Data on the prevalence of depression in adult congenital heart disease(ACHD)patients differ widely.We aim to summarize the best available information on the prevalence of depression,its prognostic impact,and psychiatr...Data on the prevalence of depression in adult congenital heart disease(ACHD)patients differ widely.We aim to summarize the best available information on the prevalence of depression,its prognostic impact,and psychiatric interventions for depressed ACHD patients.We reviewed references in relevant publications up to October 17,2017.For homogeneity of data,studies in which depression was independently assessed in patients aged 18 years or older or with a mean/median age older than 18 years were included.Retrospective and postoperative evaluation studies were excluded.Twenty publications met these criteria.Study samples included ACHD patients followed up at ACHD-specialized hospitals in 13 countries.The prevalence of depression differed widely,ranging from 6 to 69%.Depression has been shown to be an independent predictor of adverse clinical outcomes.It is also frequently associated with other prognostic variables(i.e.,poor functional class,unfavorable perceived health status,and low quality of life).Currently,no randomized clinical trials on psychiatric interventions in ACHD are available.In summary,depression is highly prevalent in ACHD patients,yet it is often unrecognized and untreated.The adverse prognostic impact of depression calls for specialized psychiatric interventions,for which more research is needed in the ACHD patient population.展开更多
Background Aortic valve stenosis(with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degene...Background Aortic valve stenosis(with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degenerative or atherosclerotic disease. Methods and Results We examined operatively excised, stenotic aortic valves from 932 patients aged 26 to 91 years(mean± SD, 70± 12), and none had associated mitral valve replacement or evidence of mitral stenosis: A total of 504(54% ) had congenitally malformed valves(unicuspid in 46[unicommissural in 42; acommissural in 4] and bicuspid in 458); 417(45% ) had tricuspid valves(either absent or minimal commissural fusion); and 11(1% ) had valves of undetermined type. It is likely that the latter 11 valves also had been congenitally malformed. Of the 584 men, 343(59% ) had either a unicuspid or a bicuspid valve; of the 348 women, 161(46% ) had either a unicuspid or a bicuspid aortic valve. Conclusions The data from this large study of adults having isolated aortic valve replacement for aortic stenosis(with or without associated aortic regurgitation) and without associated mitral stenosis or mitral valve replacement strongly suggest that an underlying congenitally malformed valve, at least in men, is more common than a tricuspid aortic valve.展开更多
文摘Data on the prevalence of depression in adult congenital heart disease(ACHD)patients differ widely.We aim to summarize the best available information on the prevalence of depression,its prognostic impact,and psychiatric interventions for depressed ACHD patients.We reviewed references in relevant publications up to October 17,2017.For homogeneity of data,studies in which depression was independently assessed in patients aged 18 years or older or with a mean/median age older than 18 years were included.Retrospective and postoperative evaluation studies were excluded.Twenty publications met these criteria.Study samples included ACHD patients followed up at ACHD-specialized hospitals in 13 countries.The prevalence of depression differed widely,ranging from 6 to 69%.Depression has been shown to be an independent predictor of adverse clinical outcomes.It is also frequently associated with other prognostic variables(i.e.,poor functional class,unfavorable perceived health status,and low quality of life).Currently,no randomized clinical trials on psychiatric interventions in ACHD are available.In summary,depression is highly prevalent in ACHD patients,yet it is often unrecognized and untreated.The adverse prognostic impact of depression calls for specialized psychiatric interventions,for which more research is needed in the ACHD patient population.
文摘Background Aortic valve stenosis(with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degenerative or atherosclerotic disease. Methods and Results We examined operatively excised, stenotic aortic valves from 932 patients aged 26 to 91 years(mean± SD, 70± 12), and none had associated mitral valve replacement or evidence of mitral stenosis: A total of 504(54% ) had congenitally malformed valves(unicuspid in 46[unicommissural in 42; acommissural in 4] and bicuspid in 458); 417(45% ) had tricuspid valves(either absent or minimal commissural fusion); and 11(1% ) had valves of undetermined type. It is likely that the latter 11 valves also had been congenitally malformed. Of the 584 men, 343(59% ) had either a unicuspid or a bicuspid valve; of the 348 women, 161(46% ) had either a unicuspid or a bicuspid aortic valve. Conclusions The data from this large study of adults having isolated aortic valve replacement for aortic stenosis(with or without associated aortic regurgitation) and without associated mitral stenosis or mitral valve replacement strongly suggest that an underlying congenitally malformed valve, at least in men, is more common than a tricuspid aortic valve.
