Highlights of the statement:

• A new scientific statement from the American Heart Association updates more than a decade of research to identify, manage, and prevent neurodevelopmental delays and disabilities in patients with congenital heart disease.
• The new statement includes revised criteria for determining which children and adults are at increased risk for neurological developmental delays and disorders, as well as an updated list of factors that may increase risk, as compared to the association’s previous statement in 2012. Important changes since the statement are outlined.
• Important next steps include research into how to prevent and reduce the impact of common neurodevelopmental problems that can affect learning, emotion, and behavior throughout the lifespan.

Embargoed until Thursday, February 22, 2024 at 4:00 a.m. Central Time/5:00 a.m. Eastern Time

DALLAS, February 22, 2024 — More than a decade of new knowledge about neurodevelopmental risks in patients with congenital heart disease reveals who is most at risk and the effects on neurodevelopment, learning, emotion, and behavior The US government has announced that it has changed its thinking about the factors.A new scientific statement from the American Heart Association was published today in the association’s flagship peer-reviewed journal Circulation.

Congenital heart disease, defined as a structural abnormality of the heart or nearby blood vessels that occurs before birth, is the most common birth defect. Although advances in treatment have allowed more than 90% of patients with congenital heart disease to live to adulthood in developed countries, the risk of neurodevelopmental problems is significant for those with more severe congenital heart disease. has not been improved.

A new scientific statement, “Neurodevelopmental Outcomes in Individuals with Congenital Heart Disease: Updates on Neuroprotection, Risk Stratification, Assessment, and Management,” explains how congenital heart disease affects an individual’s development, learning, feelings, and emotions. Significant progress has been made in understanding the effects of Behavior from childhood to adulthood.

“Neurodevelopmental difficulties are one of the most common and long-lasting complications faced by people with congenital heart disease. These difficulties can impact their ability to function well at school, at work, and with colleagues. and can impact health-related quality of life from childhood to adulthood,” said Dr. Erika Sood, vice chair of the statement writing group. , senior research scientist and pediatric psychologist at Nemours Children’s Health in the Delaware Valley. “It is important for healthcare professionals and individuals with congenital heart disease and their families to understand how common neurodevelopmental challenges are. It is also important to understand why people are at high risk of developing traumatic injuries and how these challenges can be prevented or managed.”

This statement includes up-to-date guidance for health care professionals on how to identify patients at increased risk for neurodevelopmental disorders and what assessments can help them better understand neurodevelopmental disorders. Masu. As more patients survive into adulthood, it is increasingly important to optimize neurodevelopmental outcomes through clinical care and research.

The main findings of this statement are:

• The algorithm for stratifying people with congenital heart defects into high or low risk for developmental delay or disability has been revised to reflect the latest research.
• This statement suggests that medical professionals consider the three risk categories in turn. Risk category 1 includes patients with a history of cardiac surgery with cardiopulmonary bypass during infancy. Risk category 2 is people who have a history of chronic cyanosis, a blue or purple discoloration due to low blood oxygen levels, and who have not had heart surgery with cardiopulmonary bypass during infancy. Risk Category 3 has two criteria. The first criterion for risk category 3 is a history of intervention or hospitalization secondary to congenital heart disease in infancy, childhood, or adolescence. The second criterion is the presence of one or more factors known to increase neurodevelopmental risk.
• This statement includes factors that may increase neurodevelopmental risk, including genetic, fetal and perinatal influences, surgical aspects of treatment and care, socio-economic and familial influences, and factors related to growth and development. An updated list of known factors is provided. For example, genetic mutations that can affect the development of a fetus’s heart, brain, and other organs cause up to nearly a third of congenital heart disease cases.
• Added new sections on new risk factors, including abnormal placental development, long-term or repeated exposure to anesthetics, and exposure to neurotoxic chemicals.
• Additionally, new sections have been added on neuroprotective strategies, including prenatal detection of congenital heart disease, monitoring of cerebral blood flow and oxygen delivery, and functional supportive care such as physical therapy, occupational therapy, and speech therapists.
• This statement provides updated information on age-based referral for evaluation of patients with congenital heart disease who are at high risk for developmental delay or disability. This statement references guidance from the Cardiac and Neurodevelopmental Outcomes Collaborative, which recommends that children with congenital heart disease who are at high risk for developmental delay or disability have neurodevelopmental evaluations throughout infancy, childhood, and adolescence. are doing.
• The statement also provides updated information on the management of developmental delays or disorders in infants, children, and adolescents, and a new section on the management of neuropsychological deficits in adults.

“Reducing the barriers that people with congenital heart disease and their families often face in accessing neurodevelopmental supports and services, and ensuring adequate research funding, will be a priority area for future policy. ,” said Bradley S. Marino, M.D., chair of the statement writing group. MPP, MSCE, MBA, FAHA, Chief of Cardiology and Cardiovascular Medicine at Cleveland Clinic Children’s Clinic. “Further research will provide a better understanding of how to prevent and manage neurodevelopmental conditions associated with congenital heart disease, ultimately improving neurodevelopmental outcomes and health-related life outcomes throughout the lifespan of people with congenital heart disease.” The quality will improve.”

This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association’s Council on Lifelong Congenital Heart Disease and Adolescent Heart Health and the Cardiovascular and Stroke Nursing Council. American Heart Association scientific statements help raise awareness about cardiovascular disease and stroke issues and promote informed medical decisions. A scientific statement outlines what is currently known about a topic and areas where additional research is needed. Scientific statements serve to create guidelines, but do not recommend treatments. American Heart Association guidelines provide the association’s official clinical practice recommendations.

Additional members of the writing group include Jane W. Neuberger, MD, MPH, FAHA; Julia S. Anixto, MD. Dr. Adam R. Cassidy, LP; Dr. Jamie L. Jackson. Richard A. Jonas, MD. Amy J. Lisanti, Ph.D., RN, FAHA. Kayla N. Lopez, MD, MPH. Shabnam Payvandi, MD, MAS, FAHA. Author disclosure information is provided in the manuscript.

The association is primarily funded by individuals. Foundations and corporations (including pharmaceuticals, device manufacturers, and other companies) also make contributions, which help fund specific programs and events for the association. The Society has strict policies in place to ensure that these relationships do not influence scientific content. Revenues from pharmaceutical companies, biotech companies, device manufacturers, health insurance companies, and overall financial information for the association are available here.

Additional resources:

About the American Heart Association

The American Heart Association works tirelessly to help the world live longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with thousands of organizations and the power of millions of volunteers, we fund innovative research, advocate for public health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for a century. In 2024, our 100th anniversary, we celebrate our rich 100 years of history and achievements. As we move into her second century of bold discovery and impact, our vision is to advance health and hope for everyone, everywhere. heart.org, Facebook, X Or call 1-800-AHA-USA1.

###

Media inquiries: 214-706-1173

Samantha Chencharik: 214-706-1406, samantha.chencharik@heart.org

General inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org