Metabolic Syndrome in Adult Congenital Heart Disease

被引:13
作者
Niwa, Koichiro [1 ,2 ]
机构
[1] St Lukes Int Hosp, Cardiovasc Ctr, Dept Cardiol, Tokyo, Japan
[2] St Lukes Int Hosp, Cardiovasc Ctr, Dept Cardiol, Chuo Ku, 9-1 Akashi Cho, Tokyo 1048560, Japan
关键词
Adult congenital heart disease; Metabolic syndrome; Cardiovascular diseases; Coronary artery disease; Cyanotic congenital heart disease; ARTERIAL SWITCH OPERATION; EXERCISE-INDUCED HYPERTENSION; CARDIOVASCULAR RISK-FACTORS; LEFT-VENTRICULAR MASS; CORONARY-ARTERIES; PHYSICAL-ACTIVITY; SCIENTIFIC STATEMENT; BLOOD-PRESSURE; WORKING GROUP; EXPERT PANEL;
D O I
10.4070/kcj.2019.0187
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In adult congenital heart disease (ACHD), residua and sequellae after initial repair develop late complications such as cardiac failure, arrhythmias, thrombosis, aortopathy, pulmonary hypertension and others. Acquired lesions with aging such as hypertension, diabetes mellitus, obesity can be negative influence on original cardiovascular disease (CVD). Also, atherosclerosis may pose an additional health problem to ACHD when they grow older and reach the age at which atherosclerosis becomes clinically relevant. In spite of the theoretical risk of atherosclerosis in ACHD due to above mentioned factors, cyanotic ACHDs even after repair are noted to have minimal incidence of coronary artery disease (CAD). Acyanotic ACHD has similar prevalence of CAD as the general population. However, even in cyanotic ACHD, CAD can develop when they have several risk factors for CAD. The prevalence of risk factor is similar between ACHD and the general population. Risk of premature atherosclerotic CVD in ACHD is based, 3 principal mechanisms: lesions with coronary artery abnormalities, obstructive lesions of left ventricle and aorta such as coarctation of the aorta and aortopathy. Coronary artery abnormalities are directly affected or altered surgically, such as arterial switch in transposition patients, may confer greater risk for premature atherosclerotic CAD. Metabolic syndrome is more common among ACHD than in the general population, and possibly increases the incidence of atherosclerotic CAD even in ACHD in future. Thus, ACHD should be screened for metabolic syndrome and eliminating risk factors for atherosclerotic CAD.
引用
收藏
页码:691 / 708
页数:18
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