Risk Factors ID'd for SCA in Heart Defect Repair Survivors
(HealthDay News) – In adult survivors of surgery for congenital heart disease (CHD), severe subaortic ventricular systolic dysfunction is a significant and independent predictor of sudden cardiac arrest (SCA).
Pastora Gallego, MD, PhD, of the La Paz University Hospital in Madrid, and colleagues conducted a longitudinal cohort study involving 936 adults (mean age at first examination, 21 years) with previously repaired CHD who had been followed up at a tertiary care facility for a mean period of nine years. Congenital heart defects included tetralogy of Fallot, coarctation of the aorta, transposition complexes, and single ventricle.
During 8,387 person-years of follow-up the researchers found that 22 patients presented with SCA (2.6 per 1,000 person-years). Independent risk factors for SCA were age at initial examination and severely impaired subaortic ventricular systolic function (adjusted hazard ratios, 1.05 and 29, respectively). SCA occurred in 0.7% of patients with non-severe decreased subaortic ventricular function and in 23 percent of those with severe subaortic ventricular systolic dysfunction (P<0.001).
"To our knowledge, this is the first longitudinal cohort study to analyze predictors of SCA in a large population of adult survivors after operation for CHD at <20 years of age," the authors write. "Results indicated that severe systemic ventricular dysfunction has an outstanding role as a dominant multivariate predictor of SCA for all combined diagnoses in this heterogeneous population."