Related Experiment Video

Updated: Dec 27, 2025

Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

25.1K

Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity

Fouke Ombelet1, Eva Goossens1,2,3, Alexander Van De Bruaene4,5

  • 1KU Leuven Department of Public Health and Primary Care KU Leuven-University of Leuven 3000-B Leuven Belgium.

Journal of the American Heart Association
|February 25, 2020
PubMed

Insights

The Adult Congenital Heart Disease Anatomic and Physiological classification better predicts 15-year mortality than anatomy alone. Combining anatomy with physiology improves risk stratification for adults with congenital heart disease.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease

Background:

  • Traditional risk stratification for adults with congenital heart disease (ACHD) relies on defect complexity.
  • The 2018 AHA/ACC guidelines introduced a new classification combining anatomy and physiology.
  • This study evaluates the predictive capacity of this new classification for long-term mortality.

Purpose of the Study:

  • To assess the 15-year mortality prediction of the ACHD Anatomic and Physiological classification.
  • To compare its performance against anatomic complexity alone and other models.

Main Methods:

  • Utilized data from 629 ACHD patients from a previous study.
  • Collected physiological state data to apply the ACHD Anatomic and Physiological classification.
  • Employed Cox proportional hazards regression and Harrell's concordance statistics for analysis.

Main Results:

  • The ACHD Anatomic and Physiological classification showed a concordance index of 0.71 (95% CI, 0.63-0.78).
  • Anatomic complexity alone had a concordance index of 0.67 (95% CI, 0.60-0.74).
  • The combination of anatomic complexity and the Congenital Heart Disease Functional Index yielded the highest concordance index (0.79; 95% CI, 0.73-0.84).

Conclusions:

  • The ACHD Anatomic and Physiological classification demonstrates empirical support for predicting 15-year cardiac mortality.
  • Incorporating physiological status alongside anatomic complexity enhances risk stratification accuracy in ACHD patients.
  • This approach offers improved prognostic insights for managing adults with congenital heart disease.

Keywords:
classificationcongenital heart diseasemortality

More Related Videos

Analysis of Congenital Heart Defects in Mouse Embryos Using Qualitative and Quantitative Histological Methods08:28

Analysis of Congenital Heart Defects in Mouse Embryos Using Qualitative and Quantitative Histological Methods

Published on: March 10, 2020

7.2K
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

3.2K

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
246
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
299
Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
502
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
423
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.6K
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
158