Risk factor analysis for cardiac abnormalities in patients with idiopathic scoliosis

Abstract

The proportion of cardiac abnormalities in patients with idiopathic scoliosis(IS) who required surgery is relatively high. However, the specific cause and underlying risk factors remain poorly elucidated. A retrospective study. To investigate the proportion of cardiac abnormalities in patients with IS and identify the related risk factors. Clinical and imaging data from 289 IS patients aged 6-18 years including 225 females and 64 males admitted to our center from January 2015 and March 2023 were analyzed. The records of echocardiography, spinal radiographs and magnetic resonance imaging were reviewed. Calculate the proportion of congenital heart disease and cardiac abnormalities related to heart valves in patients with IS, and screen the risk factors by multivariate analysis. Twelve patients (4.15%) had congenital heart disease, with atrial septal defect being the most common type (1.73%). Eighty-eight patients (30.45%) had cardiac abnormalities related to heart valves, with mild tricuspid regurgitation being the most common type (17.65%). There were no statistically significant differences in the proportion of congenital heart disease among groups based on gender(P = 0.096), age(6 ~ 10 vs. 11-18, P = 0.200), ethnicity(Han vs. Minority, P = 0.969), BMI grade(Emaciation vs. Normal vs. Overweight/Obesity, P = 0.512), altitude(< 2000 m vs. ≥ 2000 m, P = 0.078), main curvature location(Thoracic vs. Thoracolumbar vs. Lumbar, P = 0.326), severity of scoliosis(Deformed vs. Highly deformed, P = 0.841), main direction(P = 0.102), and chest aspect ratio(< 0.45 vs. ≥ 0.45, P = 0.341). The proportion of cardiac abnormalities related to heart valves was higher in males, patients with thoracolumbar IS, and patients with left-sided scoliosis (P < 0.05). Multivariate analysis showed that males and thoracolumbar scoliosis were risk factors for cardiac abnormalities related to heart valves in patients with IS (P < 0.05). Linear regression analysis showed that altitude had a weak correlation with IS combined with congenital heart disease (R²=0.018, P < 0.05). Among 289 patients with idiopathic scoliosis who required surgery, 4.15% had congenital heart disease, and 30.45% had cardiac abnormalities related to heart valves. Males and scoliosis in thoracolumbar were risk factors for cardiac abnormalities related to heart valves in patients with idiopathic scoliosis.

Keywords: Adolescents; Cardiac abnormalities; Children; Idiopathic scoliosis; Risk factors.