Study on the effects of hemodynamic impairment on growth and development in children with congenital heart disease

ZHENG Chun-fang; SU Xin; HUANG Xue-hua; HAN Xiao

doi:10.16048/j.issn.2095-5561.2024.02.14

Abstract：Objective To explore the impact of hemodynamic impairment on growth and development in children with congenital heart disease(CHD). Methods A total of 148 children with CHD admitted to the First Hospital of China Medical University from January 2018 to December 2022 were selected and divided into normal hemodynamic group(n=81) and impaired hemodynamic group (n=67) according to their hemodynamic impairment. General data of the two groups were collected,such as gender,age,body mass standard deviation,length standard deviation,middle arm circumference(MAC) standard deviation,triceps skinfold thickness(TSF) standard deviation. Hemodynamic indicators of the two groups including mean arterial pressure(MAP),stroke volume index(SVI),stroke volume(SV),cardiac output(CO),cardiac index(CI),and left heart work index(LCWI) were measured to assess the he-modynamic impairment. The growth and development status of the children were assessed by Bayley-Ⅲ,adaptive behavior assessment system third edition(ABAS-3) and DENVER developmental screening test Ⅱ(DENVER-Ⅱ). Results The incidence of hemody-namic impairment in CHD children was 45.3％(67/148). Among them,there were 38 cases of abnormal MAP(56.7％),25 cases of abnormal SVI(37.3％),34 cases of abnormal SV(50.7％),20 cases of abnormal CO(29.9％),22 cases of abnormal CI (32.8％),and 16 cases of abnormal LCWI (23.9％). The MAP of the impaired hemodynamic group was higher than that of the normal hemody-namic group,while SVI,SV,CO,CI,and LCWI were lower than those of normal hemodynamic group,the differences were statisti-cally significant(P＜0.05). The standard deviations of body length,MAC,and TSF in the impaired hemodynamic group were signifi-cantly lower than those in the normal hemodynamic group,the differences were statistically significant(P＜0.05). In the Bayley-Ⅲ score,the comprehensive scores of cognition,language and movement in the impaired hemodynamic group were lower than those in the normal hemodynamic group,the acceptance and rejection communication scores in the language sub item and the fine motor and gross motor scores in the motor sub item of the impaired hemodynamic group were lower than those in the normal hemodynamic group,the differences were statistically significant(P＜0.05). In the ABAS-3 score,the general adaptive comprehensive score of the impaired hemodynamic group was lower than that of the normal hemodynamic group,the difference was statistically significant(P＜0.05). The total score of DENVER-Ⅱ in the impaired hemodynamic group was lower than that in the normal hemodynamic group,and the scores of fine motor,gross motor and language were lower than those in the normal hemodynamic group,the difference was statistically signif-icant(P＜0.05). There was no statistically significant difference in individual social behavior scores between the two groups(P＞0.05). Conclusion Hemodynamic impairment may lead to delayed growth and development in children with CHD.Children with CHD need to regularly evaluate their growth and development status,and receive early targeted interventions to prevent or alleviate developmental delay.