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Congenital Heart Disease: Advances in Clinical Diagnosis and Management
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Congenital Heart Disease: Advances in Clinical Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 2919

Special Issue Editor

Dr. Efrén Martínez-Quintana

E-Mail Website
Guest Editor
Department of Cardiology, Complejo Hospitalario Universitario Insular-Materno Infantil, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Interests: congenital heart disease; pulmonary arterial hypertension; complexity; cyanosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent decades, there have been important advances in patients with congenital heart diseases that have allowed many of them to reach adulthood. In fact, currently 85% of neonates with congenital heart disease survive into adult life. These advances include genetic factors recognized as playing an important role in cardiovascular malformations, the detection of congenital heart disease using fetal echocardiography, anesthetic management, noninvasive imaging options, including cardiac magnetic resonance (CMR) imaging, cardiac computed tomography (CT), and nuclear scintigraphy, cardiovascular surgery, percutaneous interventions, intensive care, as well as improvements in pharmacotherapy. Also, the diagnosis and management of late complications in adult congenital heart disease patients is of paramount importance as residual and sequelae may progress in terms of severity with age, inducing late complications, such as arrhythmias, cardiac failure, renal and liver disease, thromboembolism, aortopathy, cyanosis, pulmonary arterial hypertension, infective endocarditis, or mental health and psychological problems due to the need to cope with stress, anxiety, or depression. In addition to this, we find that there are challenges faced by the parents of patients with congenital heart disease. The goal of this Special Issue is to provide a very contemporary and practical approach to congenital heart disease patients, from childhood to adulthood, through original research and review articles with the aim of updating the advances in clinical diagnosis and management in the field of congenital heart disease.

Dr. Efrén Martínez-Quintana
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • congenital heart disease
  • fetal
  • childhood
  • adults
  • genetic
  • imaging
  • surgery
  • percutaneous
  • complications
  • psychological

Published Papers (5 papers)

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Research

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12 pages, 456 KiB  
Article
C-Reactive Protein and Long-Term Prognosis in Adult Patients with Congenital Heart Disease
by Efrén Martínez-Quintana, María Alcántara-Castellano, Marta Isabel García-Suárez and Fayna Rodríguez-González
J. Clin. Med. 2024, 13(8), 2199; https://doi.org/10.3390/jcm13082199 - 11 Apr 2024
Viewed by 787
Abstract
Background/Objectives: Prognostic biomarkers may provide information about the patient’s cardiovascular outcomes. However, there are doubts regarding how high-sensitivity C-reactive protein (hs-CRP) impacts patients with congenital heart disease (CHD). The main objective is to evaluate whether high hs-CRP levels predict a worse prognosis [...] Read more.
Background/Objectives: Prognostic biomarkers may provide information about the patient’s cardiovascular outcomes. However, there are doubts regarding how high-sensitivity C-reactive protein (hs-CRP) impacts patients with congenital heart disease (CHD). The main objective is to evaluate whether high hs-CRP levels predict a worse prognosis in patients with CHD. Methods: Observational and prospective cohort study. Adult CHD patients and controls were matched for age and sex. Results: In total, 434 CHD patients (cases) and 820 controls were studied. The median age in the CHD patients was 30 (18–62) years and 256 (59%) were male. A total of 51%, 30%, and 19% of patients with CHD had mild, moderate, and great complexity defects, respectively. The body mass index [1.07 (1.01–1.13), p = 0.022)], diabetes mellitus [3.57 (1.07–11.97), p = 0.039], high NT-pro-BNP levels [1.00 (1.00–1.01), p = 0.021], and low serum iron concentrations [0.98 (0.97–0.99), p = 0.001] predicted high hs-CRP levels (≥0.3 mg/dL) in patients with CHD. During a follow-up time of 6.81 (1.17–10.46) years, major cardiovascular events (MACE) occurred in 40 CHD patients, showing the Kaplan–Meier test demonstrated a worse outcome among patients with hs-CRP levels above 0.3 mg/dL (p = 0.012). Also, hs-CRP showed statistical significance in the univariate Cox regression survival analysis. However, after adjusting for other variables, this significance was lost and the remaining predictors of MACE were age [HR 1.03 (1.01–1.06), p = 0.001], great complexity defects [HR 2.46 (1.07–5.69), p = 0.035], and an NT pro-BNP cutoff value for heart failure > 125 pg/mL [HR 7.73 (2.54–23.5), p < 0.001]. Conclusions: Hs-CRP obtained statistical significance in the univariate survival analysis. However, this significance was lost in the multivariate analysis in favor of age, CHD complexity, and heart failure. Full article
(This article belongs to the Special Issue Congenital Heart Disease: Advances in Clinical Diagnosis and Management)
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Review

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22 pages, 4406 KiB  
Review
Advances in Diagnostic and Interventional Catheterization in Adults with Fontan Circulation
by Yassin Belahnech, Gerard Martí Aguasca and Laura Dos Subirà
J. Clin. Med. 2024, 13(16), 4633; https://doi.org/10.3390/jcm13164633 (registering DOI) - 7 Aug 2024
Viewed by 179
Abstract
Over the past five decades, the Fontan procedure has been developed to improve the life expectancy of patients with congenital heart defects characterized by a functionally single ventricle. The Fontan circulation aims at redirecting systemic venous return to the pulmonary circulation in the [...] Read more.
Over the past five decades, the Fontan procedure has been developed to improve the life expectancy of patients with congenital heart defects characterized by a functionally single ventricle. The Fontan circulation aims at redirecting systemic venous return to the pulmonary circulation in the absence of an impelling subpulmonary ventricle, which makes this physiology quite fragile and leads to several long-term complications. Despite the importance of hemodynamic assessment through cardiac catheterization in the management and follow-up of these patients, a thorough understanding of the ultimate functioning of this type of circulation is lacking, and the interpretation of the hemodynamic data is often complex. In recent years, new tools such as combined catheterization with cardiopulmonary exercise testing have been incorporated to improve the understanding of the hemodynamic profile of these patients. Furthermore, extensive percutaneous treatment options have been developed, addressing issues ranging from obstructive problems in Fontan pathway and acquired shunts through compensatory collaterals to the percutaneous treatment of lymphatic circulation disorders and transcatheter edge-to-edge repair of atrioventricular valves. The aim of this review is to detail the various tools used in cardiac catheterization for patients with Fontan circulation, analyze different percutaneous treatment strategies, and discuss the latest advancements in this field. Full article
(This article belongs to the Special Issue Congenital Heart Disease: Advances in Clinical Diagnosis and Management)
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15 pages, 303 KiB  
Review
Updates in Arrhythmia Management in Adult Congenital Heart Disease
by Adam J. Small, Matthew Dai, Dan G. Halpern and Reina Bianca Tan
J. Clin. Med. 2024, 13(15), 4314; https://doi.org/10.3390/jcm13154314 - 24 Jul 2024
Viewed by 435
Abstract
Arrhythmias are highly prevalent in adults with congenital heart disease. For the clinician caring for this population, an understanding of pathophysiology, diagnosis, and management of arrhythmia is essential. Herein we review the latest updates in diagnostics and treatment of tachyarrhythmias and bradyarrhythmias, all [...] Read more.
Arrhythmias are highly prevalent in adults with congenital heart disease. For the clinician caring for this population, an understanding of pathophysiology, diagnosis, and management of arrhythmia is essential. Herein we review the latest updates in diagnostics and treatment of tachyarrhythmias and bradyarrhythmias, all in the context of congenital anatomy, hemodynamics, and standard invasive palliations for congenital heart disease. Full article
(This article belongs to the Special Issue Congenital Heart Disease: Advances in Clinical Diagnosis and Management)
15 pages, 3063 KiB  
Review
Update on Transcatheter Interventions in Adults with Congenital Heart Disease
by Angela Li and Jamil A. Aboulhosn
J. Clin. Med. 2024, 13(13), 3685; https://doi.org/10.3390/jcm13133685 - 25 Jun 2024
Viewed by 433
Abstract
The field of adult congenital interventions is unique in the world of cardiac catheterization, combining the structural concepts commonly employed in pediatric heart disease and applying them to adult patients, who are more amenable to device intervention as they no longer experience somatic [...] Read more.
The field of adult congenital interventions is unique in the world of cardiac catheterization, combining the structural concepts commonly employed in pediatric heart disease and applying them to adult patients, who are more amenable to device intervention as they no longer experience somatic growth. Rapid advances in the field have been made to match the growing population of adult patients with congenital heart disease, which currently surpasses the number of pediatric patients born with congenital heart disease. Many congenital defects, which once required surgical intervention or reoperation, can now be addressed via the transcatheter approach, minimizing the morbidity and mortality often encountered within adult congenital surgeries. In this paper, we aim to provide a focused review of the more common procedures that are utilized for the treatment of adult congenital heart disease patients in the catheterization laboratory, as examples of current practices in the United States, as well as emerging concepts and devices awaiting approval in the future. Full article
(This article belongs to the Special Issue Congenital Heart Disease: Advances in Clinical Diagnosis and Management)
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Other

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19 pages, 3806 KiB  
Project Report
KidsTUMove—A Holistic Program for Children with Chronic Diseases, Increasing Physical Activity and Mental Health
by Nicola Stöcker, Dominik Gaser, Renate Oberhoffer-Fritz and Christina Sitzberger
J. Clin. Med. 2024, 13(13), 3791; https://doi.org/10.3390/jcm13133791 - 28 Jun 2024
Viewed by 672
Abstract
The prevalence of chronic diseases in children and adolescents has risen alarmingly worldwide. Diseases such as asthma, diabetes, obesity, mental disorders, and congenital heart defects are increasingly affecting the lives of children and pose significant challenges for the healthcare system. Physical activity plays [...] Read more.
The prevalence of chronic diseases in children and adolescents has risen alarmingly worldwide. Diseases such as asthma, diabetes, obesity, mental disorders, and congenital heart defects are increasingly affecting the lives of children and pose significant challenges for the healthcare system. Physical activity plays a crucial role in preventing and treating these diseases. Numerous studies have shown that regular exercise improves physical performance, increases well-being, and leads to better health in the long term. Specially tailored sports programs that meet the individual needs and abilities of the children and adolescents affected are particularly important. The KidsTUMove project addresses this by developing tailored exercise programs for children with chronic diseases’ specific needs, medical conditions, and physical abilities. Therefore, it closes the gap in care provision and can thus sustainably improve the health prospects of these children and adolescents. KidsTUMove is positioned to make a significant impact on the lives of affected children across Europe. Promotion of such programs should therefore be an integral part of future health strategies. Full article
(This article belongs to the Special Issue Congenital Heart Disease: Advances in Clinical Diagnosis and Management)
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