Bordin Giulia, Padalino Massimo Antonio, Perentaler Sonja, Castaldi Biagio, Maschietto Nicola, Michieli Pierantonio, Crepaz Roberto, Frigo Anna Chiara, Vida Vladimiro Lorenzo, Milanesi Ornella
Pediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy,
Pediatr Cardiol. 2015 Aug;36(6):1261-9. doi: 10.1007/s00246-015-1156-y. Epub 2015 Apr 2.
Increasingly, more patients with univentricular heart reach adulthood. Therefore, long-term psychological features are an important concern. The aim of this study was to evaluate the clinical and psychological profile of post-Fontan adult patients and to identify the most significant determinants of quality of life. In this retrospective cross-sectional study, we reviewed the surgical and medical history of post-Fontan adult patients. Patients underwent a 24-h electrocardiogram, echocardiography and exercise testing. Self-report questionnaires were used to assess the Work Ability Index, quality of life (Satisfaction with Life Scale), perceived health status (SF-36 questionnaire), coping strategies (Brief Cope questionnaire) and presence of mood disorders (Hospital Anxiety and Depression Scale). Thirty-nine patients aged between 18 and 48 years (mean 27.5 years) were enrolled. The mean follow-up was 21.5 years. Most patients were unmarried (82.9 %), had a high school diploma (62.9 %) and were employed (62.9 %). Twenty-nine patients (82.3 %) had at least one long-term complication. The median single ventricle ejection fraction was 57 %, and the median maximal oxygen consumption was 26.8 ml/min/kg. This population tended to be anxious and to use adaptive coping strategies. Quality of life was perceived as excellent or good in 57.2 % of cases and was not related to either cardiac function or exercise capacity. Both quality of life and SF-36 domains were related to the Work Ability Index. This cohort of post-Fontan adult patients enjoyed a good quality of life irrespective of disease severity.
越来越多的单心室心脏病患者步入成年期。因此，长期的心理特征成为一个重要关注点。本研究的目的是评估Fontan手术后成年患者的临床和心理状况，并确定生活质量的最重要决定因素。在这项回顾性横断面研究中，我们查阅了Fontan手术后成年患者的手术和病史。患者接受了24小时心电图、超声心动图和运动测试。使用自我报告问卷来评估工作能力指数、生活质量（生活满意度量表）、感知健康状况（SF-36问卷）、应对策略（简易应对问卷）和情绪障碍的存在情况（医院焦虑抑郁量表）。纳入了39名年龄在18至48岁之间（平均27.5岁）的患者。平均随访时间为21.5年。大多数患者未婚（82.9%），拥有高中文凭（62.9%）且有工作（62.9%）。29名患者（82.3%）至少有一种长期并发症。单心室射血分数中位数为57%，最大耗氧量中位数为26.8毫升/分钟/千克。这群人往往容易焦虑，并采用适应性应对策略。57.2%的患者认为生活质量优秀或良好，且生活质量与心脏功能或运动能力均无关。生活质量和SF-36各领域均与工作能力指数相关。这组Fontan手术后的成年患者不论疾病严重程度如何，都享有良好的生活质量。
