Pediatric Cardiology最新文献

{"title":"Body Mass Index and Physical Activity Among U.S. Children with Congenital Heart Conditions.","authors":"Rachel O Alade, Jill Glidewell, Elizabeth C Ailes, Emily O Olsen, Karrie F Downing, Janet E Fulton, Matthew E Oster, Sherry L Farr","doi":"10.1007/s00246-025-03980-9","DOIUrl":"10.1007/s00246-025-03980-9","url":null,"abstract":"<p><p>Guidelines recommend children maintain a healthy body mass index (BMI) and do physical activity. No population-based estimates exist for elevated BMI or insufficient physical activity among children with congenital heart conditions (CHC). We estimated the national prevalence of elevated BMI and insufficient physical activity among children with and without CHC. We analyzed cross-sectional, nationally representative data on 57,080 children aged 6-17 years from the National Survey of Children's Health, 2021-2022. Among children with (N = 1135) and without (N = 55,945) CHC, we estimated prevalence and 95% confidence intervals (CI) for caregiver-reported elevated BMI (≥ 85th percentile for sex and age) and insufficient physical activity (< 60 min of physical activity < 7 days/week). Using multivariable Cox proportional hazards models adjusted for age, sex, ethnicity/race, federal poverty level, and caregiver education, we approximated adjusted prevalence ratios (aPR) and CI for each outcome by CHC status and, separately, by demographics among children with CHC. Children with CHC had a similar prevalence of elevated BMI (31.5%, aPR = 0.97, CI 0.82-1.14) and a slightly higher prevalence of insufficient physical activity (84.0%, aPR = 1.05, CI 1.00-1.09) compared to children without CHC. Among children with CHC, elevated BMI was 1.5-1.6 times higher for Hispanic compared to non-Hispanic White children, those with lower compared to higher household incomes, and those with caregivers with ≤ high school compared to ≥ college education; there were no demographic differences in insufficient physical activity. Pediatricians and cardiologists can support patients with CHC in meeting BMI and physical activity recommendations to improve their long-term cardiovascular outcomes.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1942-1952"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on The Paper by Borrelli et al.","authors":"Marek Kardos","doi":"10.1007/s00246-025-04023-z","DOIUrl":"10.1007/s00246-025-04023-z","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2281-2282"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Ventricular Septal Defect Closure in Children < 10 kg: Anatomical Challenges, and Outcomes with the Konar MFO Device.","authors":"Utku Pamuk, Hazım Alper Gursu, Emine Azak, İbrahim İlker Çetin","doi":"10.1007/s00246-025-04018-w","DOIUrl":"10.1007/s00246-025-04018-w","url":null,"abstract":"<p><p>This study evaluated the feasibility, safety, and mid-term outcomes of transcatheter ventricular septal defect (VSD) closure using the Konar MFO device in infants weighing < 10 kg, focusing on procedural challenges and anatomical complexities. A retrospective single-center analysis included 34 consecutive patients (mean age: 14.8 months; mean weight: 7.4 kg) who underwent transcatheter VSD closure between January 2022 and December 2024 via transfemoral or transjugular approaches. Technical success was achieved in 94.1% (32/34) of cases. Major complications were rare (5.9%), with no device embolization, arrhythmias, or new-onset valvular regurgitation. The Konar MFO device was successfully deployed across diverse VSD morphologies, including perimembranous, muscular outlet, mid-muscular, and apical-muscular defects, as well as cases with aortic override or multifocal defects requiring dual-device implantation. Procedural challenges, such as papillary muscle knotting during wire manipulation, were managed with tailored strategies, enabling safe device placement in all patients. Individualized procedural modifications, including novel dual-device and access strategies, enabled safe closure even in anatomically complex cases. At a median follow-up of 17 months, all patients demonstrated sustained defect closure, hemodynamic improvement, and resolution of symptoms. In conclusion, transcatheter VSD closure with the Konar MFO device provides high procedural success and favorable mid-term outcomes in infants < 10 kg, including those with challenging anatomies. Unlike previous reports focusing mainly on procedural success, this study systematically addresses anatomical complexities and mid-term outcomes in infants < 10 kg. Larger multicenter studies with extended follow-up are needed to confirm long-term safety and standardize procedural strategies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2218-2224"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Saline Echocardiography in Diagnosing Functional Pulmonary Atresia in A Newborn.","authors":"Ting Wu, Xiaohui Dai, Dan Liu, Wen Zhang, Nan Guo","doi":"10.1007/s00246-025-04128-5","DOIUrl":"10.1007/s00246-025-04128-5","url":null,"abstract":"<p><p>This case report details a neonate with functional pulmonary atresia (FPA), initially misdiagnosed prenatally as anatomical pulmonary atresia. Fetal findings included cardiomegaly, severe tricuspid regurgitation, and right ventricular dysfunction. Postnatally, the absence of antegrade pulmonary flow raised concern for anatomical atresia. However, saline contrast echocardiography definitively confirmed patent pulmonary valves, establishing the diagnosis of transient FPA secondary to severe functional right heart impairment without anatomical atresia of the pulmonary valves. This case highlights the potential value of the saline contrast test in distinguishing FPA from anatomical pulmonary atresia, which can help avoid unnecessary interventions. It also provides additional insight into the natural history of prenatally suspected isolated FPA.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2276-2278"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aerobic Fitness is Related to Sports Participation in Children with Congenital Heart Disease.","authors":"Astrid-Marie De Souza, Kathryn R Armstrong, Kimberly Hoskins, Nicholas Tran, Kaelan C Naylor, Hilary V Romans, James E Potts, Martin C Hosking, David C Clarke","doi":"10.1007/s00246-025-04014-0","DOIUrl":"10.1007/s00246-025-04014-0","url":null,"abstract":"<p><p>Anatomical and physiological differences in structural heart lesions may affect peak aerobic capacity ( <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak) and influence sports participation in children with congenital heart disease (CHD). We hypothesized that a higher frequency of sports participation would be associated with higher <math> <mrow><mover><mi>V</mi> <mo>˙</mo></mover> <msub><mi>O</mi> <mrow><mn>2</mn> <mi>p</mi> <mi>e</mi> <mi>a</mi> <mi>k</mi></mrow> </msub> </mrow> </math> in these patients. A two-year, single-center, retrospective review (May 2016-November 2018) was conducted in CHD patients who had a maximal cardiopulmonary exercise test (CPET) and documented sport participation. Sports participation was categorized into 3 groups: 0-1 days/week; 2-3 days/week; and ≥ 4 days/week. <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak z-scores, % <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂ at gas exchange threshold ( <math> <mrow><mover><mi>V</mi> <mo>˙</mo></mover> <msub><mi>O</mi> <mrow><mn>2</mn> <mi>G</mi> <mi>E</mi> <mi>T</mi></mrow> </msub> </mrow> </math> ), and O₂ pulse were calculated. Z-scores were calculated based on a reference population. Means and standard deviation (SD) are reported. p < 0.05 was considered statistically significant. In our study cohort (n = 56), <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak z-score was - 1.01 ± 0.95; 83% had a z-score within ± 2 SD, while 59% were within one SD. The overall regression for sport participation with <math> <mrow><mover><mi>V</mi> <mo>˙</mo></mover> <msub><mi>O</mi> <mrow><mn>2</mn> <mi>p</mi> <mi>e</mi> <mi>a</mi> <mi>k</mi></mrow> </msub> </mrow> </math> and <math> <mrow><mover><mi>V</mi> <mo>˙</mo></mover> <msub><mi>O</mi> <mrow><mn>2</mn> <mi>G</mi> <mi>E</mi> <mi>T</mi></mrow> </msub> </mrow> </math> was statistically significant (R² = 0.40, F(4, 54) = 11.44, p =  < .0001) and (R² = 0.17, F(4, 54) = 3.46, p = 0.0227), respectively. There was a significant main effect for O₂ pulse (R² = 0.41, F(4, 52) = 11.91, p < 0.0001) but not for HR_peak (p = 0.86), SBP_peak (p = 0.74) or DBP_peak (p = 0.94). <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak is higher in those who participate in sports compared to those who do not. It is unclear whether those with a higher <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak are more inclined to participate in sports or whether sports participation leads to a higher <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O_2peak.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2192-2200"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow Hemodynamics in Children with Tetralogy of Fallot: A Comparison Study of Cardiac Catheterization and Phase-Contrast MRI.","authors":"Alexander J Berthusen, Jochen Gerstner Saucedo, Michal Schäfer, Barry O'Callaghan, Takashi Fujiwara, Lorna P Browne, Gareth Morgan, Alex J Barker","doi":"10.1007/s00246-025-03983-6","DOIUrl":"10.1007/s00246-025-03983-6","url":null,"abstract":"<p><p>Pulmonary hemodynamics are necessary to measure for lifelong surveillance of cardiovascular function in children with tetralogy of Fallot (TOF). To measure cardiac index, invasive cardiac catheterization using the Fick principle or phase-contrast MRI (PC-MRI) can be used. However, estimates of oxygen consumption and other assumptions used in the Fick method may lead to significant inaccuracy, which are further exacerbated by disease characteristics such as pulmonary regurgitation. By comparison, PC-MRI can directly measure blood flow and regurgitant fraction. To investigate the potential complications of using the Fick principle, flow hemodynamics in 33 repaired TOF patients (7.6 ± 3.9 years) were investigated in patients who underwent cardiac catheterization and cardiac MRI. Pulmonary blood flow (Q_p) measured by catheterization and PC-MRI showed poor agreement with an absolute bias of 0.80 ± 0.910 L/min/m². Q_p by Fick was significantly higher than PC-MRI (3.15 ± 0.60 L/min/m² vs. 2.35 ± 0.95 L/min/m² [p < 0.001]). Patients were also stratified by the presence of severe pulmonary regurgitant fraction (RF > 40%). A mean difference of 1.18L/min/m² in Q_p was found in patients with RF over 40% (n = 18), while patients with RF under 40% (n = 15) had a mean Q_p difference of 0.34 L/min/m² (p = 0.013). PC-MRI may address errors associated with oxygen consumption as well as assumptions affecting Fick in all patient populations. Additional advantages may exist when assessing children with repaired TOF, especially given the common presence of regurgitant pulmonary flow in this population.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1969-1975"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Heart Under Pressure: Traumatic Gerbode Defect and Aortic Dissection After a Tire Explosion: A Case Report and Literature Review.","authors":"Bilgehan Betül Biçer, Hayrettin Hakan Aykan, Elif Tuzdelen, Timuçin Sabuncu, Murat Güvener","doi":"10.1007/s00246-025-03998-z","DOIUrl":"10.1007/s00246-025-03998-z","url":null,"abstract":"<p><p>We report an unusual case of a 13-year-old boy who sustained multiple traumatic cardiac injuries-including ventricular septal and Gerbode defects, aortic dissection, and severe tricuspid regurgitation (TR)-following a high-pressure truck tire explosion. The patient underwent successful endovascular and surgical repair, with full recovery observed at the 1-year follow-up. This case highlights the importance of thorough evaluation and individualized management in pediatric patients with complex cardiac trauma resulting from uncommon high-energy mechanisms.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2269-2275"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Pediatric Cardiologists on Screening for Conditions Associated with Sudden Cardiac Death.","authors":"Jenna L Schlondrop, Nicholas H Von Bergen, Xiao Zhang, John S Hokanson","doi":"10.1007/s00246-025-03987-2","DOIUrl":"10.1007/s00246-025-03987-2","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) in children and adolescents is rare but receives considerable attention due to its tragic nature. Even so, guidelines, provider practice and opinion regarding pre-participation screening for conditions associated with SCD in young competitive athletes and non-athletes remain varied. We sought to determine the recommendations on this topic from practicing pediatric cardiology providers. An anonymous survey regarding pediatric cardiovascular providers' opinions and practices on the screening of high school aged youth for conditions associated with SCD was collected from the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart.net online community. Responses were evaluated and compared between pediatric electrophysiologists and all other respondents. A slight majority of respondents (56.8%) believe that pre-participation screening for conditions associated with SCD high school age individuals should not be different based on one's status as a competitive athlete. Respondents felt that the current emphasis on pre-participation screening for competitive high school athletes varied with respondents considering it too little in 26.1% appropriate in 42.2% and too much in 31.7%. Our survey reflects the clinical recommendations of practicing pediatric cardiologists and pediatric electrophysiologists. Overall, our data does not demonstrate a consensus on the role of ECG for pre-participation screening, and there is no obvious desire for increased universal screening of high school aged individuals among pediatric cardiology providers.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2002-2006"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and Therapeutic Yield of Routine Esophagogastroduodenoscopy in Patients with Fontan Palliation.","authors":"Josue Diaz-Frias, Hari S Conjeevaram, Mark D Norris, Michael R Joynt, Sunkyung Yu, Ashley Duimstra, Timothy B Cotts","doi":"10.1007/s00246-025-03988-1","DOIUrl":"10.1007/s00246-025-03988-1","url":null,"abstract":"<p><p>Fontan-associated liver disease (FALD) is an impactful complication for adults with Fontan circulation. The presence of esophageal varices is associated with increased morbidity and mortality in patients with underlying cirrhosis. The diagnostic yield of routine esophagogastroduodenoscopy (EGD) screening in Fontan patients with clinical or radiographic evidence of cirrhosis is not well known with wide practice variation across centers. We performed a retrospective chart review of all patients with Fontan circulation who underwent an EGD from 2020 to 2023 at our center. During the study period, a total of 66 patients (51.5% male) with Fontan circulation underwent a screening EGD at a median age 30.2 years (range 19.8-60.4 years). Esophageal varices were present in 41 (62.1%) patients, of which 35 (53.0%) had grade I esophageal varices, and 6 (9.1%) had grade II. The study showed a high incidence of esophageal varices in our patients with a Fontan circulation, suggesting a role for routine EGD as a screening tool in this population. This diagnostic procedure was well tolerated with no associated complications.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2007-2017"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-pro Brain Natriuretic Peptide in Infants with Single Ventricle Heart Disease in the CHAMP® Multi-site Registry.","authors":"Atharva Desai, Janelle R Noel-Macdonnell, Lori A Erickson, Amy Ricketts, Melissa Elliott, Matthew Moehlmann, Ryan A Romans, Natalie Jayaram, Hayley S Hancock","doi":"10.1007/s00246-025-03999-y","DOIUrl":"10.1007/s00246-025-03999-y","url":null,"abstract":"<p><p>The role of NT-pro Brain Natriuretic Peptide (NT-proBNP) and BNP in single ventricle (SV) patients during the interstage period is not well understood. We sought to describe NT-proBNP and BNP in a large group of SV infants and to determine if there is an association between pre-discharge NT-proBNP and interstage outcomes (unplanned hospitalizations [UPH]/interventions). We identified SV infants at 11 Cardiac High Acuity Monitoring Program (CHAMP) centers from 2014 to 2021 using the CHAMP multisite registry. Patients with NT-proBNP/BNP drawn prior to neonatal discharge were included, with the last value identified. Demographics, clinical characteristics, and events were collected. zlog transformation was used to convert NT-proBNP values to a normal distribution. Two-sided t-tests (α = 0.05) were used to evaluate average differences in zlog transformed NT-proBNP between patients with an UPH/intervention versus those with neither. 268 patients (male = 178, 66.4%) were included. The most common diagnosis was hypoplastic left heart syndrome, (N = 105, 39.2%). Median NT-proBNP (N = 136) and BNP (N = 132) were 5295 (IQR 2905-8590) and 299 (IQR 158-543), respectively, with median zlog-NT-proBNP 2.87 (IQR 2.24, 3.55). UPH/interventions occurred in 142 patients (53%). There was no significant difference in zlog-NT-proBNP in patients with UPH/interventions versus neither (p-value = 0.872). We described BNP, NT-proBNP, and zlog-NT-proBNP in SV infants at interstage discharge. Further investigation is needed to understand whether NT-proBNP/BNP and zlog-NT-proBNP can prognosticate outcomes after initial SV/interstage discharge.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2095-2103"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12778363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}