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Predictive Scoring System for Spontaneous Closure of Infant Ventricular Septal Defect: The P-VSD Score

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Abstract

Ventricular septal defect (VSD) is a common congenital heart disease. However, consensus on the utility of echocardiography in predicting spontaneous closure (SC) of VSD remains lacking. This study aimed to identify and validate significant predictors of SC through a predictive scoring system. This retrospective study included medical records of 712 echocardiography instances performed on 304 patients diagnosed with VSD from 2016 to 2020 in their first year of life. A novel scoring system for predicting the SC of VSD was developed and validated using another dataset from different hospitals. Of the 304 patients, 215 (70.7%) had perimembranous (PM) VSDs and 89 had muscular (29.3%) VSDs. The median follow-up periods were 36.2 (interquartile range [IQR], 13–59) months and 13.7 9 (IQR, 5–37.4) days for PM and muscular VSDs, respectively. The overall SC rate during follow-up was 29.3%. Pulmonary hypertension (HTN), concomitant left ventricle (LV)–right atrium (RA) shunt, VSD size to aortic valve (AV) annulus size ratio, and left ventricular end-diastolic dimension (LVEDD) z-score were significant risk factors affecting SC of VSD. The “P-VSD” score, a new scoring system, demonstrated an area under the curve for predictability of 0.769. Pulmonary HTN, concomitant LV–RA shunt, LVEDD z-score, and VSD size-to-AV annulus size ratio at diagnosis were significantly associated with non-SC VSD after infancy. The P-VSD score can predict the SC of VSD in clinical settings and simplify the identification and appropriate management of high-risk patients.

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Funding

This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2021-0225).

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Author notes

  1. Ah Young Kim and Nuri Tchah have contributed equally to this work.

Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, C.P.O. Box 8044, Seoul, 03722, Korea

    Ah Young Kim, Nuri Tchah, Chang Sin Kim, Se Yong Jung, Jae Young Choi & Jo Won Jung

  2. Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Ching-yu Lin

  3. Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang-si, South Korea

    Jung Min Park

  4. Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Wongi Woo

Authors
  1. Ah Young Kim
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  2. Nuri Tchah
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  3. Ching-yu Lin
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  4. Jung Min Park
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  5. Wongi Woo
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  6. Chang Sin Kim
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  7. Se Yong Jung
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  8. Jae Young Choi
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  9. Jo Won Jung
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Contributions

AY.K. and N.T. wrote the main manuscript text and prepared figures 1, 2. C.L. and J.M.P. investigated the data. All authors were involved in statistical analysis and reviewed the manuscript.

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Correspondence to Jo Won Jung.

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Kim, A.Y., Tchah, N., Lin, Cy. et al. Predictive Scoring System for Spontaneous Closure of Infant Ventricular Septal Defect: The P-VSD Score. Pediatr Cardiol (2024). https://doi.org/10.1007/s00246-024-03434-8

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  • DOI: https://doi.org/10.1007/s00246-024-03434-8

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