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An 18-year evolution of congenital heart disease in China: An echocardiographic database-based study
DanQing Hu1, TingXiang Lan2, YiFan Chen3
1Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China; School of Health, Fujian Medical University, Fuzhou, PR China.
Insights
Congenital heart disease (CHD) in China shows a declining observed rate and fewer complex cases over 18 years. However, the proportion of simple CHD and adult CHD, particularly congenital aortic valve malformation, is increasing.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Data on the evolution of congenital heart disease (CHD) in China are limited.
- Understanding trends in CHD, especially congenital aortic valve malformation (CAVM) and adult CHD (ACHD), is crucial for public health.
- Echocardiography is a key diagnostic tool for CHD assessment.
Purpose of the Study:
- To analyze the observed rate and spectrum changes of CHD in China over an 18-year period.
- To specifically investigate trends in congenital aortic valve malformation (CAVM) and adult CHD (ACHD).
- To evaluate changes in the proportion of simple vs. complex CHD and intervention rates.
Main Methods:
- Retrospective review of 682,565 transthoracic echocardiographic records from 2003-2020.
- Analysis of 37,200 diagnosed CHD cases across three distinct time periods.
- Statistical comparison of CHD prevalence, complexity, ACHD proportion, and intervention rates over time.
Main Results:
- The observed rate of total CHD decreased significantly from 106.72 to 67.43 per 1000 cases.
- The proportion of simple CHD increased, while complex CHD decreased (p < 0.05).
- The proportion of adult CHD, including CAVM and CAVM with aortic stenosis, significantly increased across all periods (p < 0.05).
Conclusions:
- CHD in China demonstrates a trend towards a lower overall observed rate and reduced complexity.
- There is a notable increase in the prevalence of simple CHD and adult CHD, with CAVM being a significant component.
- Intervention rates for CHD patients have also increased, reflecting improved management and care.
Objective:
Data on the evolution of congenital heart disease (CHD) in China remain scarce. Based on a Chinese echocardiography database, we analyzed the observed rate (OR) and spectrum changes of CHD over the past 18 years with a focus on the congenital aortic valve malformation (CAVM) and Adult CHD (ACHD).
Methods And Results:
The transthoracic echocardiographic data of 682,565 records from 2003 to 2020 were retrospectively reviewed at Fujian Medical University Union Hospital, China. A total of 37,200 CHD cases were recruited in this study. Over the three periods (from 2003 to 2008, 2009-2014, to 2015-2020), the OR of Total CHD decreased (106.72, 90.64, and 67.43 per 1000 cases, respectively); the proportion of Simple CHD to Total CHD increased (80.96%, 83.41%, and 87.97%, respectively), with a decrease in the proportion of Complex CHD (18.11%, 15.51%, and 10.42%, respectively) (p < 0.05 for all). The proportion of ACHD increased in most types of CHD [Total CHD: 25.79%, 27.84%, and 31.43%; CAVM: 69.02%, 73.42%, and 78.16%; CAVM with aortic stenosis (AS): 67.42%, 70.73%, and 79.25%; respectively, p < 0.05 for all], with a much higher proportion in both CAVM and CAVM with AS than in the other CHD types. The proportion of CHD patients receiving intervention increased over the designated periods.
Conclusions:
This study depicts the longitudinal changes of CHD in the Chinese population with a single-center echocardiographic data, revealing an increased proportion of Simple CHD, ACHD (including CAVM and CAVM with AS), and a decreased OR of Total CHD and proportion of Complex CHD.
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