Women’s hearts need earlier help

© misterQM: photocase.com

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.

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).