Hostname: page-component-594f858ff7-jtv8x Total loading time: 0 Render date: 2023-06-07T21:52:30.368Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "corePageComponentUseShareaholicInsteadOfAddThis": true, "coreDisableSocialShare": false, "useRatesEcommerce": true } hasContentIssue false
  • English

Prevalence and composition of CHD at different altitudes in Tibet: a cross-sectional study

Published online by Cambridge University Press:  10 April 2017

Jian-Yong Zheng ,
Yi-Gang Qiu ,
Dong-Tao Li ,
Jiang-Chun He ,
Yu Chen ,
Yi Cao ,
Ying-Ming Liu ,
Xian-Feng Li ,
Hai-Tao Chi  and
Tian-Chang Li
Jian-Yong Zheng
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yi-Gang Qiu
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Dong-Tao Li
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Jiang-Chun He
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yu Chen
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Yi Cao
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Ying-Ming Liu
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Xian-Feng Li
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Hai-Tao Chi
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
Tian-Chang Li*
Affiliation:
Department of Cardiology, PLA Navy General Hospital, Beijing, People’s Republic of China
*
Correspondence to: T.-C. Li, Department of Cardiology, PLA Navy General Hospital, No. 6 Fucheng Road, Haidian District, Beijing 100048, People’s Republic of China. Tel: +86-10-66951511; Fax: +86-10-68780185; E-mail: ltc909@163.com
Get access Rights & Permissions[Opens in a new window]

Abstract

Background

The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.

Methods and results

In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.

Conclusions

A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.

Keywords

CHDhigh altitudeprevalencecompositionage
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1497 - 1503
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Jian-Yong Zheng, Yi-Gang Qiu and Dong-Tao Li contributed equally to this study, and should be considered as co-first authors.

References

1. Chen, QH, Wang, XQ, Qi, SG. Cross-sectional study of congenital heart disease among Tibetan children aged from 4 to 18 years at different altitudes in Qinghai Province. Chin Med J (Engl) 2008; 121: 2469–2472.Google Scholar
2. Zheng, JY, Tian, HT, Zhu, ZM, et al. Prevalence of symptomatic congenital heart disease in tibetan school children. Am J Cardiol 2013; 112: 1468–1470.CrossRefGoogle Scholar
3. Mitchell, SC, Korones, SB, Berendes, HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation 1971; 43: 323–332.CrossRefGoogle ScholarPubMed
4. van der Linde, D, Konings, EE, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58: 2241–2247.CrossRefGoogle ScholarPubMed
5. Hanslik, A, Pospisil, U, Salzer-Muhar, U, Greber-Platzer, S, Male, C. Predictors of spontaneous closure of isolated secundum atrial septal defect in children: a longitudinal study. Pediatrics 2006; 118: 1560–1565.CrossRefGoogle ScholarPubMed
6. Sung, RY, So, LY, Ng, HK, Ho, JK, Fok, TF. Echocardiography as a tool for determining the incidence of congenital heart disease in newborn babies: a pilot study in Hong Kong. Int J Cardiol 1991; 30: 43–47.CrossRefGoogle ScholarPubMed
7. Wu, MH, Chen, HC, Lu, CW, Wang, JK, Huang, SC, Huang, SK. Prevalence of congenital heart disease at live birth in Taiwan. J Pediatr 2010; 156: 782–785.CrossRefGoogle ScholarPubMed
8. Yang, XY, Li, XF, Lu, XD, Liu, YL. Incidence of congenital heart disease in Beijing, China. Chin Med J (Engl) 2009; 122: 1128–1132.Google ScholarPubMed
9. Zhang, Y, Riehle-Colarusso, T, Correa, A, et al. Observed prevalence of congenital heart defects from a surveillance study in China. J Ultrasound Med 2011; 30: 989–995.CrossRefGoogle Scholar
10. Zhang, Z, Li, Z, Ji, C. Prevalence study of congenital heart disease in children aged 0-2 in Zhejiang Province. Zhonghua Liu Xing Bing Xue Za Zhi 1999; 20: 155–157.Google Scholar
11. Zhao, QM, Ma, XJ, Jia, B, Huang, GY. Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening. Acta Paediatr 2013; 102: 397–402.Google Scholar
12. Schneider, DJ, Moore, JW. Patent ductus arteriosus. Circulation 2006; 114: 1873–1882.CrossRefGoogle Scholar
13. Michelakis, E, Rebeyka, I, Bateson, J, Olley, P, Puttagunta, L, Archer, S. Voltage-gated potassium channels in human ductus arteriosus. Lancet 2000; 356: 134–137.CrossRefGoogle Scholar
14. Jin, XH, Chen, QH, Tong, YF, et al. Study on the epidemiology of congenital heart disease in Tibetan ethnic children aged from 4 to 18 living at different altitudes in Qinghai province. Zhonghua Liu Xing Bing Xue Za Zhi 2008; 29: 317–320.Google ScholarPubMed
15. Ishikawa, T, Iwashima, S, Ohishi, A, Nakagawa, Y, Ohzeki, T. Prevalence of congenital heart disease assessed by echocardiography in 2067 consecutive newborns. Acta Paediatr 2011; 100: e55–e60.CrossRefGoogle ScholarPubMed
16. Miao, CY, Zuberbuhler, JS, Zuberbuhler, JR. Prevalence of congenital cardiac anomalies at high altitude. J Am Coll Cardiol 1988; 12: 224–228.CrossRefGoogle Scholar
17. Chen, QH, Lu, L, Qi, GR, Jin, XH, Wang, LM, Qi, SG. Susceptibility of patients with congenital heart disease to pulmonary hypertension at a high altitude. Zhonghua Yi Xue Za Zhi 2011; 91: 3120–3122.Google Scholar
18. Jacobs, EG, Leung, MP, Karlberg, J. Distribution of symptomatic congenital heart disease in Hong Kong. Pediatr Cardiol 2000; 21: 148–157.CrossRefGoogle ScholarPubMed
19. Zhao, QM, Zheng, JY, Du, JH. Aortic atresia with ventricular septal defect in a case. Zhonghua Er Ke Za Zhi 2010; 48: 716–717.Google ScholarPubMed