CJC Pediatric and Congenital Heart Disease最新文献

{"title":"Digitization and Linkage of PDF Formatted 12-Lead Electrocardiograms in Adult Congenital Heart Disease","authors":"Muhammet Alkan Msc ,&nbsp;Fani Deligianni PhD ,&nbsp;Christos Anagnostopoulos PhD ,&nbsp;Idris Zakariyya PhD ,&nbsp;Gruschen R. Veldtman MBChB, FRCP","doi":"10.1016/j.cjcpc.2025.03.006","DOIUrl":"10.1016/j.cjcpc.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Twelve-lead electrocardiograms (ECGs) form an essential part of the late follow-up of patients with adult congenital heart disease (ACHD). Such ECGs are most frequently reviewed by clinicians in paper or PDF formats. These visual representations of the original vector data do not easily lend themselves to be directly analysed with the increasingly powerful machine learning algorithms that hold promise in risk prediction and early prevention of adverse events.</div></div><div><h3>Methods</h3><div>In this work, we set out to create digital signals from ECG PDF documents by a series of data processing steps, validate accuracy of the process, and demonstrate its potential utility in research. Using 4153 ECG PDF documents from 436 patients with ACHD, we created a “pipeline” to successfully digitize the visually represented ECG vector datasets. We then proceeded with the validation of the digitized ECG dataset using several features that are also calculated by the vendor, such as QRS duration, PR interval, and ventricular rate, on all the patients.</div></div><div><h3>Results</h3><div>We confirmed a strong correlation with the vendor measured ECG parameters including PR interval <span><math><mrow><mo>(</mo><mrow><mi>R</mi><mo>=</mo><mn>0.941</mn><mo>,</mo><mi>P</mi><mo>&lt;</mo><mn>0.05</mn></mrow><mo>)</mo></mrow></math></span>, QRS duration <span><math><mrow><mrow><mo>(</mo><mrow><mi>R</mi><mo>=</mo><mn>0.949</mn><mo>,</mo><mi>P</mi><mo>&lt;</mo><mn>0.05</mn></mrow><mo>)</mo></mrow><mtext>,</mtext></mrow></math></span> and ventricular rate <span><math><mrow><mo>(</mo><mrow><mi>R</mi><mo>=</mo><mn>0.971</mn><mo>,</mo><mi>P</mi><mo>&lt;</mo><mn>0.05</mn></mrow><mo>)</mo></mrow></math></span>. Further, using support vector machine, a well-established machine learning model, we demonstrate the ability of the digitized ECG dataset to accurately predict anatomic diagnosis in ACHD.</div></div><div><h3>Conclusions</h3><div>Digitization of PDF formatted ECG signal data can be accomplished with good accuracy and can be used in clinical research in ACHD.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 263-273"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Knowledge Translation Intervention to Improve the Detection and Management of Pediatric Dyslipidemias in British Columbia","authors":"Venessa K. Thorsen BSc (Hons) ,&nbsp;Stephanie Glegg PhD, MSc, BScOT ,&nbsp;Kevin C. Harris MD, MHSc, BSc","doi":"10.1016/j.cjcpc.2025.05.003","DOIUrl":"10.1016/j.cjcpc.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Familial hypercholesterolemia (FH) is a common, underdiagnosed genetic condition associated with premature cardiovascular disease. Despite the availability of Canadian Cardiovascular Society (CCS)/Canadian Pediatric Cardiology Association (CPCA) guidelines, awareness and uptake among primary care providers remain limited. We developed and evaluated a continuing medical education (CME) course to improve adherence to pediatric dyslipidemia guidelines across British Columbia.</div></div><div><h3>Methods</h3><div>We conducted a quasiexperimental pre-/post-knowledge translation study. The CME course was delivered in-person at BC Children’s Hospital and remotely to urban and rural family physicians and pediatricians. Pre-course and 1-month post-course surveys assessed self-reported confidence and adherence to CCS/CPCA recommendations.</div></div><div><h3>Results</h3><div>Likelihood of screening pediatric patients for FH improved significantly after the course (<em>P</em> &lt; 0.001), as did confidence in screening (<em>P</em> &lt; 0.05) and diagnosing FH (<em>P</em> &lt; 0.001). Screening based on risk factors increased significantly: at-risk race and ethnicity (+41%), cardiometabolic conditions (+51%), early-onset high cholesterol (+46%), family history of diabetes (+26%), and premature cardiovascular events in first-degree relatives (+57%). Adherence to diagnostic recommendations improved, including dietary and exercise counseling (+31%), dietician referral (+29%), family history assessment (+46%), and lipid specialist referral (+36%). Treatment adherence also increased: cascade screening (+14%), statin initiation (+23%), dietician referral (+24%), and lipid specialist referral (+36%). Most participants (93%) agreed or strongly agreed that they acquired new knowledge and found the CME to be the most effective format for guideline dissemination.</div></div><div><h3>Conclusions</h3><div>The CME course effectively promoted CCS/CPCA guideline uptake and improved self-reported clinical practices. Expanding delivery to include trainees, nurses, and pharmacists may enhance impact and reach.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 283-294"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2772-8129(25)00116-2","DOIUrl":"10.1016/S2772-8129(25)00116-2","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Closure of Persistent Ductus Arteriosus: Complication Rates and Long-term Follow-up, a Single-Centre Retrospective Study","authors":"Ian Scott Kendall MbChB, MRCPCH ,&nbsp;Gail Davison MB BCh BAO, MRCPCH, PhD ,&nbsp;Neil Kennedy BSc, MbChB, MRCPCH, MMEDSci, DTMH ,&nbsp;Brian McCrossan MB BCh BAO, MRCPCH, MD","doi":"10.1016/j.cjcpc.2025.04.001","DOIUrl":"10.1016/j.cjcpc.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Transcutaneous closure of patent ductus arteriosus (PDA) in childhood is a common procedure. Long-term follow-up by paediatric cardiologists is variable. Identification and classification of postoperative complications may enable targeted follow-up and timelier discharges. This study aimed to characterize complication rates and assess discharge timing.</div></div><div><h3>Methods</h3><div>This is a single-centre retrospective study of paediatric patients (aged 0-15 years) who underwent a transcutaneous closure of a PDA between January 2006 and December 2015.</div></div><div><h3>Results</h3><div>A total of 156 patients who underwent interventional occlusion of a PDA were included. Complications were seen in 18 of 156 (12%) patients. High-grade complications occurred in 8 of 156 (5.1%) patients; these included device embolization, failure requiring surgical closure, or repeated interventional closure. Moderate to low-grade complications including flow acceleration in the aorta and left pulmonary artery (LPA) occurred in 10 of 156 (6.4%) patients. Fourteen of 18 (77%) complications were immediately apparent. Late mild to moderate obstruction of the descending aorta or LPA occurred in 3 of 156 (2%) patients. Later obstruction occurred in the Amplatzer ductal occluder 1 (ADO1) group only with large (4.5-5 mm) ducts. The average follow-up time for all patients was 81 (±47) months. Younger age at insertion and larger size of ADO1 devices were associated with later obstruction.</div></div><div><h3>Conclusions</h3><div>In our cohort, PDA occlusion was associated with a 5.1% major complication rate, which is evident within 24 hours; a further 2% (all treated with ADO1 devices) developed between mild and moderate aortic or LPA obstruction at least 1 year after the procedure. To date, this has not required intervention. It may therefore be prudent to continue longer-term surveillance of patients who have undergone PDA occlusion with the ADO1 device.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 277-282"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Extracorporeal Membrane Oxygenation and Atrial Pacing in Congenital Junctional Ectopic Tachycardia: A Case Report","authors":"Nicolas Mourad BSc ,&nbsp;Diego Marquez MD ,&nbsp;Cheryl Peters MD ,&nbsp;Steven Rathgeber MD ,&nbsp;Sakethram Saravu Vijayashankar MD ,&nbsp;Ryaan EL-Andari MD ,&nbsp;Muhieldin Ahamad Muhieldin MD","doi":"10.1016/j.cjcpc.2025.04.005","DOIUrl":"10.1016/j.cjcpc.2025.04.005","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 274-276"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary to New Insights on Cardiorespiratory Fitness in Adults With Systemic Right Ventricles","authors":"Jared Sheridan MBBS, MSc,&nbsp;Michael Khoury MD","doi":"10.1016/j.cjcpc.2025.05.004","DOIUrl":"10.1016/j.cjcpc.2025.05.004","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 243-244"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Chronic Thrombocytopenia After Pulmonary Valve Replacement in a Patient With Shone’s Complex","authors":"Daiki Harada MD,&nbsp;Naritaka Kimura MD, PhD,&nbsp;Hideyuki Shimizu MD, PhD","doi":"10.1016/j.cjcpc.2025.03.005","DOIUrl":"10.1016/j.cjcpc.2025.03.005","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 245-248"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Systemic Right Ventricle With a Biventricular Circulation on Cardiorespiratory Fitness","authors":"Charles Desrosiers-Gagnon MSc ,&nbsp;Naïma-Ayane Mahdi MD ,&nbsp;Michel White MD ,&nbsp;François-Pierre Mongeon MD, SM ,&nbsp;Blandine Mondésert MD ,&nbsp;Annie Dore MD ,&nbsp;Paul Khairy MD, PhD ,&nbsp;Daniel Gagnon PhD ,&nbsp;Marie-A. Chaix MD, PhD","doi":"10.1016/j.cjcpc.2025.04.004","DOIUrl":"10.1016/j.cjcpc.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Adults with transposition of the great arteries and a systemic right ventricle (sRV) generally have lower cardiorespiratory fitness (CRF) than healthy adults with a systemic left ventricle (sLV). However, studies to date have not accounted for systolic function of the systemic ventricle. The objective was to assess and compare CRF in adults with an sRV vs sLV matched for clinical characteristics and systemic ventricular function.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional analysis was conducted on 24 adults with an sRV and 24 adults with an sLV matched for sex (20 males), age, body mass index, ejection fraction of the systemic ventricle (dysfunction in 23 pairs), New York Heart Association functional class (class II-III in 18 pairs), and doses of diuretics. Peak oxygen consumption (<span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover><msub><mi>O</mi><msub><mn>2</mn><mtext>peak</mtext></msub></msub></mrow></math></span>) was compared with a Wilcoxon signed-rank test. The percentage of predicted <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover><msub><mi>O</mi><msub><mn>2</mn><mtext>peak</mtext></msub></msub></mrow></math></span> (% <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover><msub><mi>O</mi><msub><mn>2</mn><mtext>peak</mtext></msub></msub></mrow></math></span>) and ventilation/carbon dioxide production slope (<span><math><mrow><msub><mover><mi>V</mi><mo>˙</mo></mover><mi>E</mi></msub><mo>/</mo><msub><mover><mi>V</mi><mo>˙</mo></mover><msub><mtext>CO</mtext><mn>2</mn></msub></msub></mrow></math></span> slope) were presented as secondary outcomes. Statistical significance was set at P &lt; 0.05.</div></div><div><h3>Results</h3><div>The population is characterized by high previous heart failure–related hospitalizations (22% in sRV and 58% in sLV) and diagnoses of pulmonary hypertension (61% in sRV and 60% in sLV). <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover><msub><mi>O</mi><msub><mn>2</mn><mtext>peak</mtext></msub></msub></mrow></math></span> did not differ between groups, with a mean difference (sRV – sLV) of 0.17 mL/kg/min (95% confidence interval [CI]: –2.74, 2.39; <em>P</em> = 0.770). The mean difference between groups for <span><math><mrow><mo>%</mo><mspace></mspace><mover><mi>V</mi><mo>˙</mo></mover><msub><mi>O</mi><msub><mn>2</mn><mtext>peak</mtext></msub></msub></mrow></math></span> was 5% (95% CI: –13, 2), and for <span><math><mrow><msub><mover><mi>V</mi><mo>˙</mo></mover><mi>E</mi></msub><mo>/</mo><msub><mover><mi>V</mi><mo>˙</mo></mover><msub><mtext>CO</mtext><mn>2</mn></msub></msub></mrow></math></span> slope it was 0.92 (95% CI: –3.98, 2.14).</div></div><div><h3>Conclusion</h3><div>No differences in CRF were observed between adults with an sRV and an sLV when matched for clinical characteristics and systemic ventricular function.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 235-242"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantable Defibrillator in the Systemic Right Ventricle: Are We Still Baffled?","authors":"Sakethram Saravu Vijayashankar MD, MRCPCH,&nbsp;Shubhayan Sanatani MD, FRCPC","doi":"10.1016/j.cjcpc.2025.05.001","DOIUrl":"10.1016/j.cjcpc.2025.05.001","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 5","pages":"Pages 260-262"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Perception of Fontan Failure, “Acceptable” Hemodynamics, Assessment, and Indications for Intervention—Results of a Multinational Survey","authors":"Ashish H. Shah MD, MD-Res, FRCP ,&nbsp;Evan J. Wiens MD, MSc, FRCPC ,&nbsp;Jonathan Windram MD, FRCP ,&nbsp;Shakeel A. Qureshi MBChB, FRCP, FRCPCH ,&nbsp;Petra Jenkins FRCP ,&nbsp;Isma Rafiq MBBS, MRCP, MD-Res ,&nbsp;Erwin Oechslin MD, FESC, FRCPC, DRCPSC ,&nbsp;Richard A. Krasuski MD","doi":"10.1016/j.cjcpc.2025.02.004","DOIUrl":"10.1016/j.cjcpc.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Patients with complex congenital heart disease unfit for biventricular repair are often palliated with Fontan circulation (FC), which obviates the need for a subpulmonary ventricle. This approach has led to high survival rates, with over 80% of patients expected to live beyond 30 years. Despite increasing patient numbers and existing guidelines, there are no standardized hemodynamic parameters defining Fontan failure, resulting in considerable variability in management practices. This pilot project aimed to assess real-world practices in FC patient management, particularly in surveillance, defining Fontan circulatory failure, and determining treatment thresholds.</div></div><div><h3>Methods</h3><div>A cross-sectional survey with 10 multiple-choice questions and optional free-form responses was distributed globally to congenital heart disease cardiologists through 2 academic centers. Conducted from January to December 2021, the survey targeted clinicians managing adult FC patients.</div></div><div><h3>Results</h3><div>Of 310 invited cardiologists, 170 (55%) participated, including 27% from the United States, 22% from Canada, and 20% from the United Kingdom. Respondents included pediatric (37%), adult congenital (47%), and dual trained adult/pediatric cardiologists (14%), mostly in academic settings (94%). Variability existed in defining FC failure, with markers such as protein-losing enteropathy (74%), fatigue/dyspnea (62%), and elevated Fontan pressure (58%) commonly cited. Responses differed on defining elevated Fontan pressure, with 53% selecting &gt;15 mm Hg, 33% &gt;18 mm Hg, and 14% &gt;20 mm Hg. Ninety-one percent prescribed pulmonary vasodilators, though indications and thresholds varied.</div></div><div><h3>Conclusion</h3><div>Substantial heterogeneity in FC patient management currently exists, underscoring the need for standardized hemodynamic parameters.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 4","pages":"Pages 198-202"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}