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Cognitive function in adults with Fontan palliation versus acyanotic CHD patients and association with health-related quality of life

Published online by Cambridge University Press:  25 November 2022

Julia Remmele Open the ORCID record for Julia Remmele [Opens in a new window] ,
Milka Pringsheim ,
Nicole Nagdyman ,
Renate Oberhoffer-Fritz  and
Peter Ewert
Julia Remmele*
Affiliation:
German Heart Center of Munich, Department of Congenital Heart Disease and Pediatric Cardiology, Munich, Germany Institute of Preventive Pediatrics Technical University Munich, Munich, Germany
Milka Pringsheim
Affiliation:
German Heart Center of Munich, Department of Congenital Heart Disease and Pediatric Cardiology, Munich, Germany
Nicole Nagdyman
Affiliation:
German Heart Center of Munich, Department of Congenital Heart Disease and Pediatric Cardiology, Munich, Germany
Renate Oberhoffer-Fritz
Affiliation:
German Heart Center of Munich, Department of Congenital Heart Disease and Pediatric Cardiology, Munich, Germany Institute of Preventive Pediatrics Technical University Munich, Munich, Germany
Peter Ewert
Affiliation:
German Heart Center of Munich, Department of Congenital Heart Disease and Pediatric Cardiology, Munich, Germany
*
Author for correspondence: Julia Remmele, Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center of Munich, Lazarettstrasse 36, 80636 Munich, Germany. Tel: +49 89 1218 1570. E-mail: remmele@dhm.mhn.de
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Abstract

Background:

Impairments and developmental delay are often reported in infants and young children with CHD. However, currently, there is no data regarding cognitive abilities assessed by standardised intelligence tests in adults with CHD. This study assesses the cognitive function in Fontan patients compared with acyanotic CHD patients whether restrictions in cognitive function are present in adulthood and its association with health-related quality of life.

Methods:

Forty-four adult CHD (female n = 21 (47.7%); mean age 34.7 ± 11.9 years), 22 with Fontan circulation and 22 with acyanotic CHD, underwent the Wechsler Intelligence Scale for adults as patients during routine follow-up in 2018. The Medical Outcomes Study Questionnaire Short-Form 36 Health Survey (SF-36) assessed health-related quality of life.

Results:

Fontan patients showed significantly better results in the FSIQ (p = 0.020) and perceptual reasoning (p = 0.017) in comparison with patients with acyanotic CHD. All adult CHD patients showed normal IQ in subscales and full-scale IQ (FSIQ). In health-related quality of life, no association with cognitive function was found and no significant difference between both CHD groups, but trends to reduced values in acyanotic adult CHD.

Conclusions:

Interestingly, our study results in adult Fontan patients showed that it is possible to live an adult life with normal cognitive function and good health-related quality of life with a univentricular heart. Thus, this study could be a guidepost for more in-depth studies on cognitive function in Fontan survivors. In addition, the focus should be on health-related quality of life of adult CHD with simple CHD in particular, since a reduced health-related quality of life is not only medically based.

Keywords

adult CHDcognitive functionFontan patientshealth-related quality of life
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 1956 - 1961
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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