{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:57Z","timestamp":1791355977273,"version":"4.3.1"},"reference-count":27,"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":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">As survival into adulthood improves for patients with congenital heart disease (CHD), quality of that survival is paramount. We assessed health\u2010related quality of life (HRQL) in a large adult CHD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We studied 868 participants from a multicenter registry with complete Pediatric Quality of Life Inventory 4.0 Generic Core Scale and covariate data. Analyses followed 3 stages: CHD complexity across HRQL score bands, predictors of worse or better HRQL, and predictors of HRQL in severe CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Pediatric Quality of Life Inventory total scores were high (median 76.1, interquartile range 64.1\u201387.0), highest in Social functioning, with longer lower tails for Emotional and Psychosocial scales. Severe CHD was over\u2010represented in the lower and under\u2010represented in the upper 15% bands (Total HRQL:\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). At the 15th percentile, worse HRQL was linked to severe CHD (\u22125.9; 95% CI \u221211.6 to \u22120.1), poor transition support (\u221211.2; 95% CI \u221218.6 to \u22123.9), mood disorder (\u221212.7; 95% CI \u221218.3 to \u22127.1), and diabetes (\u221216.6; 95% CI \u221229.9 to \u22123.3); at the 85th percentile, to severe CHD (\u22125.2; 95% CI \u22129.2 to \u22121.1), mood disorder (\u22127.3; 95% CI \u221211.7 to \u22123.0), anxiety disorder (\u22125.6; 95% CI \u22129.7 to \u22121.5). In severe CHD, poor transition support and mood or anxiety disorders (odds ratio [OR] 0.48, 0.30, and 0.36, respectively;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01) markedly increased the odds of worse HRQL. Very well\u2010supported transition (OR 1.91) was associated with better HRQL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In adult CHD, anatomic complexity contributes modestly to HRQL extremes. Modifiable predictors (transition experience, mental\u2010health comorbidity, location, and diabetes) emerge as key targets to improve HRQL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049379","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:33:57Z","timestamp":1789738437000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Health\u2010Related Quality of Life in Adults With Congenital Heart Disease: A\u00a0Population\u2010Based Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0574-7918","authenticated-orcid":false,"given":"Tanya","family":"Badal","sequence":"first","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8259-0654","authenticated-orcid":false,"given":"William","family":"Baxter","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7698-4278","authenticated-orcid":false,"given":"Larissa","family":"Lloyd","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8431-6523","authenticated-orcid":false,"given":"Sasha","family":"Ruban","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0518-3339","authenticated-orcid":false,"given":"Calum","family":"Nicholson","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-7119","authenticated-orcid":false,"given":"Geoff","family":"Strange","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred Hospital","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rutherford","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-0439","authenticated-orcid":false,"given":"David S.","family":"Celermajer","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Camperdown, Australia"]},{"name":"Heart Research Institute","place":["Newtown, Australia"]},{"name":"Royal Prince Alfred 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