2025/11/01 by Maria de Fatima Egas‐Bejar, Gabriela Meléndez‐Ramírez, Gabriela Meléndez‐Ramirez +6
Biochemistry, Genetics and Molecular Biology · Medicine · #Cardiovascular Function and Risk Factors #Congenital Heart Disease Studies #Congenital heart defects research
paper · doi:10.1111/echo.70318
openalex publication_date 2025/11/01 · openalex created_date 2025/11/04 · openalex updated_date 2026/05/21
PURPOSE: To evaluate the percentage of adults with congenital heart disease (CHD) who are restratified according to classification of complexity classification with CT and/or CMR after an initial echocardiographic assessment. Accurate stratification of CHD complexity is relevant to determining the treatment. Echocardiography is the first-line imaging modality; nevertheless, the added value of computed tomography (CT) and cardiac magnetic resonance (CMR) as complementary modalities to restratify CHD complexity has not been fully explored. METHODS: We conducted a cross-sectional study of adult patients from the record CHD Unit in a third-level cardiology hospital from 2021 to 2024. CHD patients were classified according to the European Society of Cardiology (ESC) guidelines. We compared initial echocardiographic findings with CT and/or CMR using the kappa-statistic. RESULTS: Among 889 patients that fulfilled the inclusion criteria (women: 57%; mean age: 38.3 ± 14.4 years; genetic syndrome: 4%), the most common CHD were isolated congenital aortic valve disease and bicuspid aorta (n = 127), secundum atrial septal defect (n = 105), and tetralogy of Fallot (n = 90). The number and percentage of patients in each complexity category were mild: 180 (20.2%), moderate: 532 (59.9%), and severe: 177 (19.9%). Ten patients (1%) were restratified: 9 from the mild to moderate category and 1 from the moderate to mild category. Both imaging modalities showed strong agreement (Kappa: 0.979, 95% CI: 0.967-0.990). CONCLUSION: Restratification of adult CHD occurred in a low percentage of cases. Our results suggest that in specialized centers, echocardiographic findings are comparable to CT and/or CMR findings.