{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:39:22Z","timestamp":1781804362720,"version":"3.54.5"},"reference-count":30,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Heart Foundation (\u201cDeutsche Herzstiftung e.V.\u201d)"},{"name":"\u201cHerzkind e.V.\u201d"},{"name":"\u201cF\u00f6rderverein Deutsches Herzzentrum M\u00fcnchen e.V.\u201d"},{"name":"\u201cGesellschaft f\u00fcr Pr\u00e4vention e.V. (GPeV)\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The PATHFINDER-CHD Registry is a prospective, multicenter, non-interventional registry across tertiary care centers in Germany. The aim is to analyze real-world data on adults with congenital heart defects (ACHD) or hereditary connective tissue disorders who have manifest heart failure (HF), a history of HF, or are at significant risk of developing HF. This analysis investigates the prevalence and clinical impact of overweight and obesity in this unique population. Methods: As of 1st February, 2025, a total of 1490 ACHD had been enrolled. The mean age was 39.4 \u00b1 12.4 years, and 47.9% were female. Patients were categorized according to Perloff\u2019s functional class and the Munich Heart Failure Classification for Congenital Heart Disease (MUC-HF-Class). Results: The most common congenital heart disease (CHD) in this cohort was Tetralogy of Fallot, transposition of the great arteries, and congenital aortic valve disease. Marfan syndrome was the most common hereditary connective tissue disease. Of the patients, 46.1% were classified as overweight (32.8%) or obese (13.3%), while 4.8% were underweight. The highest prevalence of overweight (47.1%) was observed among patients who had undergone palliative surgery, whereas untreated patients showed the highest proportion of normal weight (57.2%). Cyanotic patients were predominantly of normal weight. Patients with univentricular circulation exhibited significantly lower rates of overweight and obesity (35%; p = 0.001). Overweight and obesity were statistically significantly associated with arterial hypertension, diabetes mellitus, and sleep apnea (all p &lt; 0.001). High BMI was linked to increased use of HF-specific medications, including SGLT2 inhibitors (p = 0.040), diuretics (p = 0.014), and angiotensin receptor blockers (p = 0.005). Conclusions: The data highlight the clinical relevance of overweight and obesity in ACHD with HF, emphasizing the need for individualized prevention and treatment strategies. The registry serves as a critical foundation for the optimization of long-term care in this population.<\/jats:p>","DOI":"10.3390\/jcm14134561","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T13:06:17Z","timestamp":1751288777000},"page":"4561","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Overweight and Obesity in Adults with Congenital Heart Disease and Heart Failure: Real-World Evidence from the PATHFINDER-CHD Registry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2673-4772","authenticated-orcid":false,"given":"Robert D.","family":"Pittrow","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7596-095X","authenticated-orcid":false,"given":"Stefan","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medizinische Klinik 2\u2014Kardiologie und Angiologie, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition and Preventive Medicine, Hospital Barmherzige Br\u00fcder, 80638 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Engel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medizinische Klinik 2\u2014Kardiologie und Angiologie, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Freilinger","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany"},{"name":"Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, 80638 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, University Hospital of the Technical University, 80636 Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital Gro\u00dfhadern of the Ludwig-Maximilians-University, Munich, European Kids Heart Center, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-7632","authenticated-orcid":false,"given":"Ann-Sophie","family":"Kaemmerer-Suleiman","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5335-2725","authenticated-orcid":false,"given":"Leonard B.","family":"Pittrow","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Kaulitz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Universityhospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Klawonn","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Infection Research, Biostatistics, Ostfalia University, 38124 Braunschweig, Germany"},{"name":"Institute for Information Engineering, 38302 Wolfenb\u00fcttel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz","family":"Mellert","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhoia C.","family":"Neidenbach","sequence":"additional","affiliation":[{"name":"Department of Sport and Human Movement Science, University of Vienna, 1010 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Schmiedeberg","sequence":"additional","affiliation":[{"name":"International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1639-0421","authenticated-orcid":false,"given":"Benjamin A.","family":"Pittrow","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Technical University Munich, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1161\/CIR.0000000000000204","article-title":"Congenital Heart Disease in the Older Adult","volume":"131","author":"Bhatt","year":"2015","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1016\/j.jacc.2018.08.1028","article-title":"2018 AHA\/ACC Guideline for the Management of Adults with Congenital Heart Disease: Executive Summary: A Report of the American College 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