Surveillance of adults with congenital heart disease: Current guidelines and actual clinical practice.

Congenital heart disease Diagnostic tests Follow-up

Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
16 Apr 2024
Historique:
received: 26 01 2024
revised: 08 03 2024
accepted: 04 04 2024
medline: 19 4 2024
pubmed: 19 4 2024
entrez: 18 4 2024
Statut: aheadofprint

Résumé

Congenital heart disease (CHD) is the most common birth defect with prevalence of 0.8%. Thanks to tremendous progress in medical and surgical practice, nowadays, >90% of children survive into adulthood. Recently European Society of Cardiology (ESC), American College of Cardiology (ACC)/ American Heart Association (AHA) issued guidelines which offer diagnostic and therapeutic recommendations for the different defect categories. However, the type of technical exams and their frequency of follow-up may vary largely between clinicians and centres. We aimed to present an overview of available diagnostic modalities and describe current surveillance practices by cardiologists taking care of adults with CHD (ACHD). A questionnaire was used to assess the frequency cardiologists treating ACHD for at least one year administrated the most common diagnostic tests for ACHD. The most frequently employed diagnostic modalities were ECG and echocardiography for both mild and moderate/complex CHD. Sixty-seven percent of respondents reported that they routinely address psychosocial well-being. Differences exist between reported current clinical practice and published guidelines. This is particularly true for the care of patients with mild lesions. In addition, some differences exist between ESC and American guidelines, with more frequent surveillance suggested by the Americans.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
Congenital heart disease (CHD) is the most common birth defect with prevalence of 0.8%. Thanks to tremendous progress in medical and surgical practice, nowadays, >90% of children survive into adulthood. Recently European Society of Cardiology (ESC), American College of Cardiology (ACC)/ American Heart Association (AHA) issued guidelines which offer diagnostic and therapeutic recommendations for the different defect categories. However, the type of technical exams and their frequency of follow-up may vary largely between clinicians and centres. We aimed to present an overview of available diagnostic modalities and describe current surveillance practices by cardiologists taking care of adults with CHD (ACHD).
METHODS AND RESULTS RESULTS
A questionnaire was used to assess the frequency cardiologists treating ACHD for at least one year administrated the most common diagnostic tests for ACHD. The most frequently employed diagnostic modalities were ECG and echocardiography for both mild and moderate/complex CHD. Sixty-seven percent of respondents reported that they routinely address psychosocial well-being.
CONCLUSION CONCLUSIONS
Differences exist between reported current clinical practice and published guidelines. This is particularly true for the care of patients with mild lesions. In addition, some differences exist between ESC and American guidelines, with more frequent surveillance suggested by the Americans.

Identifiants

DOI: 10.1016/j.ijcard.2024.132022 PMID: 38636602
pubmed: 38636602
pii: S0167-5273(24)00616-8
doi: 10.1016/j.ijcard.2024.132022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

132022

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Auteurs

Jolien W Roos-Hesselink (JW)

Department of Adult Congenital Cardiology, Erasmus Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands. Electronic address: j.roos@erasmusmc.nl.

Chiara Pelosi (C)

Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.

Margarita Brida (M)

Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, Croatia; Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, Guys & St Thomas's NHS Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK.

Julie De Backer (J)

Department of Cardiology and Center for Medical Genetics, Ghent University Hospital, Belgium.

Sabine Ernst (S)

Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, Guys & St Thomas's NHS Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK.

Werner Budts (W)

Department Cardiovascular Sciences (KU Leuven), Congenital and Structural Cardiology (CSC UZ Leuven), Herestraat 49, Leuven B-3000, Belgium.

Helmut Baumgartner (H)

Department of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer Campus 1, Muenster, Germany.

Erwin Oechslin (E)

Toronto Adult Congenital Heart Disease Program, University Health Network, Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada.

Daniel Tobler (D)

Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.

Adrienne H Kovacs (AH)

Equilibria Psychological Health, Toronto, Ontario, Canada.

Giovanni Di Salvo (G)

Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, Guys & St Thomas's NHS Trust, London, UK; Paediatric Cardiology and CHD, University Hospital of Padua, Italy.

Jolanda Kluin (J)

Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands.

Michael A Gatzoulis (MA)

Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, Guys & St Thomas's NHS Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK; Aristotle University Medical School, Thessaloniki, Greece.

Gerhard P Diller (GP)

Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, Guys & St Thomas's NHS Trust, London, UK; Department of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer Campus 1, Muenster, Germany; School of Cardiovascular Medicine & Sciences, Kings College, London WC2R 2LS, UK.

Classifications MeSH