Nartowicz Sonia Alicja, Jakielska Ewelina, Ratajczak Piotr, Lesiak Maciej, Trojnarska Olga
1st Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
J Clin Med. 2024 May 27;13(11):3127. doi: 10.3390/jcm13113127.
Congenitally corrected transposition of the great arteries (cc-TGA) is a defect characterized by arterio-ventricular and atrioventricular disconcordance. Most patients have co-existing cardiac abnormalities that warrant further treatment. Some patients do not require surgical intervention, but most undergo physiological repair or anatomical surgery, which enables them to reach adulthood. We aimed to evaluate mortality risk factors in patients with cc-TGA. We searched the PubMed database and included 10 retrospective cohort studies with at least a 5-year follow-up time with an end-point of cardiovascular death a minimum of 30 days after surgery. We enrolled 532 patients, and 83 met the end-point of cardiovascular death or equivalent event. As a risk factor for long-term mortality, we identified New York Heart Association (NYHA) class ≥III/heart failure hospitalization (OR = 10.53; 95% CI, 3.17-34.98) and systemic ventricle dysfunction (SVD; OR = 4.95; 95% CI, 2.55-9.64). We did not show history of supraventricular arrhythmia (OR = 2.78; 95% CI, 0.94-8.24), systemic valve regurgitation ≥moderate (SVR; OR = 4.02; 95% Cl, 0.84-19.18), and pacemaker implantation (OR = 1.48; 95% Cl, 0.12-18.82) to affect the long-term survival. In operated patients only, SVD (OR = 4.69; 95% CI, 2.06-10.71) and SVR (OR = 3.85; 95% CI, 1.5-9.85) showed a statistically significant impact on survival. The risk factors for long-term mortality for the entire cc-TGA population are NYHA class ≥III/heart failure hospitalization and systemic ventricle dysfunction. In operated patients, systemic ventricle dysfunction and at least moderate systemic valve regurgitation were found to affect survival.
先天性矫正型大动脉转位（cc-TGA）是一种以动脉-心室和房室不一致为特征的缺陷。大多数患者伴有需要进一步治疗的心脏异常。一些患者不需要手术干预，但大多数患者会接受生理性修复或解剖手术，从而能够成年。我们旨在评估cc-TGA患者的死亡风险因素。我们检索了PubMed数据库，纳入了10项回顾性队列研究，这些研究至少有5年的随访时间，终点为术后至少30天的心血管死亡。我们纳入了532例患者，其中83例达到心血管死亡或等效事件的终点。作为长期死亡的风险因素，我们确定纽约心脏协会（NYHA）分级≥III级/心力衰竭住院（OR = 10.53；95%CI，3.17 - 34.98）和体心室功能障碍（SVD；OR = 4.95；95%CI，2.55 - 9.64）。我们未发现室上性心律失常病史（OR = 2.78；95%CI，0.94 - 8.24）、中度及以上的体循环瓣膜反流（SVR；OR = 4.02；95%CI，0.84 - 19.18）和起搏器植入（OR = 1.48；95%CI，0.12 - 18.82）会影响长期生存。仅在接受手术的患者中，SVD（OR = 4.69；95%CI，2.06 - 10.71）和SVR（OR = 3.85；95%CI，1.5 - 9.85）对生存有统计学显著影响。整个cc-TGA人群长期死亡的风险因素是NYHA分级≥III级/心力衰竭住院和体心室功能障碍。在接受手术的患者中，发现体心室功能障碍和至少中度的体循环瓣膜反流会影响生存。
