Publications

BibTex format

@article{Krishnathasan:2023:eurjpc/zwad094,
author = {Krishnathasan, K and Dimopoulos, K and Duncan, N and Ricci, P and Kempny, A and Rafiq, I and Gatzoulis, M and Heng, EL and Blakey, S and Montanaro, C and Babu-Narayan, S and Francis, D and Li, W and Constantine, A},
doi = {eurjpc/zwad094},
journal = {European Journal of Preventive Cardiology},
pages = {1335--1342},
title = {Advanced heart failure in adult congenital heart disease: the role of renal dysfunction in management and outcomes},
url = {http://dx.doi.org/10.1093/eurjpc/zwad094},
volume = {30},
year = {2023}
}

Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsPrevious studies in adult congenital heart disease (CHD) have demonstrated a link between renal dysfunction and mortality. However, the prognostic significance of renal dysfunction in CHD and decompensated heart failure (HF) remains unclear. We sought to assess the association between renal dysfunction and outcomes in adults with CHD presenting to our centre with acute HF between 2010 and 2021.Methods and resultsThis retrospective analysis focused on the association between renal dysfunction, pre-existing and on admission, and outcomes during and after the index hospitalization. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate <60mL/min/1.73m2. Cox regression analysis was used to identify the predictors of death post-discharge. In total, 176 HF admissions were included (mean age 47.7 ± 14.5 years, 43.2% females). One-half of patients had a CHD of great complexity, 22.2% had a systemic right ventricle, and 18.8% had Eisenmenger syndrome. Chronic kidney disease was present in one-quarter of patients. The median length of intravenous diuretic therapy was 7 (4–12) days, with a maximum dose of 120 (80–160) mg furosemide equivalents/day, and 15.3% required inotropic support. The in-hospital mortality rate was 4.5%. The 1- and 5-year survival rates free of transplant or ventricular assist device (VAD) post-discharge were 75.4% [95% confidence interval (CI): 69.2–82.3%] and 43.3% (95% CI: 36–52%), respectively. On multivariable Cox analysis, CKD was the strongest predictor of mortality or transplantation/VAD. Highly complex CHD and inpatient requirement of inotropes also remained predictive of an adverse outcome.ConclusionAdult patients with CHD admitted with acute HF are a high-risk cohort. CKD is common and triples the risk of death/transplantation/VAD. An expert multidisciplinary approach is essential for optimizing outcomes.
AU  - Krishnathasan,K
AU  - Dimopoulos,K
AU  - Duncan,N
AU  - Ricci,P
AU  - Kempny,A
AU  - Rafiq,I
AU  - Gatzoulis,M
AU  - Heng,EL
AU  - Blakey,S
AU  - Montanaro,C
AU  - Babu-Narayan,S
AU  - Francis,D
AU  - Li,W
AU  - Constantine,A
DO  - eurjpc/zwad094
EP  - 1342
PY  - 2023///
SN  - 2047-4873
SP  - 1335
TI  - Advanced heart failure in adult congenital heart disease: the role of renal dysfunction in management and outcomes
T2  - European Journal of Preventive Cardiology
UR  - http://dx.doi.org/10.1093/eurjpc/zwad094
UR  - https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwad094/7088575
UR  - http://hdl.handle.net/10044/1/103564
VL  - 30
ER  -

Download

DrSonyaBabu-Narayan

Contact

Location

Summary

Citation

BibTex format

RIS format (EndNote, RefMan)