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Prevalence and composition of CHD at different altitudes in Tibet: a cross-sectional study

Published online by Cambridge University Press:  10 April 2017

Jian-Yong Zheng ,
Yi-Gang Qiu ,
Dong-Tao Li ,
Jiang-Chun He ,
Yu Chen ,
Yi Cao ,
Ying-Ming Liu ,
Xian-Feng Li ,
Hai-Tao Chi  and
Tian-Chang Li
Jian-Yong Zheng
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yi-Gang Qiu
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Dong-Tao Li
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Jiang-Chun He
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yu Chen
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yi Cao
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Ying-Ming Liu
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Xian-Feng Li
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Hai-Tao Chi
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Tian-Chang Li*
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
*
Correspondence to: T.-C. Li, Department of Cardiology, PLA Navy General Hospital, No. 6 Fucheng Road, Haidian District, Beijing 100048, People’s Republic of China. Tel: +86-10-66951511; Fax: +86-10-68780185; E-mail: ltc909@163.com
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Abstract

Background

The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.

Methods and results

In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.

Conclusions

A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.

Keywords

CHDhigh altitudeprevalencecompositionage
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1497 - 1503
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Copyright
© Cambridge University Press 2017 

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Footnotes

*

Jian-Yong Zheng, Yi-Gang Qiu and Dong-Tao Li contributed equally to this study, and should be considered as co-first authors.

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