title: Prevalence of Congenital Heart Disease and Pulmonary Hypertension in Down's Syndrome: An Echocardiographic Study.
abstract: BACKGROUND
  Down's syndrome (DS) is a genetic anomaly, which undergoes increased morbidity and mortality when associated with congenital heart disease (CHD). The aims of the study were to determine the prevalence of CHD and pulmonary hypertension (PH) in DS.
  
  
  METHODS
  One hundred twenty-seven patients with DS living in Mexico City were evaluated by physical exam, electrocardiogram and echocardiogram.
  
  
  RESULTS
  CHD was found in 40%. In 80% (n = 102) PH was present [systolic pulmonary artery pressure (SPAP) of 47 ± 19 mm Hg and mean pulmonary artery pressure (MPAP) of 32 ± 11 mm Hg]. Patients with CHD and PH were classified as having 1) no shunt (n = 18) with SPAP of 37 ± 9 mm Hg and MPAP of 25 ± 6 mm Hg and 2) with shunt (n = 26) with PASP of 57 ± 29 mm Hg and MPAP of 38 ± 19 mm Hg (p ≤ 0.001). In those without CHD or with CHD without shunt (n = 76), SPAP was 37 ± 19 mm Hg and the MPAP 25 ± 6 mm Hg. The prevalence of PH in DS was 5.9% at one year and 15% at 10 years. The odds ratio of PH in DS with CHD was 7.3 vs. 3 without CHD.
  
  
  CONCLUSIONS
  DS has a high prevalence of CHD and PH. PH prevalence increases when it is associated with CHD. The pathophysiology of PH in DS without CHD should be studied in the near future. Echocardiography is an indispensible tool for evaluation of DS.
authors.affiliation: ABC Medical Center I.A.P, Cardiovascular Division, Mexico City, Mexico. ; National Institute of Cardiology "Ignacio Chavez", Echocardiography in Out-Patient Clinic, Immunology Department, Embryology Department, Mexico City, Mexico.
authors.forename: Nilda
authors.initials: N
authors.lastname: Espinola-Zavaleta
authors.affiliation: ABC Medical Center I.A.P, Cardiovascular Division, Mexico City, Mexico. ; National Institute of Cardiology "Ignacio Chavez", Echocardiography in Out-Patient Clinic, Immunology Department, Embryology Department, Mexico City, Mexico.
authors.forename: María Elena
authors.initials: ME
authors.lastname: Soto
authors.affiliation: National Institute of Cardiology "Ignacio Chavez", Echocardiography in Out-Patient Clinic, Immunology Department, Embryology Department, Mexico City, Mexico.
authors.forename: Angel
authors.initials: A
authors.lastname: Romero-Gonzalez
authors.affiliation: The John Langdon Down Foundation, A.C, Pediatric Department, Mexico City, Mexico.
authors.forename: Lidia Del Carmen
authors.initials: Ldel C
authors.lastname: Gómez-Puente
authors.affiliation: National Institute of Cardiology "Ignacio Chavez", Echocardiography in Out-Patient Clinic, Immunology Department, Embryology Department, Mexico City, Mexico.
authors.forename: Luis
authors.initials: L
authors.lastname: Muñoz-Castellanos
authors.affiliation: St. Francis Hospital, Cardiac Imaging, New York, USA.
authors.forename: Aasha S
authors.initials: AS
authors.lastname: Gopal
authors.affiliation: Massachusetts General Hospital, Interpreters Service, Boston, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Keirns
authors.affiliation: ABC Medical Center I.A.P, Cardiovascular Division, Mexico City, Mexico.
authors.forename: Eulo
authors.initials: E
authors.lastname: Lupi-Herrera
keywords: Congenital heart disease; Down's syndrome; Echocardiogram; Pulmonary hypertension; Shunt