Health and Well-Being in Older Adults With a Surgically Closed or an Unrepaired Ventricular Septal Defect

BACKGROUND: Older adults with a congenital ventricular septal defect (VSD) recently exhibited reduced heart rate variability and exercise capacity. It is unknown whether these findings affect health-related quality of life. METHODS AND RESULTS: Adults with VSDs and healthy controls, all concurrently included as part of another clinical study, completed the Danish National Health Survey questionnaire. Questionnaire data distributed to the general population were included and matched 10:1 with patients. Thirty patients with surgically closed VSDs (mean +/- SD age, 51 +/- 8 years), 300 adults from the general population (mean +/- SD age, 50 +/- 8 years), and 30 controls (mean +/- SD age, 51 +/- 9 years), as well as 30 patients with unrepaired VSDs (mean +/- SD age, 55 +/- 11 years), 300 adults from the general population (mean +/- SD age, 55 +/- 12 years), and 30 controls (mean +/- SD age, 55 +/- 10 years) completed the questionnaire. Educational level, social relations, and physical activity were comparable between groups. A larger proportion of patients with unrepaired VSDs compared with the general population experienced migraine (47% versus 24%; P=0.04), whereas more patients with surgically closed VSDs were affected by depression (13% versus 4%; P=0.02). For health-related quality of life, patients with surgically closed VSDs reported lower physical functioning (P<0.01), physical component summary (P<0.01), general health perception (P<0.01), and higher stress score (P=0.03) compared with the general population and healthy controls. Patients with unrepaired VSDs reported lower scores on physical functioning (P=0.03), bodily pain (P<0.01), and mental health (P=0.02), and a higher stress score (P=0.03), than controls. CONCLUSIONS: Older patients with VSDs report lower self-perceived physical functioning, lower general health, and higher stress levels, all in line with previous findings, like lower exercise capacity and dysfunctional cognitive abilities, in adults with VSDs. Incessant follow-up is paramount, as neither successfully closed nor hemodynamically insignificant VSD is equivalent with untroubled healthy aging.

Automated summary

Older adults with a congenital ventricular septal defect (VSD) exhibit reduced heart rate variability and exercise capacity. It is unknown whether these findings affect health-related quality of life.