{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T14:14:08Z","timestamp":1770473648189,"version":"3.49.0"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Manfred Roth Stiftung F\u00fcrth"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background: Advances in diagnosis and treatment have led to a growing population of adults with congenital heart disease (ACHD). Despite increasing life expectancy, their clinical needs\u2014especially in older age\u2014remain poorly defined. Cardiac and non-cardiac comorbidities are prevalent, and emerging evidence suggests accelerated biological aging compared to the general population. However, data on older patients and geriatric patients with CHD are limited. Objectives: This study aimed to characterize patients with CHD aged \u226550 years, focusing on functional status, comorbidities, sex-specific differences, and therapeutic patterns. Methods: The PATHFINDER-CHD Registry is a prospective, observational, multicenter registry enrolling patients with CHD with manifest heart failure (HF), HF history, or high HF risk. Data include anatomy, prior treatments, comorbidities, and medication use. Results: Among 1935 patients, 297 were \u226550 years old. Most had acyanotic CHD (62%); Tetralogy of Fallot (21%) was the most frequent diagnosis. A morphologic right systemic ventricle was present in 12%, and 5% had univentricular hearts. HF was manifest in 21%; 44% were classified as ACC\/AHA stage B, 51% as stage C, yet 77% were in Perloff class I\/II. Common cardiovascular comorbidities included aortopathy (55%), hypertension (37%), and arrhythmia (33%). Non-cardiac comorbidities included thyroid dysfunction (25%), renal impairment (18%), and neurological disease (13%). Sex-specific differences were observed. Despite HF burden, SGLT2 inhibitors and ARNIs were used in only 17% and 8.4%, respectively. Conclusions: Older patients with CHD represent a clinically complex cohort with high comorbidity burden. The findings support the concept of accelerated aging and emphasize the need for tailored interdisciplinary care strategies.<\/jats:p>","DOI":"10.3390\/geriatrics10060152","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T14:21:54Z","timestamp":1763648514000},"page":"152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dual Disease Burden: Growing Older with Congenital Heart Disease and Hereditary Metabolic and Connective Tissue Disorders\u2014Data from the PATHFINDER-CHD Registry on Heart Failure"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-7632","authenticated-orcid":false,"given":"Ann-Sophie","family":"Kaemmerer-Suleiman","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1817-4207","authenticated-orcid":false,"given":"Frank","family":"Harig","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Freiberger","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5216-7978","authenticated-orcid":false,"given":"Oliver","family":"Dewald","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aysenur","family":"Akyol","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Dreher","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Engel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-1190","authenticated-orcid":false,"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3755-6481","authenticated-orcid":false,"given":"Sebastian","family":"Freilinger","sequence":"additional","affiliation":[{"name":"Chair of Preventive Pediatrics, Department Health and Sport Sciences, School of Medicine and Health, Technical University Munich, 80333 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-1424","authenticated-orcid":false,"given":"J\u00fcrgen","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Paediatric Heart Surgery, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, European Kids Heart Center, University Hospital Gro\u00dfhadern, Ludwig-Maximilians-University Munich (LMU), 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Clinic III for Internal Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-7064","authenticated-orcid":false,"given":"Stefan","family":"Holdenrieder","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2673-4772","authenticated-orcid":false,"given":"Robert David","family":"Pittrow","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0789-2684","authenticated-orcid":false,"given":"Harald","family":"Kaemmerer","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"Kaulitz","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Universit\u00e4tsklinikum T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-182X","authenticated-orcid":false,"given":"Frank","family":"Klawonn","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Infection Research, Biostatistics, Technical University Braunschweig, 38124 Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-3410","authenticated-orcid":false,"given":"Christian","family":"Meierhofer","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Montenbruck","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Nagdyman","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhoia","family":"Neidenbach","sequence":"additional","affiliation":[{"name":"Department of Sport and Human Movement Science, University of Vienna, 1010 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Ury","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5335-2725","authenticated-orcid":false,"given":"Leonard Bernhard","family":"Pittrow","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1639-0421","authenticated-orcid":false,"given":"Benjamin Alexander","family":"Pittrow","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-0862","authenticated-orcid":false,"given":"Fabian","family":"von Scheidt","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Wolfrum","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Huntgeburth","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, University Hospital of the Technical University, 80636 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelagija","family":"Zlatic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-9888","authenticated-orcid":false,"given":"Mathieu N.","family":"Suleiman","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fritz","family":"Mellert","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.5830\/CVJA-2013-028","article-title":"The global burden of congenital heart disease","volume":"24","author":"Hoffman","year":"2013","journal-title":"Cardiovasc. 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BMJ Open, 11.","DOI":"10.1136\/bmjopen-2021-049531"}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/10\/6\/152\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T14:27:37Z","timestamp":1763648857000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/10\/6\/152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["geriatrics10060152"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics10060152","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]}}}