Pujol Claudia, Schiele Sandra, Maurer Susanne J, Hock Julia, Fritz Celina, Hager Alfred, Ewert Peter, Tutarel Oktay
Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University of Munich, 80636 Munich, Germany.
Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, 80636 Munich, Germany.
J Clin Med. 2020 Dec 18;9(12):4085. doi: 10.3390/jcm9124085.
Single-ventricle physiology (SVP) is associated with significant morbidity and mortality at a young age. However, survival prospects have improved and risk factors for a negative outcome are well described in younger cohorts. Data regarding older adults is scarce.
In this study, SVP patients under active follow-up at our center who were ≥40 years of age at any point between January 2005 and December 2018 were included. Demographic data, as well as medical/surgical history were retrieved from hospital records. The primary end-point was all-cause mortality.
Altogether, 49 patients (19 female (38.8%), mean age 49.2 ± 6.4 years) were included. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8-8.5). Of these patients, 40 (81.6%) had undergone at least one cardiac surgery. The most common extracardiac comorbidities were thyroid dysfunction ( = 27, 55.1%) and renal disease ( = 15, 30.6%). During follow-up, 10 patients (20.4%) died. On univariate analysis, renal disease and liver cirrhosis were predictors of all-cause mortality. On multivariate analysis, only renal disease (hazard ratio (HR): 12.5, 95% confidence interval (CI): 1.5-106.3, = 0.021) remained as an independent predictor.
SVP patients ≥40 years of age are burdened with significant morbidity and mortality. Renal disease is an independent predictor of all-cause mortality.
单心室生理（SVP）与年轻时的高发病率和死亡率相关。然而，生存前景已有所改善，且年轻队列中不良结局的危险因素已得到充分描述。关于老年人的数据却很稀少。
在本研究中，纳入了2005年1月至2018年12月期间在我们中心接受积极随访且在任何时间点年龄≥40岁的SVP患者。从医院记录中获取人口统计学数据以及医疗/手术史。主要终点是全因死亡率。
共纳入49例患者（19例女性（38.8%），平均年龄49.2±6.4岁）。中位随访时间为4.9年（四分位间距（IQR）：1.8 - 8.5）。这些患者中，40例（81.6%）至少接受过一次心脏手术。最常见的心脏外合并症是甲状腺功能障碍（n = 27，55.1%）和肾脏疾病（n = 15，30.6%）。随访期间，10例患者（20.4%）死亡。单因素分析显示，肾脏疾病和肝硬化是全因死亡率的预测因素。多因素分析显示，只有肾脏疾病（风险比（HR）：12.5，95%置信区间（CI）：1.5 - 106.3，P = 0.021）仍然是独立预测因素。
年龄≥40岁的SVP患者负担着显著的发病率和死亡率。肾脏疾病是全因死亡率的独立预测因素。
