Korean Circ J.  2019 Aug;49(8):691-708. 10.4070/kcj.2019.0187.

Metabolic Syndrome in Adult Congenital Heart Disease

Affiliations
  • 1Cardiovascular Center, Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan. koniwa@luke.or.jp, kniwa@aol.com

Abstract

In adult congenital heart disease (ACHD), residua and sequellae after initial repair develop late complications such as cardiac failure, arrhythmias, thrombosis, aortopathy, pulmonary hypertension and others. Acquired lesions with aging such as hypertension, diabetes mellitus, obesity can be negative influence on original cardiovascular disease (CVD). Also, atherosclerosis may pose an additional health problem to ACHD when they grow older and reach the age at which atherosclerosis becomes clinically relevant. In spite of the theoretical risk of atherosclerosis in ACHD due to above mentioned factors, cyanotic ACHDs even after repair are noted to have minimal incidence of coronary artery disease (CAD). Acyanotic ACHD has similar prevalence of CAD as the general population. However, even in cyanotic ACHD, CAD can develop when they have several risk factors for CAD. The prevalence of risk factor is similar between ACHD and the general population. Risk of premature atherosclerotic CVD in ACHD is based, 3 principal mechanisms: lesions with coronary artery abnormalities, obstructive lesions of left ventricle and aorta such as coarctation of the aorta and aortopathy. Coronary artery abnormalities are directly affected or altered surgically, such as arterial switch in transposition patients, may confer greater risk for premature atherosclerotic CAD. Metabolic syndrome is more common among ACHD than in the general population, and possibly increases the incidence of atherosclerotic CAD even in ACHD in future. Thus, ACHD should be screened for metabolic syndrome and eliminating risk factors for atherosclerotic CAD.

Keyword

Adult congenital heart disease; Metabolic syndrome; Cardiovascular diseases; Coronary artery disease; Cyanotic congenital heart disease

MeSH Terms

Adult*
Aging
Aorta
Aortic Coarctation
Arrhythmias, Cardiac
Atherosclerosis
Cardiovascular Diseases
Coronary Artery Disease
Coronary Vessels
Diabetes Mellitus
Heart Defects, Congenital*
Heart Failure
Heart Ventricles
Humans
Hypertension
Hypertension, Pulmonary
Incidence
Obesity
Prevalence
Risk Factors
Thrombosis
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