Epidemiology of Valvular and Nonvalvular Congenital Heart Disease in a Large Teenage Cohort- Interesting Demographic and Medical Relationships

Daniel Fink Rivka Farkash
cardiology, Sheba Medical Center, Tel Hashomer, Israel

We present the investigation of a large 23 year cohort (113,460 army recruits from one geographical area of Israel between the years 1988-2011 with birth years from 1969-1994) mostly between the ages of 16 and 19. We present interesting findings after multi regression analysis of multiple demographic and disease categories.

A very highly significant and large relationship was found between diabetes and more severe valvular and nonvalvular congenital heart disease in males. Also a significant relationship was found between endocrine disorders and more severe valvular disease in males and females.

An unexpected finding was an inverse ("protective") relationship between the diagnosis of flat feet and valvular and nonvalvular congenital heart disease in males.

Although a BMI in the "Obese" and "Overweight" ranges confers an inverse, "protective" effect in relation to congenital heart disease- this appears to be related to a diagnostic bias. The "Underweight" BMI category is related to both mild and severe valvular and nonvalvular congenital cardiac disease in males, and as such, seems to be a true relationship, independent of bias.

Significant Nonvalvar Disease- Males

Significant Valvar Disease- Males

All Valvar Disease- Males

OR 18.5 (2.4-141.2) p=.005

OR 39.2 (8.4-182.8) p<.001

OR 5.0 (1.2-21.1) p=0.03

Diabetes

Significant Valvar Disease- Females

Significant Valvar Disease- Males

OR 13.7 (3.07-61.3) p=.001

OR 6.2 (1.7-21.9) p=.005

Endocrine Disorders

Significant Nonvalvar Disease- Males

All Nonvalvar Disease- Males

All Valvar Disease- Males

OR 0.32 (0.12-0.90) p=0.03

OR 0.69 (0.50-0.94) p=.02

OR 0.83 (0.69-0.99) p=0.04

Flat Feet

Significant Nonvalvar Disease- Males

All Nonvalvar Disease- Males

Significant Valvar Disease- Males

All Valvar Disease- Males

OR 4.28 (2.01-9.13) p<.001

OR 2.42 (1.52-3.85) p<.001

OR 2.0 (1.02-4.0) p=.04

OR 2.52 (1.9-3.3) p<.001

BMI "Underweight"

OR, odds ratio, (95 %




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