Dual Disease Burden: Growing Older with Congenital Heart Disease and Hereditary Metabolic and Connective Tissue Disorders—Data from the PATHFINDER-CHD Registry on Heart Failure

<b>Background:</b> Advances in diagnosis and treatment have led to a growing population of adults with congenital heart disease (ACHD). Despite increasing life expectancy, their clinical needs-especially in older age-remain poorly defined. Cardiac and non-cardiac comorbidities are prevalent, and emerging evidence suggests accelerated biological aging compared to the general population. However, data on older patients and geriatric patients with CHD are limited. <b>Objectives:</b> This study aimed to characterize patients with CHD aged ≥50 years, focusing on functional status, comorbidities, sex-specific differences, and therapeutic patterns. <b>Methods:</b> The PATHFINDER-CHD Registry is a prospective, observational, multicenter registry enrolling patients with CHD with manifest heart failure (HF), HF history, or high HF risk. Data include anatomy, prior treatments, comorbidities, and medication use. <b>Results:</b> Among 1935 patients, 297 were ≥50 years old. Most had acyanotic CHD (62%); Tetralogy of Fallot (21%) was the most frequent diagnosis. A morphologic right systemic ventricle was present in 12%, and 5% had univentricular hearts. HF was manifest in 21%; 44% were classified as ACC/AHA stage B, 51% as stage C, yet 77% were in Perloff class I/II. Common cardiovascular comorbidities included aortopathy (55%), hypertension (37%), and arrhythmia (33%). Non-cardiac comorbidities included thyroid dysfunction (25%), renal impairment (18%), and neurological disease (13%). Sex-specific differences were observed. Despite HF burden, SGLT2 inhibitors and ARNIs were used in only 17% and 8.4%, respectively. <b>Conclusions:</b> Older patients with CHD represent a clinically complex cohort with high comorbidity burden. The findings support the concept of accelerated aging and emphasize the need for tailored interdisciplinary care strategies.

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Journal
Geriatrics
Published
2025-11-20
DOI
https://doi.org/10.3390/geriatrics10060152
Citations
1
Primary Topic
Congenital Heart Disease Studies
Type
article
Field-Weighted Citation Impact
1.35
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article

Dual Disease Burden: Growing Older with Congenital Heart Disease and Hereditary Metabolic and Connective Tissue Disorders—Data from the PATHFINDER-CHD Registry on Heart Failure

Frank Harig, Anna Engel, Fritz Mellert, Michael Huntgeburth et al.
1 citations
Geriatrics
Congenital Heart Disease Studies
1.35
article

Dual Disease Burden: Growing Older with Congenital Heart Disease and Hereditary Metabolic and Connective Tissue Disorders—Data from the PATHFINDER-CHD Registry on Heart Failure

Frank Harig, Anna Engel, Fritz Mellert, Michael Huntgeburth, Rhoia Clara Neidenbach, Oliver Dewald, H. Michael Dreher, Christopher Hohmann, Ann-Sophie Kaemmerer, Stephan Achenbach, Peter Ewert, Frank Klawonn, Renate Kaulitz, Mathieu N. Suleiman, Christian Meierhofer, Nicole Nagdyman, Fabian von Scheidt, Annika Freiberger, Ahmet Akyol, Stefan Holdenrieder, Sebastian Freilinger, Benjamin Alexander Pittrow, Robert David Pittrow, Harald Kaemmerer, L. Pittrow, Jürgen Hörer, Elsa Ury, Nicole Wolfrum, Pelagija Zlatic, Steffen Montenbruck
article en
1 citations

Abstract

<b>Background:</b> Advances in diagnosis and treatment have led to a growing population of adults with congenital heart disease (ACHD). Despite increasing life expectancy, their clinical needs-especially in older age-remain poorly defined. Cardiac and non-cardiac comorbidities are prevalent, and emerging evidence suggests accelerated biological aging compared to the general population. However, data on older patients and geriatric patients with CHD are limited. <b>Objectives:</b> This study aimed to characterize patients with CHD aged ≥50 years, focusing on functional status, comorbidities, sex-specific differences, and therapeutic patterns. <b>Methods:</b> The PATHFINDER-CHD Registry is a prospective, observational, multicenter registry enrolling patients with CHD with manifest heart failure (HF), HF history, or high HF risk. Data include anatomy, prior treatments, comorbidities, and medication use. <b>Results:</b> Among 1935 patients, 297 were ≥50 years old. Most had acyanotic CHD (62%); Tetralogy of Fallot (21%) was the most frequent diagnosis. A morphologic right systemic ventricle was present in 12%, and 5% had univentricular hearts. HF was manifest in 21%; 44% were classified as ACC/AHA stage B, 51% as stage C, yet 77% were in Perloff class I/II. Common cardiovascular comorbidities included aortopathy (55%), hypertension (37%), and arrhythmia (33%). Non-cardiac comorbidities included thyroid dysfunction (25%), renal impairment (18%), and neurological disease (13%). Sex-specific differences were observed. Despite HF burden, SGLT2 inhibitors and ARNIs were used in only 17% and 8.4%, respectively. <b>Conclusions:</b> Older patients with CHD represent a clinically complex cohort with high comorbidity burden. The findings support the concept of accelerated aging and emphasize the need for tailored interdisciplinary care strategies.

GeriatricsVol. 10(6)
University of Vienna (AT), Friedrich-Alexander-Universität Erlangen-Nürnberg (DE), Universitätsklinikum Erlangen (DE), Universitätsklinikum Tübingen (DE), Helmholtz Centre for Infection Research (DE), Deutsches Herzzentrum München (DE), University Hospital Cologne (DE), Technical University of Munich (DE), Ludwig-Maximilians-Universität München (DE)
Openalex Percentile: Top 14%
Congenital Heart Disease Studies
1.35
DOIOpen Access PDFOpenAlex
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