{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:06:24Z","timestamp":1788822384668,"version":"build-2803163510"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1688,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Information on the prevalence, outcome and factors associated with heart failure in patients with adult congenital heart disease (CHD) (ACHD-HF) is lacking. We aimed at assessing the prevalence and outcome of ACHD-HF, the variables associated with ACHD-HF, and the differences between major anatomical\/pathophysiological ACHD subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We included 3905 patients (age 35.4 \u00b1 13.2 years) under active follow-up in our institution (last visit &amp;gt;2010). Outcome of ACHD-HF cases was compared with sex- and age-matched cases. Univariable and multivariable binary logistic regression with ACHD-HF diagnosis as a dependent variable was performed. Overall prevalence of ACHD-HF was 6.4% (mean age 49.5 \u00b1 16.7 years), but was higher in patients with cyanotic CHD (41%), Fontan circulation (30%), and a systemic right ventricle (25%). All-cause mortality was higher in ACHD-HF cases when compared with controls (mortality rate ratio 4.67 (2.36\u20139.27); P = 0.0001). In multivariable logistic regression analysis, age at latest follow-up [per 10 years; odds ratio (OR) 1.52; 95% confidence interval (CI) 1.31\u20131.77], infective endocarditis (OR 4.11; 95%CI 1.80\u20139.38), history of atrial arrhythmia (OR 3.52; 95%CI 2.17\u20135.74), pacemaker implantation (OR 2.66; 95% CI 1.50\u20134.72), end-organ dysfunction (OR 2.41; 95% CI 1.03\u20135.63), New York Heart Association class (OR 9.28; 95% CI 6.04\u201314.25), heart rate (per 10 bpm; OR 1.27; 95% CI 1.08\u20131.50), ventricular dysfunction (OR 3.62; 95% CI 2.54\u20135.17), and pulmonary hypertension severity (OR 1.66; 95% CI 1.21\u20132.30) were independently related to the presence of ACHD-HF. Some variables (age, atrial arrhythmia, pacemaker, New York Heart Association, and ventricular dysfunction) were related to ACHD-HF in all anatomical\/physiological subgroups, whereas others were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ACHD-HF is prevalent especially in complex CHD and is associated with poor prognosis. Our data provide insight in the factors related to ACHD-HF including differences between specific anatomical and physiological subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13378","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T19:31:42Z","timestamp":1620502302000},"page":"2940-2950","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Heart Failure Related to Adult Congenital Heart Disease: Prevalence, Outcome and Risk Factors"],"prefix":"10.1093","volume":"8","author":[{"given":"Stijn","family":"Arnaert","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Internal Medicine, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"De Meester","sequence":"additional","affiliation":[{"name":"Division of Structural and Congenital Cardiology, University Hospitals Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Els","family":"Troost","sequence":"additional","affiliation":[{"name":"Division of Structural and Congenital Cardiology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Droogne","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Van Aelst","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Van Cleemput","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Voros","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Gewillig","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Division of Pediatric Cardiology, University Hospitals Leuven , Herestraat 49, Leuven, 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Cools","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Division of Pediatric Cardiology, University Hospitals Leuven , Herestraat 49, Leuven, 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Institute of Health and Care Sciences, University of Gothenborg , Gothenburg ,","place":["Sweden"]},{"name":"Departments of Pediatrics and Child Health, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Rega","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Division of cardiac surgery, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Meyns","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Division of cardiac surgery, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Budts","sequence":"additional","affiliation":[{"name":"Division of Structural and Congenital Cardiology, University Hospitals Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Van De Bruaene","sequence":"additional","affiliation":[{"name":"Division of Structural and Congenital Cardiology, University 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