Characteristics and outcomes of heart failure-related hospitalization in adults with congenital heart disease

Summary Background Heart failure (HF) is the main cause of death in adult congenital heart disease (ACHD). Aims We aimed to characterize HF-related hospitalization of patients with ACHD, and to determine HF risk factors and prognosis in this population. Methods We prospectively included 471 patients with ACHD admitted to our unit over 24 months. Clinical and biological data and HF management were recorded. Major cardiovascular events were recorded for ACHD with HF. Results HF was the main reason for hospitalization in 13% of cases (76/583 hospitalizations). Patients with HF were significantly older (median age 44 ± 14 years vs. 37 ± 15 years; P P  = 0.04). In the multivariable analysis, pulmonary arterial hypertension (odds ratio [OR] 6.2, 95% confidence interval [CI] 3.5–10.7), history of HF (OR 9.8, 95% CI 5.7–16.8) and history of atrial arrhythmia (OR 3.6, 95% CI 2.2–5.9) were significant risk factors for HF-related admissions ( P P Conclusions HF is emerging as a leading cause of morbidity and mortality in the ACHD population. Earlier diagnosis and more active management are required to improve outcomes of HF in ACHD.