Analysis of risk factors causing health deficiency and its indicators in children with congenital heart diseases two years after radical surgery
L.N. Igisheva1,2, А.А. Rumyantseva1, А.V. Shabaldin1,2, А.V. Sinitskaya1, N.А. Litvinova2, О.V. Dolgikh3
1Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnoviy Blvd, Kemerovo, 650002, Russian Federation
2Kemerovo State Medical University, 22a Voroshilova Str., Kemerovo, 650056, Russian Federation
3Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, 82 Monastyrskaya Str., Perm, 614045, Russian Federation
Our research goal was to analyze risk factors that could cause health disorders in children two years after a radical heart surgery. It is vital for optimizing diagnostics and predicting negative outcomes of surgical treatment for congenital heart diseases (CHD) using data taken from anamnesis vitae and genetic indicators.
We performed prospective cohort monitoring of 89 children with CHD during two years starting from the moment they had a radical heart surgery. The study design included the following stages: quality of life assessment using “Cardiac Module” in the Pediatric Quality of Life Questionnaire (USA, 2001); collecting data to create anamnesis vitae by questioning; identifying types of polymorphisms of xenobiotic biotransformation genes, inborn and adaptive immunity genes participating in embryogenesis of the cardiovascular system; logistic regression incremental multifactorial analysis of independent variables in anamnesis vitae, peculiarities of a radical surgery, health indicators prior to an operation, as well as polymorph variants of the examined genes with dependent variants: types of functioning and the complex integral health indicator two years after surgical treatment.
The complex integral health indicator and indicators of physical functioning were significant ones in 2-year dynamics of patients’ health after surgical treatment for CHD. These indicators reflected children’s quality of life long time after a radical heart surgery. Health deficiency and impaired quality of life two years after a radical heart surgery was associated with HLADRB104, HLADRB111, HLADRB112, HLADRB113 alleles and the major allele Т in the polymorph variant of CYP1A1 T/C (rs1048943) gene. Influence exerted by these alleles on quality of life long time after a radical heart surgery is determined by long-term toxic inflammation in an operated heart. CHD severity, an age when a radical surgery was performed, as well as unsatisfactory material benefits and living conditions are common medical and social risk factors that cause health deficiency and impaired quality of life long time after a radical heart surgery.
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