{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:23:10Z","timestamp":1783016590681,"version":"3.54.6"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Neurocognitive impairment is a common complication of congenital heart disease (CHD) as well as acquired cardiovascular disease. Data are limited on neurocognitive function in adults with CHD (ACHD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 1020 individuals with mild\u2010to\u2010moderate ACHD and 497\u00a0987 individuals without ACHD from the volunteer\u2010based UK Biobank study underwent neurocognitive tests for fluid intelligence, reaction time, numeric memory, symbol\u2010digit substitution, and trail making at enrollment and follow\u2010up. Performance scores were compared before and after exclusion of preexisting stroke or coronary artery disease as measures of cerebro\u2010 and cardiovascular disease. Individuals with ACHD had significantly poorer performance on alpha\u2010numeric trail making, a measure of visual attention and cognitive flexibility, spending 6.4\u00a0seconds longer on alpha\u2010numeric trail making (95% CI, 3.0\u20139.9\u00a0seconds,\n              <jats:italic>P<\/jats:italic>\n              =0.002) and 2.5\u00a0seconds longer on numeric trail making (95% CI, 0.5\u20134.6\u00a0seconds,\n              <jats:italic>P<\/jats:italic>\n              =0.034), a measure of visual attention and processing speed. The ACHD cohort had modestly lower performance on symbol\u2010digit substitution, a measure of processing speed, with 0.9 fewer correct substitutions (95% CI,\u00a0\u2212\u00a01.5 to\u00a0\u2212\u00a00.2 substitutions,\n              <jats:italic>P<\/jats:italic>\n              =0.021). After excluding preexisting stroke or coronary artery disease, individuals with ACHD continued to show poorer performance in all 6 domains (\n              <jats:italic>P<\/jats:italic>\n              =NS).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Individuals with mild\u2010to\u2010moderate ACHD had poorer neurocognitive performance, most significantly in tests of cognitive flexibility, analogous to deficits in children with CHD. These differences appear to be driven by increased burden of cerebro\u2010 and cardiovascular disease among individuals with ACHD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015379","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T08:57:26Z","timestamp":1601283446000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Adults With Mild\u2010to\u2010Moderate Congenital Heart Disease Demonstrate Measurable Neurocognitive Deficits"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-0106","authenticated-orcid":false,"given":"Melissa L.","family":"Perrotta","sequence":"first","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Medicine Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Pediatrics University of Louisville School of Medicine and Norton Children\u2019s Hospital Louisville KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5106-9751","authenticated-orcid":false,"given":"Priyanka","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Pediatrics University of Washington School of Medicine Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Zawadzki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Beidelman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Ingelsson","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Medicine Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George K.","family":"Lui","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Medicine Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Priest","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine Palo Alto CA"},{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital and Stanford University School of Medicine Palo Alto CA"},{"name":"Chan\u2010Zuckerberg Biohub San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12409"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.064113"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu299"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019881"},{"key":"e_1_3_2_6_2","first-page":"1708","volume-title":"Moss & Adams\u2019 Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult","author":"Goldberg CS","year":"2012","unstructured":"Goldberg CS, Newburger JW. 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