Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea

Hisanori Sakazaki, Koichiro Niwa, Makoto Nakazawa, Tsutomu Saji, Toshio Nakanishi, Motoki Takamuro, Michihiko Ueno, Hitoshi Kato, Shinichi Takatsuki, Masaki Matsushima, Namiko Kojima, Fukiko Ichida, Shigetoyo Kogaki, Sachiko Kido, Yoshio Arakaki, Kenji Waki, Teiji Akagi, Kunitaka Joo, Jun Muneuchi, Kenji Suda & 2 others Heung Jae Lee, Haruo Shintaku

Research output: Contribution to journalArticle

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Abstract

Background: There are few articles on mortality and morbidity of adult patients with Eisenmenger's syndrome (ES) in the current era when disease targeting therapy (DTT) has been available. Methods and results: 198 patients (a median age 35 years, 64% female) with ES who visited the 16 participating institutes in Japan and Korea from 1998 to 2009 were enrolled. Clinical data during adulthood were collected from each institutional chart and analyzed centrally. During a median follow-up of 8 years, 30 patients died including 14 sudden deaths. 89 patients took oral medication of DTT and clinical improvement was observed in 54 of them. However, survival rate in patients taking DTT was not different from those without (87% vs 84%, p = 0.55). When the clinical data in between first and last clinic visits were compared in 85 patients, the patients with NYHA ≧ III increased from 24% to 48% (p <0.001), SpO2 decreased from 89% to 85% (p = 0.008) and hematocrit increased from 51.4% to 52.9% (p = 0.04). Non-survivors had poorer NYHA function class, lower body weight (BW), lower body mass index (BMI), and higher serum level of Cr at the first visits than survivors. Conclusions: Long term survival and clinical status of adult patients with ES remains unsatisfactory even in the current era of DTT. Poor NYHA functional class, low BW, low BMI and high serum level of Cr were related to mortality. DTT therapy improved clinical status in many patients with Eisenmenger's syndrome, but no significant impact on survival could be shown.

Original languageEnglish
Pages (from-to)205-209
Number of pages5
JournalInternational Journal of Cardiology
Volume167
Issue number1
DOIs
Publication statusPublished - Jul 15 2013

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Eisenmenger Complex
Korea
Japan
Mouth Diseases
Body Mass Index
Therapeutics
Body Weight
Survival
Mortality
Ambulatory Care
Sudden Death
Serum
Hematocrit
Survivors
Survival Rate
Morbidity

Keywords

  • Congenital heart disease
  • Eisenmenger's syndrome
  • Hypoxemia
  • Pulmonary hypertension
  • Pulmonary vasodilator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sakazaki, H., Niwa, K., Nakazawa, M., Saji, T., Nakanishi, T., Takamuro, M., ... Shintaku, H. (2013). Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea. International Journal of Cardiology, 167(1), 205-209. https://doi.org/10.1016/j.ijcard.2011.12.030

Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea. / Sakazaki, Hisanori; Niwa, Koichiro; Nakazawa, Makoto; Saji, Tsutomu; Nakanishi, Toshio; Takamuro, Motoki; Ueno, Michihiko; Kato, Hitoshi; Takatsuki, Shinichi; Matsushima, Masaki; Kojima, Namiko; Ichida, Fukiko; Kogaki, Shigetoyo; Kido, Sachiko; Arakaki, Yoshio; Waki, Kenji; Akagi, Teiji; Joo, Kunitaka; Muneuchi, Jun; Suda, Kenji; Lee, Heung Jae; Shintaku, Haruo.

In: International Journal of Cardiology, Vol. 167, No. 1, 15.07.2013, p. 205-209.

Research output: Contribution to journalArticle

Sakazaki, H, Niwa, K, Nakazawa, M, Saji, T, Nakanishi, T, Takamuro, M, Ueno, M, Kato, H, Takatsuki, S, Matsushima, M, Kojima, N, Ichida, F, Kogaki, S, Kido, S, Arakaki, Y, Waki, K, Akagi, T, Joo, K, Muneuchi, J, Suda, K, Lee, HJ & Shintaku, H 2013, 'Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea', International Journal of Cardiology, vol. 167, no. 1, pp. 205-209. https://doi.org/10.1016/j.ijcard.2011.12.030
Sakazaki, Hisanori ; Niwa, Koichiro ; Nakazawa, Makoto ; Saji, Tsutomu ; Nakanishi, Toshio ; Takamuro, Motoki ; Ueno, Michihiko ; Kato, Hitoshi ; Takatsuki, Shinichi ; Matsushima, Masaki ; Kojima, Namiko ; Ichida, Fukiko ; Kogaki, Shigetoyo ; Kido, Sachiko ; Arakaki, Yoshio ; Waki, Kenji ; Akagi, Teiji ; Joo, Kunitaka ; Muneuchi, Jun ; Suda, Kenji ; Lee, Heung Jae ; Shintaku, Haruo. / Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 1. pp. 205-209.
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abstract = "Background: There are few articles on mortality and morbidity of adult patients with Eisenmenger's syndrome (ES) in the current era when disease targeting therapy (DTT) has been available. Methods and results: 198 patients (a median age 35 years, 64{\%} female) with ES who visited the 16 participating institutes in Japan and Korea from 1998 to 2009 were enrolled. Clinical data during adulthood were collected from each institutional chart and analyzed centrally. During a median follow-up of 8 years, 30 patients died including 14 sudden deaths. 89 patients took oral medication of DTT and clinical improvement was observed in 54 of them. However, survival rate in patients taking DTT was not different from those without (87{\%} vs 84{\%}, p = 0.55). When the clinical data in between first and last clinic visits were compared in 85 patients, the patients with NYHA {\^a}‰§ III increased from 24{\%} to 48{\%} (p <0.001), SpO2 decreased from 89{\%} to 85{\%} (p = 0.008) and hematocrit increased from 51.4{\%} to 52.9{\%} (p = 0.04). Non-survivors had poorer NYHA function class, lower body weight (BW), lower body mass index (BMI), and higher serum level of Cr at the first visits than survivors. Conclusions: Long term survival and clinical status of adult patients with ES remains unsatisfactory even in the current era of DTT. Poor NYHA functional class, low BW, low BMI and high serum level of Cr were related to mortality. DTT therapy improved clinical status in many patients with Eisenmenger's syndrome, but no significant impact on survival could be shown.",
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AU - Sakazaki, Hisanori

AU - Niwa, Koichiro

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AU - Saji, Tsutomu

AU - Nakanishi, Toshio

AU - Takamuro, Motoki

AU - Ueno, Michihiko

AU - Kato, Hitoshi

AU - Takatsuki, Shinichi

AU - Matsushima, Masaki

AU - Kojima, Namiko

AU - Ichida, Fukiko

AU - Kogaki, Shigetoyo

AU - Kido, Sachiko

AU - Arakaki, Yoshio

AU - Waki, Kenji

AU - Akagi, Teiji

AU - Joo, Kunitaka

AU - Muneuchi, Jun

AU - Suda, Kenji

AU - Lee, Heung Jae

AU - Shintaku, Haruo

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N2 - Background: There are few articles on mortality and morbidity of adult patients with Eisenmenger's syndrome (ES) in the current era when disease targeting therapy (DTT) has been available. Methods and results: 198 patients (a median age 35 years, 64% female) with ES who visited the 16 participating institutes in Japan and Korea from 1998 to 2009 were enrolled. Clinical data during adulthood were collected from each institutional chart and analyzed centrally. During a median follow-up of 8 years, 30 patients died including 14 sudden deaths. 89 patients took oral medication of DTT and clinical improvement was observed in 54 of them. However, survival rate in patients taking DTT was not different from those without (87% vs 84%, p = 0.55). When the clinical data in between first and last clinic visits were compared in 85 patients, the patients with NYHA ≧ III increased from 24% to 48% (p <0.001), SpO2 decreased from 89% to 85% (p = 0.008) and hematocrit increased from 51.4% to 52.9% (p = 0.04). Non-survivors had poorer NYHA function class, lower body weight (BW), lower body mass index (BMI), and higher serum level of Cr at the first visits than survivors. Conclusions: Long term survival and clinical status of adult patients with ES remains unsatisfactory even in the current era of DTT. Poor NYHA functional class, low BW, low BMI and high serum level of Cr were related to mortality. DTT therapy improved clinical status in many patients with Eisenmenger's syndrome, but no significant impact on survival could be shown.

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KW - Congenital heart disease

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KW - Hypoxemia

KW - Pulmonary hypertension

KW - Pulmonary vasodilator

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