ArticlePediatric cardiology2015
Immunologic Aging in Adults with Congenital Heart Disease: Does Infant Sternotomy Matter?
Article in Pediatric cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review.Frontiers in immunology · 2021Pooled it
- Long-term immunological impairment after early thymectomy in congenital heart disease.Immunologic research · 2026Article
- The Proteomic Profile of Adults With a Fontan Circulation.JACC. Advances · 2026Article
- Sustained Effector Functions and Memory Accumulation of αβ T Cells in Children With Congenital Heart Disease.European journal of immunology · 2026Article
- Adults With Congenital Heart Disease Have an Increased Prevalence of Autoimmunity.JACC. Advances · 2025Article
- Early-life thymectomy leads to an increase of granzyme-producing γδ T cells in children with congenital heart disease.Nature communications · 2024Article
- Altered Inflammatory State and Mitochondrial Function Identified by Transcriptomics in Paediatric Congenital Heart Patients Prior to Surgical Repair.International journal of molecular sciences · 2024Article
- Health Consequences of Thymus Removal in Adults.The New England journal of medicine · 2023Article
- Immunity and inflammation: the neglected key players in congenital heart disease?Heart failure reviews · 2022Review
- Deep sequencing unveils altered cardiac miRNome in congenital heart disease.Molecular genetics and genomics : MGG · 2022Article
- T Cell Response to Influenza Vaccination Remains Intact in Adults with Congenital Heart Disease Who Underwent Early Thymectomy.International journal of cardiology. Congenital heart disease · 2022Article
- Accelerated Cardiac Aging in Patients With Congenital Heart Disease.Frontiers in cardiovascular medicine · 2022Review
- Disseminated-cutaneous sporotrichosis in an immunocompetent adult.JAAD case reports · 2021Article
- Building a T cell compartment: how immune cell development shapes function.Nature reviews. Immunology · 2020Review
- Congenital Heart Disease and Risk of Central Nervous System Infections: A Nationwide Cohort Study.Pediatric cardiology · 2020Article
- The significance of neonatal thymectomy for shaping the immune system in children with congenital heart defects.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2017Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
Thymectomy is performed routinely in infants undergoing cardiothoracic surgery. Children post-sternotomy have decreased numbers of T lymphocytes, although the mechanisms involved and long-term consequences of this have not been defined. We hypothesized that lymphopenia in patients with adult congenital heart disease (ACHD) would be reflective of premature T cell maturation and exhaustion. Adults with ACHD who had sternotomy to repair congenital heart disease as infants (<1 year) and age-matched ACHD patients without prior sternotomy were studied using polychromatic flow cytometry interrogating markers of lymphocyte maturation, exhaustion and senescence. Group differences were analyzed using Mann-Whitney U and Fisher's exact tests. Eighteen ACHD patients aged 21-40 years participated: 10 cases and 8 controls. Median age at sternotomy for cases was 52 days. Cases and controls were matched for age (28.9 vs. 29.1 years; p = 0.83), gender (p = 0.15) and race (p = 0.62) and had similar case complexity. Cases had a lower mean percentage of cytotoxic CD8 lymphocytes compared to controls (26.8 vs. 33.9 %; p = 0.016), with fewer naive, undifferentiated CD8 T cells (31.0 vs. 53.6 %; p = 0.027). CD8 cells expressing PD1, a marker of immune exhaustion, trended higher in cases versus controls (25.6 vs. 19.0 %; p = 0.083). Mean percentage of CD4 cells was higher in cases versus controls (65.6 vs. 59.6 %; p = 0.027), without differences in CD4 T cell maturation subtype. In summary, ACHD patients who undergo sternotomy as infants exhibit differences in T lymphocyte composition compared to ACHD controls, suggesting accelerated immunologic exhaustion. Investigation is warranted to assess the progressive nature and clinical impact of this immune phenotypic change.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.