Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark.
Department of Clinical Medicine Aarhus University Aarhus N Denmark.
J Am Heart Assoc. 2023 Aug 15;12(16):e028538. doi: 10.1161/JAHA.122.028538. Epub 2023 Aug 7.
Background Older adults with a congenital ventricular septal defect (VSD) recently exhibited reduced heart rate variability and exercise capacity. It is unknown whether these findings affect health-related quality of life. Methods and Results Adults with VSDs and healthy controls, all concurrently included as part of another clinical study, completed the Danish National Health Survey questionnaire. Questionnaire data distributed to the general population were included and matched 10:1 with patients. Thirty patients with surgically closed VSDs (mean±SD age, 51±8 years), 300 adults from the general population (mean±SD age, 50±8 years), and 30 controls (mean±SD age, 51±9 years), as well as 30 patients with unrepaired VSDs (mean±SD age, 55±11 years), 300 adults from the general population (mean±SD age, 55±12 years), and 30 controls (mean±SD age, 55±10 years) completed the questionnaire. Educational level, social relations, and physical activity were comparable between groups. A larger proportion of patients with unrepaired VSDs compared with the general population experienced migraine (47% versus 24%; =0.04), whereas more patients with surgically closed VSDs were affected by depression (13% versus 4%; =0.02). For health-related quality of life, patients with surgically closed VSDs reported lower physical functioning (<0.01), physical component summary (<0.01), general health perception (<0.01), and higher stress score (=0.03) compared with the general population and healthy controls. Patients with unrepaired VSDs reported lower scores on physical functioning (=0.03), bodily pain (<0.01), and mental health (=0.02), and a higher stress score (=0.03), than controls. Conclusions Older patients with VSDs report lower self-perceived physical functioning, lower general health, and higher stress levels, all in line with previous findings, like lower exercise capacity and dysfunctional cognitive abilities, in adults with VSDs. Incessant follow-up is paramount, as neither successfully closed nor hemodynamically insignificant VSD is equivalent with untroubled healthy aging. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03684161.
背景 最近，患有先天性室间隔缺损 (VSD) 的老年人表现出心率变异性和运动能力降低。目前尚不清楚这些发现是否会影响健康相关的生活质量。
方法和结果 同时作为另一项临床研究的一部分，纳入了 VSD 患者和健康对照者，他们都完成了丹麦国家健康调查问卷。该问卷的数据来自一般人群，且与患者 10:1 匹配。30 名接受过手术修复的 VSD 患者（平均年龄±标准差，51±8 岁）、300 名来自一般人群的成年人（平均年龄±标准差，50±8 岁）和 30 名对照组（平均年龄±标准差，51±9 岁），以及 30 名未修复的 VSD 患者（平均年龄±标准差，55±11 岁）、300 名来自一般人群的成年人（平均年龄±标准差，55±12 岁）和 30 名对照组（平均年龄±标准差，55±10 岁）完成了问卷调查。各组之间的教育水平、社会关系和体力活动相当。与一般人群相比，未修复 VSD 的患者偏头痛的比例更大（47%对 24%；=0.04），而手术修复的 VSD 患者抑郁的比例更高（13%对 4%；=0.02）。在健康相关的生活质量方面，与一般人群和健康对照组相比，手术修复的 VSD 患者的身体机能（<0.01）、身体成分综合评分（<0.01）、总体健康感（<0.01）和压力评分（=0.03）较低。未修复 VSD 的患者的身体机能（=0.03）、躯体疼痛（<0.01）和心理健康（=0.02）评分较低，压力评分（=0.03）较高。
结论 老年 VSD 患者自我感知的身体机能、一般健康状况和压力水平较低，这些都与先前的研究结果一致，如 VSD 患者的运动能力降低和认知功能障碍。应进行持续的随访，因为无论是成功修复的 VSD 还是血流动力学无意义的 VSD，都与健康的衰老不同。
