Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exceeds the RV's adaptive capacity, ventricular-arterial uncoupling occurs, ultimately causing right heart failure and death. In this clinical setting the primary treatment goal is to achieve low mortality risk and right heart reverse remodeling (RHRR). Unfortunately, the definition of RHRR vary across studies and imaging modalities (echocardiography or Cardiac Magnetic Resonance). The likelihood of RHRR increases with a significant reduction in pulmonary vascular resistance (PVR) from baseline, ideally by at least 50 %. Evidence supports initial triple therapy, including parenteral prostanoids, as the most effective approach to reduce PVR enough to facilitate RHRR and thus achieve the low-risk status.
{"title":"Right heart reverse remodeling: “facta non verba”","authors":"Tommaso Recchioni , Giovanna Manzi , Alexandra Mihai , Francesca Ileana Adamo , Annalisa Caputo , Domenico Filomena , Giorgia Serino , Silvia Papa , Nadia Cedrone , Carmine Dario Vizza , Roberto Badagliacca","doi":"10.1016/j.ijcchd.2025.100568","DOIUrl":"10.1016/j.ijcchd.2025.100568","url":null,"abstract":"<div><div>Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exceeds the RV's adaptive capacity, ventricular-arterial uncoupling occurs, ultimately causing right heart failure and death. In this clinical setting the primary treatment goal is to achieve low mortality risk and right heart reverse remodeling (RHRR). Unfortunately, the definition of RHRR vary across studies and imaging modalities (echocardiography or Cardiac Magnetic Resonance). The likelihood of RHRR increases with a significant reduction in pulmonary vascular resistance (PVR) from baseline, ideally by at least 50 %. Evidence supports initial triple therapy, including parenteral prostanoids, as the most effective approach to reduce PVR enough to facilitate RHRR and thus achieve the low-risk status.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100568"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The frailty of family caregivers (FCs) of adults with congenital heart disease (CHD) is an underrecognized yet critical issue in healthcare. As individuals with CHD live longer, their FCs, often aging alongside them, face escalating physical, emotional, and psychological challenges. This brief report examines frailty in FCs as a multidimensional issue stemming from prolonged caregiving demands and cumulative stress. The evidence gathered in this regard identifies three key domains affecting FCs: psychological stress and childcare, physical health decline, and the challenges of caregiving during transitions to adulthood. These findings underscore the urgent need for family-centered care models that incorporate tailored frailty assessments and targeted interventions to support FCs throughout their caregiving journey. Addressing caregiver frailty could improve outcomes for both patients and caregivers, strengthen resilience, and optimize resource allocation. This perspective calls for immediate action in research and policy to prioritize caregiver well-being in transition care programs, enhancing the quality of life for both caregivers and patients.
{"title":"Family caregiver frailty in adult congenital heart disease is overlooked: A call to action","authors":"Arianna Magon , Serena Francesca Flocco , Laura Schianchi , Massimo Chessa , Daniele Ciofi , Salvatore Angileri , Maddalena De Maria , Gianluca Conte , Silvia Favilli , Cristina Arrigoni , Rosario Caruso","doi":"10.1016/j.ijcchd.2025.100567","DOIUrl":"10.1016/j.ijcchd.2025.100567","url":null,"abstract":"<div><div>The frailty of family caregivers (FCs) of adults with congenital heart disease (CHD) is an underrecognized yet critical issue in healthcare. As individuals with CHD live longer, their FCs, often aging alongside them, face escalating physical, emotional, and psychological challenges. This brief report examines frailty in FCs as a multidimensional issue stemming from prolonged caregiving demands and cumulative stress. The evidence gathered in this regard identifies three key domains affecting FCs: psychological stress and childcare, physical health decline, and the challenges of caregiving during transitions to adulthood. These findings underscore the urgent need for family-centered care models that incorporate tailored frailty assessments and targeted interventions to support FCs throughout their caregiving journey. Addressing caregiver frailty could improve outcomes for both patients and caregivers, strengthen resilience, and optimize resource allocation. This perspective calls for immediate action in research and policy to prioritize caregiver well-being in transition care programs, enhancing the quality of life for both caregivers and patients.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100567"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with repaired tetralogy of Fallot (TOF) now live longer. However, dysrhythmia becomes prevalent in adults with repaired TOF, especially atrial tachyarrhythmia.
Objective
To identify the characteristics of patients who develop atrial tachycardia (AT) and the mechanism of the clinical AT and the induced one.
Method
Seventy-seven patients with repaired TOF were enrolled. The patients were divided into two groups (AT and non-AT). Clinical and electrophysiologic data were studied.
Results
The mean age was 34 years. Twenty-three patients had AT (30 %). In AT group, the left ventricular ejection fraction was lower (58 ± 6 vs 62 ± 5; P = 0.011), the right and left atrial area (cm2) was larger (29 ± 13 vs 15 ± 5; P < 0.001, and 19 ± 3 vs 16 ± 4; P < 0.001, respectively), and the right ventricular S′ wave (cm/s) was smaller (8 ± 2 vs 10 ± 3; P = 0.029).
Patients with AT underwent catheter ablation, and 32 AT were ablated. The mechanism of AT was intra-atrial reentrant tachycardia in 14 AT (44 %), cavotricuspid isthmus-dependent in 12 AT (37 %), and focal activity in the remaining 6 AT (19 %). An important finding was that after the first AT was ablated, another AT was induced in 7 patients. The mechanism was focal in about half of them, in contrast to the first ablated AT, where the focal mechanism was the least common. After a median follow-up of 37 months, four patients had AT recurrence.
Conclusion
The patients with AT had biventricular dysfunction and bi-atrial dilatation. Aggressive induction and ablation of the induced AT may reduce the future AT recurrence.
背景：修复法洛四联症（TOF）的患者现在寿命更长。然而，心律失常在修复TOF的成年人中变得普遍，尤其是心房性心动过速。目的探讨心房心动过速（AT）患者的特点及临床和诱发性心房心动过速的发生机制。方法入选77例修复性TOF患者。患者分为AT组和非AT组。研究临床和电生理数据。结果患者平均年龄34岁。23例患者有AT（30%）。AT组左室射血分数较低（58±6 vs 62±5）；P = 0.011)，左右心房面积（cm2）较大(29±13 vs 15±5；P & lt;0.001, 19±3 vs 16±4；P & lt;右心室S波（cm/ S）较小(8±2 vs 10±3；p = 0.029)。AT患者行导管消融，32例AT消融。AT的发生机制为14例（44%）心房再入性心动过速，12例（37%）心房再入性心动过速，其余6例（19%）心房再入性心动过速。一个重要的发现是，在第一个AT消融后，7例患者又诱导了另一个AT。与第一次消融AT相比，其中大约一半的机制是焦点性的，焦点机制是最不常见的。中位随访37个月后，4例AT复发。结论AT患者存在双室功能障碍和双房扩张。积极诱导和消融诱发的AT可能减少未来AT的复发。
{"title":"Atrial tachycardia in patients with repaired tetralogy of Fallot; its characteristics and catheter ablation outcome","authors":"Qasim J. Naeemah , Miyako Igarashi , Noor K. Albakaa , Yuichi Hanaki , Noboru Ichihara , Chihiro Ota , Akira Kimata , Kojiro Ogawa , Naoto Kawamatsu , Tomoko Machino , Yuki Komatsu , Hiro Yamasaki , Akihiko Nogami , Masaki Ieda , Tomoko Ishizu","doi":"10.1016/j.ijcchd.2024.100558","DOIUrl":"10.1016/j.ijcchd.2024.100558","url":null,"abstract":"<div><h3>Background</h3><div>Patients with repaired tetralogy of Fallot (TOF) now live longer. However, dysrhythmia becomes prevalent in adults with repaired TOF, especially atrial tachyarrhythmia.</div></div><div><h3>Objective</h3><div>To identify the characteristics of patients who develop atrial tachycardia (AT) and the mechanism of the clinical AT and the induced one.</div></div><div><h3>Method</h3><div>Seventy-seven patients with repaired TOF were enrolled. The patients were divided into two groups (AT and non-AT). Clinical and electrophysiologic data were studied.</div></div><div><h3>Results</h3><div>The mean age was 34 years. Twenty-three patients had AT (30 %). In AT group, the left ventricular ejection fraction was lower (58 ± 6 vs 62 ± 5; <em>P</em> = 0.011), the right and left atrial area (cm<sup>2</sup>) was larger (29 ± 13 vs 15 ± 5; <em>P</em> < 0.001, and 19 ± 3 vs 16 ± 4; <em>P</em> < 0.001, respectively), and the right ventricular S′ wave (cm/s) was smaller (8 ± 2 vs 10 ± 3; <em>P</em> = 0.029).</div><div>Patients with AT underwent catheter ablation, and 32 AT were ablated. The mechanism of AT was intra-atrial reentrant tachycardia in 14 AT (44 %), cavotricuspid isthmus-dependent in 12 AT (37 %), and focal activity in the remaining 6 AT (19 %). An important finding was that after the first AT was ablated, another AT was induced in 7 patients. The mechanism was focal in about half of them, in contrast to the first ablated AT, where the focal mechanism was the least common. After a median follow-up of 37 months, four patients had AT recurrence.</div></div><div><h3>Conclusion</h3><div>The patients with AT had biventricular dysfunction and bi-atrial dilatation. Aggressive induction and ablation of the induced AT may reduce the future AT recurrence.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100558"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-15DOI: 10.1016/j.ijcchd.2025.100576
Renée S. Joosen , Michiel Voskuil , Wieke G. de Pater , Sebastiaan W.H. van Wijk , Dominika Suchá , Abraham van Wijk , Heleen B.van der Zwaan , Gregor J. Krings , Tim Takken , Johannes M.P.J. Breur
Background
Patients with transposition of the great arteries (TGA) experience reduced exercise capacity after the arterial switch operation (ASO), possibly due to limited stroke volume. This study evaluates the role of stroke volume in reduced exercise capacity in these patients.
Methods
A retrospective analysis was conducted on TGA patients who underwent a transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) within one year between September 2009 and February 2024 at the University Medical Center Utrecht. Excluding those with submaximal CPET results, the remaining patients were divided into <18 and ≥ 18 years old groups. Reduced exercise capacity was defined as a peak oxygen uptake (VO2peak) with a Z-score < -2. Left and right ventricular (LV and RV) data including volumes, function, strain and RV outflow tract obstructions were collected from TTE and CMR.
Results
A total of 126 patients (72 % male, mean age 19 ± 8 years) were included. Left ventricular function, RV volumes, function and strain were relatively preserved on CMR. Reduced VO2peak was seen in 55 % of patients ≥18 years, significantly more than those <18 years (23 %, p < 0.001). Reduced VO2peak was independently associated with time since ASO, body mass index, peak heat rate (HRpeak), and O2pulse. VO2peak showed weak to moderate correlations with time after ASO (R = −0.295,p < 0.001), body mass index (R = −0.468,p < 0.001) and HRpeak (R = 0.270,p = 0.002) and a strong correlation with O2pulse (R = 0.621,p < 0.001).
Conclusion
Exercise capacity in TGA patients after ASO might be limited by an impaired ability to increase stroke volume.
{"title":"Does stroke volume limit exercise capacity in TGA patients after the arterial switch operation?","authors":"Renée S. Joosen , Michiel Voskuil , Wieke G. de Pater , Sebastiaan W.H. van Wijk , Dominika Suchá , Abraham van Wijk , Heleen B.van der Zwaan , Gregor J. Krings , Tim Takken , Johannes M.P.J. Breur","doi":"10.1016/j.ijcchd.2025.100576","DOIUrl":"10.1016/j.ijcchd.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Patients with transposition of the great arteries (TGA) experience reduced exercise capacity after the arterial switch operation (ASO), possibly due to limited stroke volume. This study evaluates the role of stroke volume in reduced exercise capacity in these patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on TGA patients who underwent a transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) within one year between September 2009 and February 2024 at the University Medical Center Utrecht. Excluding those with submaximal CPET results, the remaining patients were divided into <18 and ≥ 18 years old groups. Reduced exercise capacity was defined as a peak oxygen uptake (VO<sup>2</sup>peak) with a Z-score < -2. Left and right ventricular (LV and RV) data including volumes, function, strain and RV outflow tract obstructions were collected from TTE and CMR.</div></div><div><h3>Results</h3><div>A total of 126 patients (72 % male, mean age 19 ± 8 years) were included. Left ventricular function, RV volumes, function and strain were relatively preserved on CMR. Reduced VO<sup>2</sup>peak was seen in 55 % of patients ≥18 years, significantly more than those <18 years (23 %, p < 0.001). Reduced VO<sup>2</sup>peak was independently associated with time since ASO, body mass index, peak heat rate (HRpeak), and O<sup>2</sup>pulse. VO<sup>2</sup>peak showed weak to moderate correlations with time after ASO (R = −0.295,p < 0.001), body mass index (R = −0.468,p < 0.001) and HRpeak (R = 0.270,p = 0.002) and a strong correlation with O<sup>2</sup>pulse (R = 0.621,p < 0.001).</div></div><div><h3>Conclusion</h3><div>Exercise capacity in TGA patients after ASO might be limited by an impaired ability to increase stroke volume.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100576"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-20DOI: 10.1016/j.ijcchd.2024.100559
Joshua J. Price , Kalani Ruiz , Jaewon Lim , Yuli Kim , Jonathan Buber
Background
Despite increasing frequency of pregnancies among patients with cardiac conditions, including the presence of prosthetic heart valves, data on the effects of physiological changes during pregnancy on the function of bioprosthetic valves remains scarce and shows conflicting results.
Objectives
This study was aimed to determine the effect of pregnancy on the rate of bioprosthetic structural valve degeneration.
Methods
We designed a retrospective matched cohort study of patients seen between June 2018 and February 2023. All pregnant patients with bioprosthetic valves were matched to non-pregnant controls with prior valve replacement based on bioprosthetic valve location, time since valve implantation, age of the patient at valve implantation and time between baseline and follow up echocardiograms. Echocardiograms of pregnant patients were evaluated for bioprosthetic structural valve degeneration grade based on a dedicated scale before and after pregnancy. Non-pregnant controls had echocardiogram scoring of structural valve degeneration over a similar time period.
Results
Thirty four pregnant patients with bioprosthetic valves in the pulmonary, aortic and mitral positions were matched with 71 non-pregnant controls with identical bioprosthetic valves locations. Over a median follow up period of 13.5 months that included the gestational period, 18 (53 %) pregnant patients had an increase in structural valve degeneration score as compared to 17 (26 %) of the non-pregnant patients in median follow up of 13.7 months (OR 3.87, p = 0.004). On multivariable analysis, pregnancy was the only variable associated with increased structural valve degeneration score.
Conclusions
Our results suggest that pregnancy is associated with increased bioprosthetic structural valve degeneration.
尽管有心脏疾病的患者怀孕的频率越来越高，包括人工心脏瓣膜的存在，但关于怀孕期间生理变化对生物人工心脏瓣膜功能影响的数据仍然很少，并且结果相互矛盾。目的探讨妊娠对人工瓣膜退行性变发生率的影响。方法我们设计了一项回顾性匹配队列研究，纳入了2018年6月至2023年2月期间就诊的患者。根据生物瓣膜置换术的位置、瓣膜置换术的时间、瓣膜置换术患者的年龄以及基线和随访超声心动图之间的时间，将所有接受生物瓣膜置换术的孕妇与未接受过瓣膜置换术的未怀孕对照组进行匹配。采用超声心动图对妊娠患者在妊娠前后的生物假体结构瓣膜退行性变分级进行评价。未怀孕的对照组在相似的时间内有结构性瓣膜变性的超声心动图评分。结果34例在肺动脉、主动脉和二尖瓣位置放置生物瓣膜的孕妇与71例具有相同生物瓣膜位置的非妊娠对照组匹配。在包括妊娠期在内的中位随访13.5个月期间，18例（53%）妊娠患者的结构性瓣膜退变评分增加，而在中位随访13.7个月期间，17例（26%）非妊娠患者的结构性瓣膜退变评分增加（OR 3.87, p = 0.004）。在多变量分析中，妊娠是唯一与结构性瓣膜变性评分增加相关的变量。结论妊娠与生物假体结构瓣膜变性增加有关。
{"title":"Effect of pregnancy on bioprosthetic structural valve degeneration","authors":"Joshua J. Price , Kalani Ruiz , Jaewon Lim , Yuli Kim , Jonathan Buber","doi":"10.1016/j.ijcchd.2024.100559","DOIUrl":"10.1016/j.ijcchd.2024.100559","url":null,"abstract":"<div><h3>Background</h3><div>Despite increasing frequency of pregnancies among patients with cardiac conditions, including the presence of prosthetic heart valves, data on the effects of physiological changes during pregnancy on the function of bioprosthetic valves remains scarce and shows conflicting results.</div></div><div><h3>Objectives</h3><div>This study was aimed to determine the effect of pregnancy on the rate of bioprosthetic structural valve degeneration.</div></div><div><h3>Methods</h3><div>We designed a retrospective matched cohort study of patients seen between June 2018 and February 2023. All pregnant patients with bioprosthetic valves were matched to non-pregnant controls with prior valve replacement based on bioprosthetic valve location, time since valve implantation, age of the patient at valve implantation and time between baseline and follow up echocardiograms. Echocardiograms of pregnant patients were evaluated for bioprosthetic structural valve degeneration grade based on a dedicated scale before and after pregnancy. Non-pregnant controls had echocardiogram scoring of structural valve degeneration over a similar time period.</div></div><div><h3>Results</h3><div>Thirty four pregnant patients with bioprosthetic valves in the pulmonary, aortic and mitral positions were matched with 71 non-pregnant controls with identical bioprosthetic valves locations. Over a median follow up period of 13.5 months that included the gestational period, 18 (53 %) pregnant patients had an increase in structural valve degeneration score as compared to 17 (26 %) of the non-pregnant patients in median follow up of 13.7 months (OR 3.87, p = 0.004). On multivariable analysis, pregnancy was the only variable associated with increased structural valve degeneration score.</div></div><div><h3>Conclusions</h3><div>Our results suggest that pregnancy is associated with increased bioprosthetic structural valve degeneration.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100559"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-31DOI: 10.1016/j.ijcchd.2025.100572
Hall Skaara
{"title":"My journey with pulmonary hypertension: From diagnosis to thriving","authors":"Hall Skaara","doi":"10.1016/j.ijcchd.2025.100572","DOIUrl":"10.1016/j.ijcchd.2025.100572","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100572"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143265824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-12DOI: 10.1016/j.ijcchd.2025.100574
Francesca D'Aiuto , Jeanie Suvan , Nisachon Siripaiboonpong , Michael A. Gatzoulis , Francesco D'Aiuto
Oral health is increasingly recognized as a vital component of general health, influencing various systemic systems. Periodontal diseases, particularly periodontitis, a chronic inflammatory condition affecting the gums and supporting tissues of teeth, have far-reaching implications beyond the oral cavity. Treating periodontitis not only benefits oral health but also plays a crucial role in reducing the burden of these chronic conditions, improving patient outcomes and lowering healthcare costs. Regular screenings for oral health issues, especially in patients with conditions such as cardiovascular disease or diabetes, should become standard practice in medical settings. Additionally, oral health professionals must be empowered to identify early signs of systemic diseases, creating a bidirectional flow of referrals between dentists and physicians. Ultimately, prioritizing oral health not only enhances individual well-being but also serves the greater public health good.
{"title":"The root of the matter: Linking oral health to chronic diseases prevention","authors":"Francesca D'Aiuto , Jeanie Suvan , Nisachon Siripaiboonpong , Michael A. Gatzoulis , Francesco D'Aiuto","doi":"10.1016/j.ijcchd.2025.100574","DOIUrl":"10.1016/j.ijcchd.2025.100574","url":null,"abstract":"<div><div>Oral health is increasingly recognized as a vital component of general health, influencing various systemic systems. Periodontal diseases, particularly periodontitis, a chronic inflammatory condition affecting the gums and supporting tissues of teeth, have far-reaching implications beyond the oral cavity. Treating periodontitis not only benefits oral health but also plays a crucial role in reducing the burden of these chronic conditions, improving patient outcomes and lowering healthcare costs. Regular screenings for oral health issues, especially in patients with conditions such as cardiovascular disease or diabetes, should become standard practice in medical settings. Additionally, oral health professionals must be empowered to identify early signs of systemic diseases, creating a bidirectional flow of referrals between dentists and physicians. Ultimately, prioritizing oral health not only enhances individual well-being but also serves the greater public health good.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100574"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-31DOI: 10.1016/j.ijcchd.2024.100564
Ioannis Kasouridis , Heather Probert , Michael A. Gatzoulis
{"title":"Cardiac rehabilitation in ACHD: Further investment is now due","authors":"Ioannis Kasouridis , Heather Probert , Michael A. Gatzoulis","doi":"10.1016/j.ijcchd.2024.100564","DOIUrl":"10.1016/j.ijcchd.2024.100564","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100564"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-11-29DOI: 10.1016/j.ijcchd.2024.100555
Polona Kačar , Pietro Paolo Tamborrino , Giulia Iannaccone , Gianfranco Butera , Margarita Brida , Katja Prokšelj , Michael A. Gatzoulis , Claudia Montanaro
Hypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects (CHD), characterized by a hypoplastic left ventricle (LV), dominant right ventricle (RV) and small left-sided heart structures. The introduction of the Norwood operation has significantly improved outcomes, with 5-year survival reported up to 65 %. Despite these advances, post-operative morbidity and mortality remain high, and the long-term complications in adult survivors represent a challenge. The number of HLHS patients with Fontan circulation is expected to double in the next 20 years, leading to a growing population requiring specialized care from adult congenital heart disease (ACHD) teams.
This article reviews current management strategies for HLHS, outlines potential long-term complications, and highlights existing knowledge gaps. Specific considerations in this population include the assessment of the neo-aorta and aortic arch, and systemic RV dysfunction in the setting of a Fontan circulation. The proposed surveillance strategy emphasizes the need for vigilant monitoring and timely intervention to treat the complications unique to this population, ensuring better outcomes for HLHS patients reaching adulthood.
{"title":"Hypoplastic left heart syndrome (HLHS) becomes of age: Assessing the young adult with HLHS including the neoaorta/aortic arch","authors":"Polona Kačar , Pietro Paolo Tamborrino , Giulia Iannaccone , Gianfranco Butera , Margarita Brida , Katja Prokšelj , Michael A. Gatzoulis , Claudia Montanaro","doi":"10.1016/j.ijcchd.2024.100555","DOIUrl":"10.1016/j.ijcchd.2024.100555","url":null,"abstract":"<div><div>Hypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects (CHD), characterized by a hypoplastic left ventricle (LV), dominant right ventricle (RV) and small left-sided heart structures. The introduction of the Norwood operation has significantly improved outcomes, with 5-year survival reported up to 65 %. Despite these advances, post-operative morbidity and mortality remain high, and the long-term complications in adult survivors represent a challenge. The number of HLHS patients with Fontan circulation is expected to double in the next 20 years, leading to a growing population requiring specialized care from adult congenital heart disease (ACHD) teams.</div><div>This article reviews current management strategies for HLHS, outlines potential long-term complications, and highlights existing knowledge gaps. Specific considerations in this population include the assessment of the neo-aorta and aortic arch, and systemic RV dysfunction in the setting of a Fontan circulation. The proposed surveillance strategy emphasizes the need for vigilant monitoring and timely intervention to treat the complications unique to this population, ensuring better outcomes for HLHS patients reaching adulthood.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100555"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-11DOI: 10.1016/j.ijcchd.2024.100556
Jamil Aboulhosn
{"title":"The Ahmanson/UCLA adult congenital heart disease center, at UCLA, los angeles, USA: The history of a leading ACHD institution and its vision for the future","authors":"Jamil Aboulhosn","doi":"10.1016/j.ijcchd.2024.100556","DOIUrl":"10.1016/j.ijcchd.2024.100556","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100556"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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