Sing Alan C, Tsaur Stephen, Paridon Stephen M, Brothers Julie A
1The Children's Hospital of Philadelphia,Division of Cardiology,Philadelphia,Pennsylvania,United States of America.
2Perelman School of Medicine at the University of Pennsylvania,Philadelphia,Pennsylvania,United States of America.
Cardiol Young. 2017 Jul;27(5):895-904. doi: 10.1017/S1047951116001542. Epub 2016 Sep 26.
Anomalous aortic origin of a coronary artery is a congenital cardiac condition that can be associated with increased risk of sudden death. To date, quality of life and exercise performance have not been evaluated in patients with this condition who do not undergo surgical repair.
We carried out a cross-sectional analysis of patients with unoperated anomalous aortic origin of a coronary artery at our institution from 1 January, 2000 to 31 January, 2016. We prospectively assessed quality of life using standardised questionnaires. Medical records were reviewed for clinical and exercise stress test data. Statistical analyses were performed using Student's t-tests and Spearman's correlation coefficients.
In total, 56 families completed the questionnaires. The average age at enrolment was 14.7±6 years. The majority were male (n=44, 78.6%) and had interarterial anomalous right coronary artery (n=38, 67.9%). Patients had normal quality of life on the PedsQL 4.0 Report, Child Health Questionnaire Child Form 87, and SF-36v2. Their parents had normal quality of life on the PedsQL 4.0 Parent Report, but parents of exercise-restricted patients had decreased Physical Functioning, General Health Perception, Emotional Impact on Parent, and Physical Summary scores (p<0.001-0.048) on the Child Health Questionnaire Parent Form 50.
Patients with unoperated anomalous aortic origin of a coronary artery appear to have normal quality of life, but parents of exercise-restricted patients have decreased general health and emotional and physical quality of life scores. Improved counselling of families may be beneficial in this group. Future studies with more patients should evaluate quality of life and exercise performance over time.
冠状动脉异常起源于主动脉是一种先天性心脏疾病,可能与猝死风险增加有关。迄今为止,尚未对未接受手术修复的此类患者的生活质量和运动能力进行评估。
我们对2000年1月1日至2016年1月31日在我院未接受手术治疗的冠状动脉异常起源于主动脉的患者进行了横断面分析。我们使用标准化问卷前瞻性地评估生活质量。查阅病历以获取临床和运动应激试验数据。使用学生t检验和Spearman相关系数进行统计分析。
共有56个家庭完成了问卷。入组时的平均年龄为14.7±6岁。大多数为男性(n = 44,78.6%),且右冠状动脉为动脉间异常起源(n = 38,67.9%)。患者在儿童生活质量量表4.0报告、儿童健康问卷儿童版87以及简明健康调查问卷第2版上的生活质量正常。他们的父母在儿童生活质量量表4.0家长报告上的生活质量正常,但运动受限患者的父母在儿童健康问卷家长版50上的身体功能、总体健康感知、对家长的情绪影响以及身体综合评分有所下降(p<0.001 - 0.048)。
未接受手术治疗的冠状动脉异常起源于主动脉的患者生活质量似乎正常,但运动受限患者的父母总体健康以及情绪和身体生活质量评分有所下降。改善对家庭的咨询可能对此类患者有益。未来纳入更多患者的研究应评估生活质量和运动能力随时间的变化情况。