CJC Pediatric and Congenital Heart Disease最新文献

{"title":"Evaluation of a Video-Based Education Intervention for Parents of Children Undergoing Fontan Surgery: A Cluster Randomized Controlled Trial","authors":"Julie K. Rehman RN, MN ,&nbsp;Gwen R. Rempel RN, PhD ,&nbsp;Elina Williams RN, BScN, PMP ,&nbsp;Leanne Meakins NP, MN ,&nbsp;Mary E. Bauman NP, MN ,&nbsp;M. Patricia Massicotte MD ,&nbsp;Roberta Davis BA ,&nbsp;Judy Dahl CCLS ,&nbsp;Andrew S. Mackie MD, SM","doi":"10.1016/j.cjcpc.2023.05.003","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.05.003","url":null,"abstract":"<div><h3>Background</h3><p>Fontan surgery is performed at 2-4 years of age and is the third planned surgical intervention for children with a univentricular heart. Major challenges for children and parents after Fontan include (a) psychological distress, (b) prolonged pleural drainage, and (c) the need for postoperative anticoagulation. The aim of this study was to evaluate a pre-Fontan video-based intervention for parents to address these challenges.</p></div><div><h3>Methods</h3><p>This study is a single-centre mixed-methods cluster randomized controlled trial. The intervention consisted of 3 brief whiteboard videos offered online from preadmission clinic to 1 month postoperatively. The parent’s State Trait Anxiety Inventory score and the child’s Post Hospital Behaviour Questionnaire score were measured 1 week and 1 month postoperatively. Semistructured interviews were conducted to obtain parental feedback on the videos.</p></div><div><h3>Results</h3><p>We enrolled 26 children (13 female patients; 16 intervention group) and 1 parent per child. Mean State Trait Anxiety Inventory scores were similar between groups at both 1 week (52.8 vs 55.5, <em>P</em> = 0.25) and 1 month postoperatively (50.9 vs 53.9, <em>P</em> = 0.25). Post Hospital Behaviour Questionnaire scores were in the maladaptive range but did not differ between groups. Parents agreed or strongly agreed that the videos were helpful but should be provided earlier in the preoperative process. The main value of the videos was recognized as being a method for standardizing information provided to parents.</p></div><div><h3>Conclusions</h3><p>A video-based education intervention did not impact State Trait Anxiety Inventory or Post Hospital Behaviour Questionnaire scores. However, the majority of parents agreed that the videos were helpful.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762477","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":"Right Ventricular Function and Right Ventricular-Vascular Coupling Assessment After Coarctation Repair in Adults","authors":"Luc L. Mertens MD, PhD","doi":"10.1016/j.cjcpc.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.07.001","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762471","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":"Prognostic Role of Tricuspid Annular Plane Systolic Excursion/Right Ventricular Systolic Pressure Ratio in Coarctation of Aorta","authors":"Marwan Ahmed MBBS,&nbsp;Snigdha Karnakoti MBBS,&nbsp;Omar Abozied MBBS,&nbsp;Sriharsha Kandlakunta MBBS,&nbsp;Ahmed Younis MBBS,&nbsp;Alexander C. Egbe MD, MPH, MS","doi":"10.1016/j.cjcpc.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Right ventricular (RV) systolic dysfunction and pulmonary hypertension are associated with mortality in adults with coarctation of aorta (COA). The tricuspid annular plane systolic excursion/RV systolic pressure (TAPSE/RVSP) ratio is a validated noninvasive tool for the assessment of RV-pulmonary arterial (RV-PA) coupling in patients with PA hypertension, but similar data are lacking in adults with COA. The purpose of this study was to assess the relationship between the TAPSE/RVSP ratio and outcomes in this population.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of adults with repaired COA was performed. RV systolic dysfunction was defined as RV free wall strain ≥−24% at baseline, whereas new-onset RV systolic dysfunction was defined RV free wall strain ≥−24% during follow-up.</p></div><div><h3>Results</h3><p>Of 661 patients, TAPSE, RVSP, and TAPSE/pulmonary artery systolic pressure ratio were 22 ± 6 mm, 34 ± 12 mm Hg, and 0.71 (0.48-0.89) mm/mm Hg, respectively. Of 661 patients, 152 (23%) had RV systolic dysfunction at baseline, and TAPSE/RVSP &lt;0.43 mm/mm Hg was the optimal threshold to detect RV systolic dysfunction. TAPSE/RVSP &lt;0.43 mm Hg was associated with RV systolic dysfunction (adjusted odds ratio: 3.11 [1.83-6.19], <em>P</em> = 0.004). Of 509 patients with normal RV systolic function, 42 (8%) and 36 (7%) developed new-onset RV systolic dysfunction and new-onset right heart failure, respectively, during follow-up. TAPSE/RVSP &lt;0.43 mm/mm Hg was associated with new-onset RV systolic dysfunction (adjusted hazard ratio: 1.95 [1.46-2.77], <em>P</em> = 0.008) and new-onset right heart failure (adjusted hazard ratio: 0.81 [0.68-0.92], <em>P</em> = 0.005).</p></div><div><h3>Conclusions</h3><p>The TAPSE/RVSP ratio can potentially be used to identify patients at risk for new-onset RV systolic dysfunction and right heart failure and provide opportunity for proactive interventions to prevent adverse outcomes.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762476","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":"Regional Elevation of Liver T1 in Fontan Patients","authors":"Paul G. Greidanus MSc ,&nbsp;Joseph J. Pagano MD, PhD ,&nbsp;Carolina A. Escudero MD, MSc ,&nbsp;Richard Thompson PhD ,&nbsp;Edythe B. Tham MBBS","doi":"10.1016/j.cjcpc.2023.03.004","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.03.004","url":null,"abstract":"<div><h3>Background</h3><p>Fontan-associated liver disease (FALD) is characterized by hepatic congestion and progressive hepatic fibrosis in patients with the Fontan operation. This condition is generally clinically silent until late, necessitating techniques for early detection. Liver T1 mapping has been used to screen for FALD, but without consideration of regional variations in T1 values.</p></div><div><h3>Methods</h3><p>Liver T1 measured with a liver-specific T1 mapping sequence (PROFIT1) in Fontan patients was compared with cohorts of patients with biventricular congenital heart disease (BiV-CHD) and controls with normal cardiac function and anatomy.</p></div><div><h3>Results</h3><p>Liver T1 was significantly elevated in the Fontan cohort (n = 20) compared with patients with BiV-CHD (n = 12) and controls (n = 9) (781, 678, and 675 milliseconds, respectively; <em>P</em> &lt; 0.001), with a consistent pattern of significantly elevated T1 values in the peripheral compared with central liver regions (ΔT1 = 54, 2, and 11 milliseconds; <em>P</em> &lt; 0.001). PROFIT1 also yielded simultaneous T2∗ maps and fat fraction values that were similar in all groups. Fontan liver T1 values were also significantly elevated as compared with BiV-CHD and controls as measured with the cardiac (modified Look-Locker inversion) acquisitions (728, 583, and 583 milliseconds, respectively; <em>P</em> &lt; 0.001) and values correlated with PROFIT1 liver T1 (R = 0.87, <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Fontan patients have globally increased liver T1 values and consistent spatial variations, with higher values in the peripheral liver regions as compared with spatially uniform values in BiV-CHD and controls. The spatial patterns may provide insight into the progression of FALD. Liver T1 mapping studies should include uniform spatial coverage to avoid bias based on slice locations in this population.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762470","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":"Cardiac Magnetic Resonance Imaging in Individuals With Prenatal Alcohol Exposure","authors":"Danielle Beaulieu BSc ,&nbsp;Sarah Treit PhD ,&nbsp;Joseph J. Pagano MD, PhD ,&nbsp;Christian Beaulieu PhD ,&nbsp;Richard Thompson PhD","doi":"10.1016/j.cjcpc.2023.03.005","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.03.005","url":null,"abstract":"<div><h3>Background</h3><p>Prenatal alcohol exposure (PAE) has teratogenic effects on numerous body systems including the heart. However, research magnetic resonance imaging (MRI) studies in humans with PAE have thus far been limited to the brain. This study aims to use MRI to examine heart structure and function, brain volumes, and body composition in children and adolescents with PAE.</p></div><div><h3>Methods</h3><p>Heart, brain, and abdominal 3T MRI of 17 children, adolescents, and young adults with PAE and 53 unexposed controls was acquired to measure: (1) left ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, cardiac output, longitudinal strain, circumferential strain, and heart mass; (2) total brain, cerebellum, white matter, grey matter, caudate, thalamus, putamen, and globus pallidus volumes; and (3) subcutaneous fat, visceral fat, muscle fat, and muscle (body composition).</p></div><div><h3>Results</h3><p>Cardiac MRI revealed no abnormalities in the PAE group on evaluation by a paediatric cardiologist and by statistical comparison with a control group. Cardiac parameters in both groups were in line with previous reports, including expected sex- and age-related differences. Cerebellum, caudate, and globus pallidus volumes were all smaller. Body mass index and subcutaneous fat percent were higher in females with PAE relative to control females, but lower in males with PAE relative to control males.</p></div><div><h3>Conclusions</h3><p>Children with PAE did not have abnormalities in MRI-derived measures of cardiac structure or function despite smaller brain volumes and sex-specific differences in body composition relative to healthy controls.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725246","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":"Call for papers: Special Issue on Tetralogy of Fallot","authors":"","doi":"10.1016/S2772-8129(23)00081-7","DOIUrl":"https://doi.org/10.1016/S2772-8129(23)00081-7","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49724762","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(23)00074-X","DOIUrl":"https://doi.org/10.1016/S2772-8129(23)00074-X","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49751415","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":"Late Palpitations in Young Patients After Ablation for Tachyarrhythmias","authors":"Christopher O.Y. Li MD,&nbsp;Dania Kallas MSc,&nbsp;Lucy LePoidevin,&nbsp;Amelia Hart RCT,&nbsp;Sonia Franciosi PhD,&nbsp;Shubhayan Sanatani MD, FHRS","doi":"10.1016/j.cjcpc.2022.12.004","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2022.12.004","url":null,"abstract":"<div><h3>Background</h3><p>Patients after ablation for tachyarrhythmias may continue to experience palpitations in the setting of sinus rhythm. The objective of our study was to investigate if patients who have undergone ablation for tachyarrhythmia have palpitations and other somatic complaints more frequently than healthy controls.</p></div><div><h3>Methods</h3><p>Paediatric patients after ablation for tachyarrhythmia at BC Children’s Hospital from 2009 to 2020 and healthy controls were invited to participate in a survey about palpitations. Demographics, palpitation symptoms, frequency, duration, and need for medical attention were collected and compared between patients and controls.</p></div><div><h3>Results</h3><p>We received responses from 111 patients (response rate of 27.5%; mean age = 20.0 ± 4.6 years, 52% male) and 62 controls (age = 19.8 ± 5.7 years, 40% male). Sixty-two (56%) patients experienced palpitations beyond the initial 4 weeks after ablation, of whom 77% (n = 48/62) reported their palpitations feeling different. Tachyarrhythmia recurrence rate after ablation was 7.2%. There was no difference in the prevalence of palpitations experienced between patients and controls (<em>P</em> = 0.74). Patients after ablation sought medical attention more often for their palpitations (<em>P</em> = 0.003) and chest symptoms (<em>P</em> = 0.001) compared to controls.</p></div><div><h3>Conclusion</h3><p>The prevalence of palpitations did not differ in ablation patients compared to healthy controls. Patients reported that their palpitations felt different after ablation and were more likely to seek medical attention for their palpitations. Paediatric patients with tachyarrhythmias may have heightened awareness due to their history. Clinicians can incorporate this into procedural counselling to reduce patient concern and need for medical attention.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49751416","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":"Atrial Septal Defect Devices and Nickel Allergies: An Unexpected Silver Lining","authors":"Michael N. Gritti MD,&nbsp;Gilles Mets MD,&nbsp;Alexandra Jevremovic MD,&nbsp;Lee N. Benson MD","doi":"10.1016/j.cjcpc.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.03.002","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762475","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":"Anomalous Aortic Origin of the Right Coronary Artery: Invasive Haemodynamic Assessment in Adult Patients With High-Risk Anatomic Features","authors":"Diederick B.H. Verheijen MD ,&nbsp;Anastasia D. Egorova MD, PhD ,&nbsp;Monique R.M. Jongbloed MD, PhD ,&nbsp;Frank van der Kley MD, PhD ,&nbsp;Dave R. Koolbergen MD, PhD ,&nbsp;Mark G. Hazekamp MD, PhD ,&nbsp;Hildo J. Lamb MD, PhD ,&nbsp;J. Wouter Jukema MD, PhD ,&nbsp;Philippine Kiès MD, PhD ,&nbsp;Hubert W. Vliegen MD, PhD, FESC","doi":"10.1016/j.cjcpc.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Anomalous aortic origin of a right coronary artery (AAORCA) with an interarterial course merits further evaluation; however, robust risk assessment strategies for myocardial ischemia and sudden cardiac death are currently lacking. The aim of this study is to explore the potential role of fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and intravascular ultrasound (IVUS) in patients with AAORCA.</p></div><div><h3>Methods</h3><p>Consecutive adult patients with AAORCA with an interarterial course were included. Computed tomography angiography, noninvasive ischemia detection, and FFR, iFR, and IVUS were performed at baseline and during adrenaline-induced stress. External compression was evaluated with IVUS.</p></div><div><h3>Results</h3><p>Eight patients (63% female, mean age: 53 ± 9.5 years) were included. Five patients (63%) were symptomatic, and computed tomography angiography revealed high-risk anatomy of the AAORCA in all patients. Only in 1 (12.5%) patient FFR and iFR were positive; however, this was attributed at large to concomitant diffuse atherosclerosis. In 2 of 8 (25%), IVUS revealed external compression; however, the ostial coronary surface area remained unchanged. In all patients, a conservative treatment strategy was pursued. During a mean follow-up of 29.3 months (standard deviation ±2.6 months), symptoms spontaneously disappeared in 4 of 5 (80%) and no adverse cardiac events occurred in any of the patients.</p></div><div><h3>Conclusions</h3><p>Despite the presence of high-risk anatomy in all patients, none had proven ischemia prompting a conservative treatment strategy. No adverse cardiac events occurred during follow-up, and in the majority of patients, symptoms spontaneously disappeared. Therefore, FFR, iFR, and IVUS with pharmacologic stress merit further investigation and might contribute to ischemia-based risk stratification and management strategies in adult patients with AAORCA.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762469","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}