PMID- 30269081
OWN - NLM
STAT- MEDLINE
DCOM- 20190502
LR  - 20190502
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 105
IP  - 6
DP  - 2019 Mar
TI  - Hospitalisations for heart failure predict mortality in pulmonary hypertension 
      related to congenital heart disease.
PG  - 465-469
LID - 10.1136/heartjnl-2018-313613 [doi]
AB  - OBJECTIVE: Despite the progress in the management of patients with adult 
      congenital heart disease (ACHD), a significant proportion of patients still 
      develop pulmonary hypertension (PH). We aimed to highlight the rate of the 
      complications in PH-ACHD and the predicting factors of cumulative mortality risk 
      in this population. METHODS: Data were obtained from the cohort of the national 
      registry of ACHD in Greece from February 2012 until January 2018. RESULTS: 
      Overall, 65 patients receiving PH-specific therapy were included (mean age 
      46.1+/-14.4 years, 64.6% females). Heavily symptomatic (New York Heart Association 
      (NYHA) class III/IV) were 53.8% of patients. The majority received monotherapy, 
      while combination therapy was administered in 41.5% of patients. Cardiac 
      arrhythmia was reported in 30.8%, endocarditis in 1.5%, stroke in 4.6%, pulmonary 
      arterial thrombosis in 6.2%, haemoptysis in 3.1% and hospitalisation due to heart 
      failure (HF) in 23.1%. Over a median follow-up of 3 years (range 1-6), 12 (18.5%) 
      patients died. On univariate Cox regression analysis history of HF 
      hospitalisation emerged as a strong predictor of mortality (HR 8.91, 95% CI 2.64 
      to 30.02, p<0.001), which remained significant after adjustment for age and for 
      NYHA functional class. CONCLUSIONS: Long-term complications are common among 
      patients with PH-ACHD. Hospitalisations for HF predict mortality and should be 
      considered in the risk stratification of this population.
CI  - (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Ntiloudi, Despoina
AU  - Ntiloudi D
AD  - Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
FAU - Apostolopoulou, Sotiria
AU  - Apostolopoulou S
AD  - Department of Pediatric Cardiology and ACHD, Onassis Cardiac Surgery Center, 
      Athens, Greece.
FAU - Vasiliadis, Konstantinos
AU  - Vasiliadis K
AD  - Department of Cardiology, General Hospital 'George Papanikolaou', Thessaloniki, 
      Greece.
FAU - Frogoudaki, Alexandra
AU  - Frogoudaki A
AD  - Second Department of Cardiology, Attikon University Hospital, Athens, Greece.
FAU - Tzifa, Aphrodite
AU  - Tzifa A
AD  - Department of Congenital Heart Disease, Mitera Children's Hospital, Athens, 
      Greece.
FAU - Ntellos, Christos
AU  - Ntellos C
AD  - Department of Cardiology, Tzaneio General Hospital of Piraeus, Athens, Greece.
FAU - Brili, Styliani
AU  - Brili S
AD  - Department of Cardiology, Ippokrateion University Hospital, Athens, Greece.
FAU - Manginas, Athanasios
AU  - Manginas A
AD  - Department of Cardiology, Mediterraneo Hospital, Athens, Greece.
FAU - Pitsis, Antonios
AU  - Pitsis A
AD  - Department of Cardiothoracic Surgery, St Luke's Hospital, Thessaloniki, Greece.
FAU - Kolios, Marios
AU  - Kolios M
AD  - Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
FAU - Karvounis, Haralambos
AU  - Karvounis H
AD  - Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
FAU - Tsioufis, Costas
AU  - Tsioufis C
AD  - Department of Cardiology, Ippokrateion University Hospital, Athens, Greece.
FAU - Goudevenos, John
AU  - Goudevenos J
AD  - Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
FAU - Rammos, Spyridon
AU  - Rammos S
AD  - Department of Pediatric Cardiology and ACHD, Onassis Cardiac Surgery Center, 
      Athens, Greece.
FAU - Giannakoulas, George
AU  - Giannakoulas G
AD  - Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
CN  - CHALLENGE investigators
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180929
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Cardiovascular Agents)
SB  - IM
MH  - Adult
MH  - *Arrhythmias, Cardiac/epidemiology/etiology/therapy
MH  - Cardiovascular Agents/*therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Greece/epidemiology
MH  - *Heart Defects, Congenital/complications/mortality
MH  - *Heart Failure/epidemiology/etiology/therapy
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - *Hypertension, Pulmonary/diagnosis/etiology/mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Prognosis
MH  - Registries/statistics & numerical data
MH  - Risk Assessment
MH  - *Stroke/epidemiology/etiology/therapy
OTO - NOTNLM
OT  - congenital heart disease
OT  - heart failure
OT  - secondary pulmonary hypertension
COIS- Competing interests: GG has acted as a consultant and/or received unrestricted 
      educational or research grants from Actelion, Bayer, MSD, GlaxoSmithKline, Lilly, 
      Pfizer and United Therapeutics. AF received travel grants from Actelion and 
      GlaxoSmithKline.
EDAT- 2018/10/01 06:00
MHDA- 2019/05/03 06:00
CRDT- 2018/10/01 06:00
PHST- 2018/05/18 00:00 [received]
PHST- 2018/08/28 00:00 [revised]
PHST- 2018/08/30 00:00 [accepted]
PHST- 2018/10/01 06:00 [pubmed]
PHST- 2019/05/03 06:00 [medline]
PHST- 2018/10/01 06:00 [entrez]
AID - heartjnl-2018-313613 [pii]
AID - 10.1136/heartjnl-2018-313613 [doi]
PST - ppublish
SO  - Heart. 2019 Mar;105(6):465-469. doi: 10.1136/heartjnl-2018-313613. Epub 2018 Sep 
      29.