Metabolic syndrome in adults with congenital heart disease and increased intima-media thickness

Congenit Heart Dis. 2019 Nov;14(6):945-951. doi: 10.1111/chd.12845. Epub 2019 Sep 26.

Abstract

Aims: Age-related cardiovascular diseases are a relevant risk in the aging population of adults with congenital heart diseases (ACHD). Risk factors such as the metabolic syndrome (MetS) impact the risk of increased carotid intima-media thickness (cIMT) and thereby long-term cardiovascular diseases. The aim of the study was to assess MetS in ACHD and outline a possible association to cIMT.

Methods and results: In total, 512 ACHD (43.0 ± 9.6 years, 48.9% female) were screened for MetS by the standards of the International Diabetes Federation, and their cIMT by ultrasound from January 2017 to June 2019. MetS was prevalent in 72 (14.1%) of the ACHD population (34 female, 15.5%). Regarding severity class, patients with simple forms of CHD had a MetS prevalence of 11.8%, moderate 16.7%, and severe 13.8%. ACHD with MetS had significantly increased cIMT compared to ACHD without MetS (ACHD with MetS: 0.587 ± 0.079 mm, ACHD without MetS: 0.560 ± 0.087 mm, mean difference: 0.028 mm, P = .013). Such a difference in vascular structure corresponds to roughly five years of normal vascular aging of the vessels.

Conclusion: ACHD with MetS have a thicker cIMT compared to ACHD without MetS. Screening for MetS and targeting risk factors in ACHD might help to prevent structural alterations of the vessels at an early stage.

Keywords: carotid intima-media thickness; congenital heart disease; metabolic syndrome.

MeSH terms

  • Adult
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology*
  • Carotid Intima-Media Thickness*
  • Female
  • Germany / epidemiology
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / epidemiology*
  • Humans
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index

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