Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound: experience from 20 European registries.

OBJECTIVES: To evaluate prenatal diagnosis of congenital heart diseases by ultrasound investigation in well-defined European populations. DESIGN: Data from 20 registries of congenital malformations in 12 European countries were included. The prenatal ultrasound screening programs in the countries ranged from no routine screening to three ultrasound investigations per patient routinely performed. RESULTS: There were 2454 cases with congenital heart disease with an overall prenatal detection rate of 25%. Termination of pregnancy was performed in 293 cases (12%). There was considerable variation in prenatal detection rate between regions, with the lowest detection rates being in countries without ultrasound screening (11%) and in Eastern European countries (Croatia, Lithuania and Ukraine; 8%). In Western European countries with ultrasound screening, detection rate ranged from 19-48%. There was a significant difference in prenatal detection rate and proportion of induced abortions between isolated congenital heart disease and congenital heart disease associated with chromosome anomalies, multiple malformations and syndromes (P < 0.0001). There were 1694 cases with isolated congenital heart disease of which 16% were diagnosed prenatally. Malformations affecting the size of the ventricles were detected prenatally in half of the cases. CONCLUSIONS: Prenatal detection rate of congenital heart disease varies significantly between countries even with the same screening recommendations. The presence of associated malformations significantly increases the prenatal detection rate.

Heart to Heart, April 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, May 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, June 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, July 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, August 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, September 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, October 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, November 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, December 2011

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, January 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, February 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

L'athérosclérose est-elle une maladie gingivo-induite [Is atherosclerosis a periodontally-induced disease?]

Traditional risk factors do not explain all of cases of ischemic cardiovascular disease. The literature now identifies periodontal disease, a chronic oral infection, as a potential risk factor of atherosclerosis. Three plausible biologic pathways have been proposed to explain this link: a direct action of periodontal bacteria migrating by bacteriemia, an indirect action by inflammation, mediators an immunopathogenic pathway related to heat shock proteins. Clinical studies show an increase in the CRP or recirculating specific immunoglobulins in presence of advanced periodontal disease. Other interventional studies show a reduction in cardiovascular risk factors when intensive periodontal therapy is used in patients with advanced periodontal disease. Literature therefore confirms a modest link between periodontal and cardiovascular diseases even if causality is not confirmed so far.

A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings.

Obstructive disease of the large coronary arteries is the prominent cause for angina pectoris. However, angina may also occur in the absence of significant coronary atherosclerosis or coronary artery spasm, especially in women. Myocardial ischaemia in these patients is often associated with abnormalities of the coronary microcirculation and may thus represent a manifestation of coronary microvascular disease (CMD). Elucidation of the role of the microvasculature in the genesis of myocardial ischaemia and cardiac damage-in the presence or absence of obstructive coronary atherosclerosis-will certainly result in more rational diagnostic and therapeutic interventions for patients with ischaemic heart disease. Specifically targeted research based on improved assessment modalities is needed to improve the diagnosis of CMD and to translate current molecular, cellular, and physiological knowledge into new therapeutic options.

Heart to Heart, March 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.