Respiratory morbidity in children with congenital heart disease - 29/10/21
, N. Bertille b, D. Khraiche c, D. Bonnet c, d, M. Lebourgeois a, F. Goffinet b, d, N. Lelong b, B. Khoshnood b, C. Delacourt a, dfor the EPICARD study group1
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| pages | 5 |
| Iconographies | 2 |
| Vidéos | 0 |
| Autres | 0 |
Abstract |
Objective |
To evaluate the respiratory outcome in children with congenital heart disease (CHD), considering recent management procedures and the CHD pathophysiology.
Design and Setting |
Clinical and functional respiratory outcome were evaluated in 8-year-old children with isolated CHD followed up from birth in the prospective population-based EPICARD cohort.
Patients |
Children were assigned to two groups, based on the pathophysiology of the CHD: CHDs with left-to-right shunt (n = 212) and CHDs with right outflow tract obstruction (n = 113).
Results |
Current wheezing episodes were observed in 15% of the children with isolated CHD and left-to-right shunt, and 11% of the children with isolated CHD and right outflow tract obstruction (not significant). Total lung capacity (TLC) was the only respiratory function parameter that significantly differed between the two groups. It was lower in children with left-to-right shunt (88.72 ± 0.65% predicted) than in those with right outflow tract obstruction (91.84 ± 0.96, p = 0.006). In multivariate analysis, CHD with left-to-right shunt (coeff. [95% CI]: -3.17 [-5.45; -0.89]) and surgery before the age of 2 months (-6.52 [-10.90; -2.15]) were identified as independent factors associated with significantly lower TLC values.
Conclusion |
Lower TLC remains a long-term complication in CHD, particularly in cases with left-to-right shunt and in patients requiring early repair. These findings suggest that an increase in pulmonary blood flow may directly impair lung development.
Le texte complet de cet article est disponible en PDF.Keywords : Lung development, Lung restriction, Lung function tests, Asthma
Plan
| Short title: Respiratory outcome in children with CHD |
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| Funding sources: French Ministry of Health (PHRC AOM11148 et AOM11198), Abbvie Company (ACA-FRAN-12–04). Study sponsors did not interfere with the study design; collection, analysis, and interpretation of data; writing of the report; or decision to submit the manuscript for publication. SG and CD wrote the first draft of the manuscript and received no honorarium grant or other form of payment from study sponsors to produce the manuscript. |
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| Previous communication: Oral communication at E-CPAP 2020 (Sophie GUERIN). |
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| Conflict of interest: None. |
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| List of the EPICARD study group: Johanna Calderon: Department of Psychiatry, Harvard Medical School, Boston, United States et Department of Psychiatry, Cardiac Neurodevelopmental Program, Boston Children's Hospital Jean Marie Jounannic : Fetal Medecine Department, Armand Trousseau Hospital, AP-HP, UPMC-Sorbonne Université, F-75,012 Paris, France Lucile Houyel M3C‐Paediatric Cardiology, Necker Enfants Malades, AP‐HP, Université de Paris, Paris, France Suzel Magnier : Hôpital Robert Debré, AP-HP, Service de cardiologie Jean-François Magny : Department of Neonatology, Necker Enfants Malades AP-HP, Université de Paris, Paris, France Laure Faure: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Claire Andrieu: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Dominique Salomon: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Morgane Ballon: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Ingrid Godard: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Clémentine Tiberghien: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Charlotte Pinabiaux: Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France Anne-Sophie Bouillot: Explorations Fonctionnelles Respiratoires, Necker Enfants Malades, AP‐HP, Paris, France Gwenael Henry: Explorations Fonctionnelles Respiratoires, Necker Enfants Malades, AP‐HP, Paris, France Corinne Rochette: Explorations Fonctionnelles Respiratoires, Necker Enfants Malades, AP‐HP, Paris, France, Marie-Antoinette Urity: Explorations Fonctionnelles Respiratoires, Necker Enfants Malades, AP‐HP, Paris, France |
Vol 28 - N° 7
P. 525-529 - octobre 2021 Retour au numéro
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