Women’s hearts need earlier help

In Germany, around 15,000 people are living with Tetralogy of Fallot – the most common cyanotic heart defect. The babies affected are also known as “blue babies” because they are born with a bluish skin tone. A team of researchers at the Competence Network for Congenital Heart Defects has now examined how these children are doing several years after their operation. “The study shows that women with Tetralogy of Fallot have been disadvantaged in treatment practices to date because they should have received different treatment to men. Existing threshold values do not sufficiently reflect the specifics of the female heart”, explains the head of research  Dr. Samir Sarikouch from Hannover Medical School. The study will be published on 16th of November 2011 in Circulation: Cardiovascular Imaging. (doi:10.1161/CIRCIMAGING.111.963637).

Course of the disease differs in women

In an extensive study under the direction of the Heart and Diabetes Center North Rhine-Westphalia in Bad Oeynhausen, scientists have examined more than 400 patients with Tetralogy of Fallot at 14 cardiac centres in Germany and gathered gender-specific reference values for this heart defect. The results show that when data is standardised to uniform body sizes, women’s hearts are still smaller than men’s and that the exercise capacity of women with Tetralogy of Fallot is considerably smaller. “The long-term development of this malformation differs in that women with similar residual findings need earlier reoperations in order to avoid irreparable strain on the right ventricle”, explains Sarikouch. Heart insufficiency or heart failure are just two possible outcomes if reoperations are carried out at too late a stage.

Guidelines should be reconsidered

Sarikouch is convinced that “in dealing with congenital heart defects, we have previously neglected the fact that women’s hearts require different treatment to men’s hearts. The guidelines for reoperations on Tetralogy of Fallot should be reconsidered and should in future take gender of the patient into account.” As a next step the scientists wish to develop a method to offer patients individual risk analyses.

On the illness

Tetralogy of Fallot is the most common cyanotic heart defect. Since it accounts for 2.5% of all heart defects, it is also one of the most common defects from birth. The heart shows a narrowing of the right ventricular outflow tract (pulmonary stenosis), a defect in the chamber septum (ventricular septal defect), a displacement of the aorta and a thickening of the right ventricle (right ventricular hypertrophy).

Sarikouch S, Koerperich H, Dubowy KO, Boethig D, Boettler P, Mir TS, Peters B, Kuehne T, Beerbaum P. Impact of Gender and Age on Cardiovascular Function Late After Repair of Tetralogy of Fallot: Percentiles Based on Cardiac Magnetic Resonance. Circ Cardiovasc Imaging 2011


Competence Network for Congenital Heart Defects

The Competence Network for Congenital Heart Defects carries out research on disease mechanisms, new methods of treatment and the current state of care for children, adolescents and adults with heart defects in Germany. The research association brings together physicians, scientists, parents’ associations and self-help groups to cooperate in ensuring that there is a rapid exchange of new findings between research and treatment. The network is receiving funding from the German Federal Ministry of Education and Research (BMBF) under the programme “Health Research: Scientific Research for the People” for a period of nine years. In this the BMBF wishes to reinforce cross-structural scientific cooperation. The Competence Network’s patron is Friede Springer.

Press contact

Wiebke Lesch
Competence Network for Congenital Heart Defects
Tel.: +49 (0)30 40048783
Fax: +49 (0)30  40048781
E-mail: presse(at)kompetenznetz-ahf.de

Dr. Samir Sarikouch
Hannover Medical School
Tel.: +49 (0)511 532 5567
Fax: +49 (0)511  532 9832
E-mail: sarikouch.samir(at)mh-hannover.de