engleski

EPIDEMIOLOGY OF CONGENITAL HEART DISEASE - A MULTICENTRIC NATIONAL STUDY IN CROATIA, 1995-2000

Congenital heart diseases (CHD) comprise a group of aetiologically and phenotypically different conditions seen in 0, 6-1% of live births. There is a tendency to classify CHD's according to Clark's pathogenic classification, which assumes that relatively few pathogenic mechanisms cause a wide spectrum of phenotypic forms of CHD, which is in line with recently acquired knowledge from embryonic and genetic investigations. The aim of this study was to classify CHD in Croatian population according to Clark’ s classification, to calculate incidence rates of CHD in the total Croatian population and compare the results with other populations. We formed the Registry including all children with CHD treated in all 16 Departments of Paediatrics in Croatia, born between 1995 and 2000. Diagnosis of CHD was confirmed by echocardiography and in some cases by cathetherisation or operation. The data on total number of livebirths were obtained from the Croatian Institute for Public Health. All patients and liveborn children were divided by counties of the Republic of Croatia. Basic information and calculated incidence according to the year of occurrence is presented in Table 1.Statistically significant difference was found between CHD incidence rates in several counties (0, 42-1, 41/1.000 live births). The incidence of all main pathogenic groups of CHD was constant in time, except for cell death defects where threefold increase in incidence of muscular ventricular septal defect (VSD) was noted (0, 5-1, 5/1.000 live births). This can be explained by better diagnostics of smaller muscular VSD. The most common diagnosis was perimembranous VSD (19, 1%), followed by atrial septal defect (ASD) type II (14, 4%), muscular VSD (11, 3%), pulmonary stenosis without VSD (8, 5%), patent arterial duct (6, 3%), subarterial VSD (5, 3%) and Tetralogy of Fallot (3, 9%). The incidence and diagnostic possibilities in our population are not significantly different from those presented in the literature. However, the differences in incidence of CHD between counties warrant the need for further investigation into the development and etiology of CHD.

congenital heart diseases; epidemiology

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