{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:53:58Z","timestamp":1773809638202,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Previous studies in adult congenital heart disease (CHD) have demonstrated a link between renal dysfunction and mortality. However, the prognostic significance of renal dysfunction in CHD and decompensated heart failure (HF) remains unclear. We sought to assess the association between renal dysfunction and outcomes in adults with CHD presenting to our centre with acute HF between 2010 and 2021.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This retrospective analysis focused on the association between renal dysfunction, pre-existing and on admission, and outcomes during and after the index hospitalization. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate &amp;lt;60 mL\/min\/1.73 m2. Cox regression analysis was used to identify the predictors of death post-discharge. In total, 176 HF admissions were included (mean age 47.7 \u00b1 14.5 years, 43.2% females). One-half of patients had a CHD of great complexity, 22.2% had a systemic right ventricle, and 18.8% had Eisenmenger syndrome. Chronic kidney disease was present in one-quarter of patients. The median length of intravenous diuretic therapy was 7 (4\u201312) days, with a maximum dose of 120 (80\u2013160) mg furosemide equivalents\/day, and 15.3% required inotropic support. The in-hospital mortality rate was 4.5%. The 1- and 5-year survival rates free of transplant or ventricular assist device (VAD) post-discharge were 75.4% [95% confidence interval (CI): 69.2\u201382.3%] and 43.3% (95% CI: 36\u201352%), respectively. On multivariable Cox analysis, CKD was the strongest predictor of mortality or transplantation\/VAD. Highly complex CHD and inpatient requirement of inotropes also remained predictive of an adverse outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Adult patients with CHD admitted with acute HF are a high-risk cohort. CKD is common and triples the risk of death\/transplantation\/VAD. An expert multidisciplinary approach is essential for optimizing outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwad094","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T14:35:30Z","timestamp":1679927730000},"page":"1335-1342","source":"Crossref","is-referenced-by-count":13,"title":["Advanced heart failure in adult congenital heart disease: the role of renal dysfunction in management and outcomes"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7097-6012","authenticated-orcid":false,"given":"Kaushiga","family":"Krishnathasan","sequence":"first","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-0504","authenticated-orcid":false,"given":"Konstantinos","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3820-6859","authenticated-orcid":false,"given":"Neill","family":"Duncan","sequence":"additional","affiliation":[{"name":"Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust , London , UK"},{"name":"Department of Immunology and Inflammation, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piera","family":"Ricci","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kempny","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-7996","authenticated-orcid":false,"given":"Isma","family":"Rafiq","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2700-7232","authenticated-orcid":false,"given":"Michael A","family":"Gatzoulis","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ee Ling","family":"Heng","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Blakey","sequence":"additional","affiliation":[{"name":"Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust , London , UK"},{"name":"Department of Immunology and Inflammation, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Montanaro","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1558-8447","authenticated-orcid":false,"given":"Sonya V","family":"Babu-Narayan","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrel P","family":"Francis","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , London , UK"},{"name":"Hammersmith Hospital, Imperial College Healthcare NHS Trust, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3394-5559","authenticated-orcid":false,"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7899-463X","authenticated-orcid":false,"given":"Andrew","family":"Constantine","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Sydney Street, London SW3 6NP , UK"},{"name":"National Heart and Lung Institute, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"2023092217531629200_zwad094-B1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1161\/CIRCULATIONAHA.113.008396","article-title":"Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010","volume":"130","author":"Marelli","year":"2014","journal-title":"Circulation"},{"key":"2023092217531629200_zwad094-B2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S2352-4642(19)30402-X","article-title":"Global, regional, and national burden of congenital heart disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 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The task force for the management of adult congenital heart disease of the ESC","volume":"42","author":"Baumgartner","journal-title":"Eur Heart J"},{"key":"2023092217531629200_zwad094-B20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12963-015-0063-z","article-title":"Projected growth of the adult congenital heart disease population in the United States to 2050: an integrative systems modeling approach","volume":"13","author":"Benziger","year":"2015","journal-title":"Popul Health Metrics"},{"key":"2023092217531629200_zwad094-B21","first-page":"81","article-title":"Renal function in children with cyanotic congenital heart disease: pre- and post-cardiac surgery evaluation","volume":"24","author":"Amoozgar","year":"2014","journal-title":"Iran J Pediatr"},{"key":"2023092217531629200_zwad094-B22","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.ahj.2019.04.018","article-title":"Creatinine versus cystatin C to estimate glomerular filtration rate in adults with congenital heart disease: results of the Boston Adult Congenital Heart Disease Biobank","volume":"214","author":"Opotowsky","year":"2019","journal-title":"Am Heart J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwad094\/49809357\/zwad094.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/30\/13\/1335\/51717202\/zwad094.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/30\/13\/1335\/51717202\/zwad094.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T17:54:06Z","timestamp":1695405246000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/30\/13\/1335\/7088575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,28]]},"references-count":22,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,3,28]]},"published-print":{"date-parts":[[2023,9,20]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwad094","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,3,28]]}}}