 (2022)

مصطلحات موضوعية: Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background: The long-term outcome of adults with repaired total anomalous pulmonary venous connection (TAPVC) is poorly documented. Therefore, the present study aims to provide current clinical data on adult survivors with repaired TAPVC focusing on arrhythmia. Methods: Clinical and imaging data (prevalence and type of arrhythmias, symptoms, surgical and medical treatment, echocardiographic and cardiac magnetic resonance haemodynamic parameters) were retrospectively collected from 8 European centres and compared between patients with and without arrhythmias. Results: Fifty-seven patients were included (age 20 [16-67] years [female 28, 49%]). At the last follow-up, that is, 21 (8-51) years after surgery, 79% and 93% of patients were free of symptoms and cardiac medication, respectively. The prevalence of late arrhythmias was 21%; 9 (16%) patients showed intra-atrial re-entrant tachycardia (IART) and 2 (4%) ventricular arrhythmias. Patients with IART were older (P = 0.018) and 4 (7%) required antiarrhythmic medication. Three patients (5%) underwent an electrophysiological study, and another 3 (5%) underwent pacemaker implantation within 36 months after surgical correction, which were removed in 2 patients after 7 years. Early postoperative arrhythmias (P = 0.005), right ventricular dilatation (P = 0.003), and valvulopathy (P = 0.009) were more often present in patients with late IART. Conclusions: Adult survivors after isolated-TAPVC repair presented a high prevalence of arrhythmias. Age, right ventricular dilatation, early arrhythmias, and valvular lesions are risk factors for IART. Long-term follow-up is important as some of these currently asymptomatic patients will probably develop arrhythmias in the future. Résumé: Contexte: Les résultats de santé à long terme chez les adultes ayant subi la correction d’un retour veineux pulmonaire anormal total (RVPAT) sont mal connus. Notre étude vise donc à recueillir des données cli-niques au sujet des patients ayant subi cette intervention et ayant survécu jusqu’à l’âge adulte, en particulier pour ce qui est des arythmies. Méthodologie: Les données d’observation clinique et d’imagerie (la prévalence et le type d’arythmies, les symptômes, les traitements chirurgicaux et médicaux, et les paramètres hémodynamiques obtenus par échographie et par résonance magnétique cardiaque) ont été recueillies de façon rétrospective dans huit centres européens et comparées selon que les patients présentaient ou non une arythmie. Résultats: Cinquante-sept patients ont été retenus (âge médian : 20 [16-67] ans; 28 [49 %] femmes). Au dernier suivi, soit 21 (8-51) ans après l’intervention chirurgicale, 79 % des patients ne présentaient pas de symptômes et 93 % des patients ne prenaient pas de médicaments pour des troubles cardiaques. La prévalence d’arythmies tardives s’élevait à 21 %; neuf patients (16 %) présentaient une tachycardie par réentrée intra-atriale (TRIA) et deux patients (4 %) présentaient des arythmies ventriculaires. Les patients qui présentaient une TRIA étaient plus âgés (P = 0,018) et quatre d’entre eux (7 %) devaient prendre des médicaments antiarythmiques. Trois patients (5 %) avaient subi des études électrophysiologiques et trois autres patients (5 %) avaient subi l'implantation d’un stimulateur cardiaque au cours des 36 mois suivant la correction chirurgicale; le stimulateur cardiaque a été retiré sept ans plus tard dans deux de ces cas. Les arythmies postopératoires précoces (P = 0,005), la dilation du ventricule droit (P = 0,003) et la valvulopathie (P = 0,009) étaient plus fréquentes chez les patients qui présentaient une TRIA tardive. Conclusions: La prévalence d’arythmies chez les patients survivant jusqu’à l’âge adulte après la correction isolée d’un RVPAT était élevée. L’âge, la dilation du ventricule droit, les arythmies précoces et les lésions valvulaires sont des facteurs de risque de TRIA. Il est important d’effectuer un suivi à long terme des patients ayant subi une RVPAT puisque certains d’entre eux, asymptomatiques pour le moment, présenteront sans doute des arythmies dans les années à venir.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2772812922000872Test; https://doaj.org/toc/2772-8129Test

الوصول الحر: https://doaj.org/article/0bab82a695ab4918b15d11e78bb8f09cTest

المؤلفون: Nikolas Nozica, Babken Asatryan, Stefania Aur, Judith Bouchardy Clement, Markus Schwerzmann, Fu Guan, Patrizio Pascale, Matthias Gass, Firat Duru, Tobias Reichlin, Etienne Pruvot, Thomas Wolber, Laurent Roten

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 12, Iss 13 (2023)

مصطلحات موضوعية: atrial switch procedure, cardiac arrhythmia, implantable cardioverter‐defibrillator, intra‐atrial re‐entry tachycardia, pacemaker, sudden cardiac death, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background Data on the incidence of arrhythmias, associated cardiac interventions, and outcome in patients with dextro‐transposition of the great arteries and atrial switch are scarce. Methods and Results In this multicenter analysis, we included adult patients with dextro‐transposition of the great arteries and atrial switch regularly followed up at 3 Swiss tertiary care hospitals. The primary outcome was a composite of left ventricular assist device, heart transplantation, and death. The secondary outcome was occurrence of ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. We identified 207 patients (34% women; median age at last follow‐up, 35 years) with dextro‐transposition of the great arteries and atrial switch. Arrhythmias occurred in 97 patients (47%) at a median age of 22 years. A pacemaker or an implantable cardioverter‐defibrillator was implanted in 39 (19%) and 13 (6%) patients, respectively, and 33 (16%) patients underwent a total of 51 ablation procedures to target 60 intra‐atrial re‐entry tachycardias, 4 atrioventricular nodal re‐entry tachycardias, and 1 atrial fibrillation. The primary outcome occurred in 21 patients (10%), and the secondary outcome occurred in 18 patients (9%); both were more common in patients with concomitant ventricular septum defect than in those without (hazard ratio [HR], 3.06 [95% CI, 1.29–7.27], P=0.011; and HR, 3.62 [95% CI, 1.43–9.18], P=0.007, respectively). Conclusions In patients with dextro‐transposition of the great arteries and atrial switch reaching adulthood, arrhythmias occur in almost half of patients, and associated rhythm interventions are frequent. One‐tenth of those patients do not survive until the age of 35 years free from left ventricular assist device or heart transplantation, and the outcome is worse in patients with concomitant ventricular septum defect.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/cb55feb8c958470e9acde25bf5492729Test

المؤلفون: Francisco Javier Ruperti-Repilado, Helmut Baumgartner, Berto Bouma, Judith Bouchardy, Werner Budts, Laurence Campens, Massimo Chessa, Maria Jesús del Cerro Marin, Harald Gabriel, Pastora Gallego, Elvira Ana González, Annette Schophuus Jensen, Magalie Ladouceur, Christopher Lockhart, Berta Miranda-Barrio, Marielle Morissens, Eduardo Moreno Escobar, Agnès Pasquet, Joaquin Rueda Soriano, Annemien Elise van den Bosch, Heleen Berdina van der Zwaan, Daniel Tobler, Matthias Greutmann, Markus Schwerzmann

المصدر: International Journal of Cardiology Congenital Heart Disease, Vol 11, Iss , Pp 100428- (2023)

مصطلحات موضوعية: Adult congenital heart disease, Coronavirus disease 2019, Risk stratification, Outcomes, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background: At the beginning of the COVID-19 pandemic, professionals in charge of particularly vulnerable populations, such as adult congenital heart disease (ACHD) patients, were confronted with difficult decision-making. We aimed to assess changes in risk stratification and outcomes of ACHD patients suffering from COVID-19 between March 2020 and April 2021. Methods and results: Risk stratification among ACHD experts (before and after the first outcome data were available) was assessed by means of questionnaires. In addition, COVID-19 cases and the corresponding patient characteristics were recorded among participating centres. Predictors for the outcome of interest (complicated disease course) were assessed by means of multivariable logistic regression models calculated with cluster-robust standard errors. When assessing the importance of general and ACHD specific risk factors for a complicated disease course, their overall importance and the corresponding risk perception among ACHD experts decreased over time. Overall, 638 patients (n = 168 during the first wave and n = 470 during the subsequent waves) were included (median age 34 years, 52% women). Main independent predictors for a complicated disease course were male sex, increasing age, a BMI >25 kg/m2, having ≥2 comorbidities, suffering from a cyanotic heart disease or having suffered COVID-19 in the first wave vs. subsequent waves. Conclusions: Apart from cyanotic heart disease, general risk factors for poor outcome in case of COVID-19 reported in the general population are equally important among ACHD patients. Risk perception among ACHD experts decreased during the course of the pandemic.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666668522001112Test; https://doaj.org/toc/2666-6685Test

الوصول الحر: https://doaj.org/article/aa9997d324d043cfb53e2e2a985704c4Test

المؤلفون: Francisco Javier Ruperti-Repilado, Jan Affolter, Judith Bouchardy, Harald Gabriel, Simon F. Stämpfli, Reto Engel, Markus Schwerzmann, Matthias Greutmann, Daniel Tobler

المصدر: Swiss Medical Weekly, Vol 152, Iss 0708 (2022)

مصطلحات موضوعية: Medicine

الوصف: BACKGROUND: Adults with transposition of the great arteries (d-TGA) after the arterial switch operation (ASO) are an evolving cohort in adult cardiology. We aimed to analyze cardiac function and cardiac events after transition to the adult clinic in Switzerland. MATERIALS AND METHODS: Adults with prior ASO enrolled in the Swiss Adult Congenital HEart disease Registry (SACHER) were included. We analyzed initial cardiac anatomy, surgical history, residual lesions and cardiac function at the time of inclusion, as well as cardiac events during follow-up. Patients were classified as complex (with ventricular septal defect) or simple (with intact interventricular septum) d-TGA. RESULTS: The cohort included 149 patients (99 simple d-TGA, 50 complex d-TGA; age 21±3 years; 71% male, follow-up 27 [15–46] months). Prior to inclusion, patients with complex d-TGA had undergone more interventions related to the left ventricular outflow tract (16% vs. 3%, p = 0.01). Functional and cardiovascular status were similar between the groups. Eleven patients (7%) had a total of 19 cardiac events (5 complications and 14 re-interventions) during follow-up. Patients with complex d-TGA had more cardiac-related complications compared to those with simple d-TGA (8% vs. 1%, p = 0.03). The frequency of re-interventions was not statistically different between the two groups (12% vs. 4%, p = 0.07). During follow-up, an increase in QRS duration was observed. Other parameters of cardiac function remained unchanged. CONCLUSION: The majority of adult ASO patients have normal functional class and cardiac function. Complex anatomy and residual lesions play a key role when regarding the occurrence of cardiac-related complications during follow-up. The role of QRS prolongation over time needs to be investigated further.

وصف الملف: electronic resource

العلاقة: https://smw.ch/index.php/smw/article/view/3157Test; https://doaj.org/toc/1424-3997Test

الوصول الحر: https://doaj.org/article/817c02b2d5e249e6900710d1b02f0d72Test

المؤلفون: Paula Appenzeller, Mona Lichtblau, Charlotte Berlier, John‐David Aubert, Andrea Azzola, Jean‐Marc Fellrath, Thomas Geiser, Frederic Lador, Susanne Pohle, Isabelle Opitz, Markus Schwerzmann, Hans Stricker, Michael Tamm, Stéphanie Saxer, Silvia Ulrich

المصدر: Pulmonary Circulation, Vol 12, Iss 1, Pp n/a-n/a (2022)

مصطلحات موضوعية: chronic thromboembolic pulmonary hypertension, pulmonary arterial hypertension, survival, Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the respiratory system, RC705-779

الوصف: Abstract Pulmonary hypertension (PH), especially pulmonary arterial and chronic thromboembolic pulmonary hypertension (PAH/CTEPH), are rare and progressive conditions. Despite recent advances in treatment and prognosis, PH is still associated with impaired quality of life and survival. Long‐term PH‐registry data provide information on the changing PH‐epidemiology and may help to direct resources to patient's needs. This retrospective analysis of the Swiss Pulmonary Hypertension Registry includes patients newly diagnosed with PH (mainly PAH/CTEPH) registered from January 2001 to June 2019 at 13 Swiss hospitals. Patient characteristics (age, body mass index, gender, diagnosis), hemodynamics at baseline, treatment, days of follow‐up, and events (death, transplantation, pulmonary endarterectomy, or loss to follow‐up) at last visit were analyzed. Patients were stratified into four time periods according to their date of diagnosis. Survival was analyzed overall and separately for PAH/CTEPH and time periods. 1427 PH patients were included (thereof 560 PAH, 383 CTEPH). Over the years, age at baseline (mean ± SD) significantly increased from 59 ± 14 years in 2001–2005 to 66 ± 14 years in 2016–2019 (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-8940Test

الوصول الحر: https://doaj.org/article/1b143183601047438801ced42ae879c1Test

المؤلفون: Thomas Kueffer, MS, Markus Schwerzmann, MD, Alexander Kadner, MD, Laurent Roten, MD

المصدر: JACC: Case Reports, Vol 2, Iss 2, Pp 230-234 (2020)

مصطلحات موضوعية: 3-dimensional imaging, ablation, congenital heart defect, electroanatomic mapping, idiopathic enlargement, supraventricular arrhythmias, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: A 25-year-old male patient with a giant right atrium presented with atrial tachycardia. Electroanatomic mapping revealed micro–re-entry from a low-voltage zone in the region of the right atrial appendage. Linear ablations across the low-voltage zone terminated the tachycardia. The remaining right atrial tissue was electrically normal. (Level of Difficulty: Intermediate.)

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S266608491930498XTest; https://doaj.org/toc/2666-0849Test

الوصول الحر: https://doaj.org/article/39e2675ee40b42c89792f09c5ea50baeTest

المؤلفون: Francisco Javier Ruperti Repilado, Helmut Baumgartner, Berto Bouma, Judith Bouchardy, Werner Budts, Laurence Campens, Massimo Chessa, Maria Jesús del Cerro Marin, Harald Gabriel, Pastora Gallego, Rocío García-Orta, Elvira Ana González, Annette Schophuus Jensen, Magalie Ladouceur, Christopher Lockhart, Berta Miranda-Barrio, Marielle Morissens, Agnès Pasquet, Joaquin Rueda Soriano, Annemien Elise van den Bosch, Heleen Berdina van der Zwaan, Daniel Tobler, Matthias Greutmann, Markus Schwerzmann

المصدر: International Journal of Cardiology Congenital Heart Disease, Vol 5, Iss , Pp 100253- (2021)

مصطلحات موضوعية: Diseases of the circulatory (Cardiovascular) system, RC666-701

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666668521001774Test; https://doaj.org/toc/2666-6685Test

الوصول الحر: https://doaj.org/article/ef42a9eb87504a56a0de7125e6462880Test