Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea.
BACKGROUND
There are few articles on mortality and morbidity of adult patients with Eisenmenger's syndrome (ES) in the current era when disease targeting therapy (DTT) has been available.


RESULTS
198 patients (a median age 35 years, 64% female) with ES who visited the 16 participating institutes in Japan and Korea from 1998 to 2009 were enrolled. Clinical data during adulthood were collected from each institutional chart and analyzed centrally. During a median follow-up of 8 years, 30 patients died including 14 sudden deaths. 89 patients took oral medication of DTT and clinical improvement was observed in 54 of them. However, survival rate in patients taking DTT was not different from those without (87% vs 84%, p=0.55). When the clinical data in between first and last clinic visits were compared in 85 patients, the patients with NYHA >/=III increased from 24% to 48% (p<0.001), SpO2 decreased from 89% to 85% (p=0.008) and hematocrit increased from 51.4% to 52.9% (p=0.04). Non-survivors had poorer NYHA function class, lower body weight (BW), lower body mass index (BMI), and higher serum level of Cr at the first visits than survivors.


CONCLUSIONS
Long term survival and clinical status of adult patients with ES remains unsatisfactory even in the current era of DTT. Poor NYHA functional class, low BW, low BMI and high serum level of Cr were related to mortality. DTT therapy improved clinical status in many patients with Eisenmenger's syndrome, but no significant impact on survival could be shown.
Department of Pediatric Cardiology, Hyogo Prefectural Amagasaki Hospital, Japan. sakazaki@pb4.so-net.ne.jp
Hisanori
H
Sakazaki
Koichiro
K
Niwa
Makoto
M
Nakazawa
Tsutomu
T
Saji
Toshio
T
Nakanishi
Motoki
M
Takamuro
Michihiko
M
Ueno
Hitoshi
H
Kato
Shinichi
S
Takatsuki
Masaki
M
Matsushima
Namiko
N
Kojima
Fukiko
F
Ichida
Shigetoyo
S
Kogaki
Sachiko
S
Kido
Yoshio
Y
Arakaki
Kenji
K
Waki
Teiji
T
Akagi
Kunitaka
K
Joo
Jun
J
Muneuchi
Kenji
K
Suda
Heung Jae
HJ
Lee
Haruo
H
Shintaku
D000293:Adolescent; D000328:Adult; D000368:Aged; D004541:Eisenmenger Complex / Q000175:diagnosis* / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000208:ethnology; D012189:Retrospective Studies; D055815:Young Adult