Pediatric Cardiology最新文献_第2页

Right Atrial Strain in Pediatric Pulmonary Hypertension-A Prospective Observational Study. 小儿肺动脉高压的右心房应变--一项前瞻性观察研究

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-22 DOI: 10.1007/s00246-024-03523-8

Subhrashis Guha Niyogi, Avneet Singh, Bhupesh Kumar, Anand Kumar Mishra, Goverdhan Dutt Puri

{"title":"Right Atrial Strain in Pediatric Pulmonary Hypertension-A Prospective Observational Study.","authors":"Subhrashis Guha Niyogi, Avneet Singh, Bhupesh Kumar, Anand Kumar Mishra, Goverdhan Dutt Puri","doi":"10.1007/s00246-024-03523-8","DOIUrl":"10.1007/s00246-024-03523-8","url":null,"abstract":"Right ventricular (RV) afterload due to elevated pulmonary arterial (PA) pressure in pulmonary hypertension (PH) causes long-term right atrial (RA) remodeling and dysfunction. RA function has been shown to correlate with PA pressures and outcome in both adult and pediatric patients with PH. We studied the role of RA strain in estimating PA pressures in congenital heart disease (CHD)-associated PH. Children below 12 years undergoing elective repair of CHD with left-to-right shunts and echocardiographic evidence of PH were included. RA reservoir, conduit and contractile strain along with conventional measures of RV function and PA pressure were measured using transthoracic echocardiography after induction of anaesthesia. Pre-and post-repair invasive PA pressures were measured after surgical exposure. 51 children with a median age of 24 months (range 4-144 months) were included, most of whom were undergoing VSD closure. Contractile RA strain showed good correlation with pre-repair systolic PA pressure in mmHg (r = 0.59, 95%CI 0.37-0.75) or expressed as a percentage of SBP (r = 0.67, 95%CI 0.49-0.80). It also predicted persistent postoperative PH as well as pre-repair pulmonary artery acceleration time and right ventricular systolic pressure measured from tricuspid regurgitation jet. The trends of correlation observed suggest a possible prognostic role of RA strain in ACHD with PH and potential utility in its echocardiographic assessment. The observed findings merit deeper evaluation in larger cohorts.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"976-984"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081031","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}

引用次数: 0

Suboptimal Imaging on Obstetric Ultrasound Should Prompt Early Referral for Fetal Echocardiography. 产科超声成像不佳应及早转诊进行胎儿超声心动图检查。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-06-04 DOI: 10.1007/s00246-024-03495-9

Hailey N Chambers, Elizabeth Caris, Jeffrey Conwell, Lindsay A Edwards, J Eddie Hulse, Mark Lewin, Nelangi M Pinto, Elana Wolfe, Bhawna Arya

{"title":"Suboptimal Imaging on Obstetric Ultrasound Should Prompt Early Referral for Fetal Echocardiography.","authors":"Hailey N Chambers, Elizabeth Caris, Jeffrey Conwell, Lindsay A Edwards, J Eddie Hulse, Mark Lewin, Nelangi M Pinto, Elana Wolfe, Bhawna Arya","doi":"10.1007/s00246-024-03495-9","DOIUrl":"10.1007/s00246-024-03495-9","url":null,"abstract":"Recent studies suggest that suboptimal cardiac imaging on routine obstetric anatomy ultrasound (OB-scan) is not associated with a higher risk for congenital heart disease (CHD) and, therefore, should not be an indication for fetal echocardiography (F-echo). We aim to determine the incidence of CHD in patients referred for suboptimal imaging in a large catchment area, including regions that are geographically distant from a tertiary care center. We conducted a retrospective chart review of patients referred to Seattle Children's Hospital (SCH) and SCH Regional Cardiology sites (SCH-RC) from 2011 to 2021 for F-echo with the indication of suboptimal cardiac imaging by OB-scan. Of 454 patients referred for suboptimal imaging, 21 (5%) of patients were diagnosed with CHD confirmed on postnatal echo. 10 patients (2%) required intervention by age one. Mean GA at F-echo was significantly later for suboptimal imaging compared to all other referral indications (27.5 ± 3.9 vs 25.2 ± 5.2 weeks, p < 0.01). Mean GA at F-echo was also significantly later at SCH-RC compared to SCH (29.2 ± 4.6 vs 24.2 ± 2.9 weeks; p < 0.01). In our experience, CHD in patients referred for suboptimal imaging is higher (5%) than previously described, suggesting that routine referral for is warranted. Furthermore, while suboptimal imaging was associated with a delayed F-echo compared to other indications, this delay was most striking for those seen at regional sites. This demonstrates a potential disparity for these patients and highlights opportunities for targeted education in cardiac assessment for primary providers in these regions.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"778-784"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237471","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}

引用次数: 0

Rebuttal to Gut Microbiome in Children with Congenital Heart Disease After Cardiopulmonary Bypass Surgery (GuMiBear Study). 对先天性心脏病患儿体外循环手术后肠道微生物组的反驳（GuMiBear研究）。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2025-02-03 DOI: 10.1007/s00246-025-03795-8

Catherine Stanton, Fatma Koc, Sean Kelleher, Paul Ross, Claire Magnier, Colin J McMahon

引用次数: 0

Adverse Effect of Bundle Branch Block on Exercise Performance in Patients with Fontan Physiology: From the Pediatric Heart Network Fontan Public Data Set. 束支传导阻滞对丰坦生理学患者运动表现的不利影响：来自儿科心脏网络Fontan公共数据集。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-09 DOI: 10.1007/s00246-024-03500-1

Omar Meziab, Emily Dereszkiewicz, Claudia E Guerrero, Andrew W Hoyer, Brent J Barber, Scott E Klewer, Michael D Seckeler

{"title":"Adverse Effect of Bundle Branch Block on Exercise Performance in Patients with Fontan Physiology: From the Pediatric Heart Network Fontan Public Data Set.","authors":"Omar Meziab, Emily Dereszkiewicz, Claudia E Guerrero, Andrew W Hoyer, Brent J Barber, Scott E Klewer, Michael D Seckeler","doi":"10.1007/s00246-024-03500-1","DOIUrl":"10.1007/s00246-024-03500-1","url":null,"abstract":"Patients with Fontan physiology have reduced exercise performance compared to their peers as well as a higher incidence of bundle branch block (BBB). This study aims to investigate the association between BBB and exercise performance in the Fontan population through a retrospective review of the Pediatric Heart Network Fontan study public use dataset. \"Low Performers\" were defined as ≤ 25th percentile (for Fontan patients) for each exercise parameter at anaerobic threshold (AT) for gender and age and \"Normal Performers\" were all other patients. A total of 303 patients with Fontan physiology who underwent exercise testing reached AT and had complete data for BBB. BBB occurred more frequently in Low Performers for VO2 [OR (95% CI): 2.6 (1.4, 4.8)] and Work [OR (95% CI): 2.7 (1.4, 5.1)], suggesting that BBB in the Fontan population is associated with reduced exercise performance. This data adds to the existing clinical evidence of the adverse effects of conduction abnormalities on single ventricle cardiac output and adds support for consideration of cardiac resynchronization and multi-site ventricular pacing in this patient population.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"813-818"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898610","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}

引用次数: 0

Pediatric Primary Raynaud's Phenomenon: A Comprehensive Cardiovascular Analysis. 小儿原发性雷诺现象：心血管综合分析

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-13 DOI: 10.1007/s00246-024-03514-9

Şeyma Özpınar, Helen Bornaun, Hafize Emine Sönmez, Sümeyra Doğan, Süleyman Sönmez, Halil Harman

{"title":"Pediatric Primary Raynaud's Phenomenon: A Comprehensive Cardiovascular Analysis.","authors":"Şeyma Özpınar, Helen Bornaun, Hafize Emine Sönmez, Sümeyra Doğan, Süleyman Sönmez, Halil Harman","doi":"10.1007/s00246-024-03514-9","DOIUrl":"10.1007/s00246-024-03514-9","url":null,"abstract":"Our aim in this study is to evaluate the cardiovascular findings of pediatric patients with primary Raynaud's phenomenon (RP) and to determine if there are any pathological findings. Our study included 42 pediatric patients aged between 7 and 18 who were diagnosed with primary RP and did not have any additional underlying structural vascular disease or secondary rheumatological conditions. The control group consisted of 30 healthy volunteers aged 7-18 years, matched by age and sex, without any additional diseases. We evaluated demographic, clinical, and laboratory findings, echocardiographic and capillaroscopic features, as well as carotid intima-media thickness. Compared to the control group, pediatric patients with primary RP showed increased A wave velocity and E/E' ratio parameters in the left ventricle, indicating diastolic dysfunction of the heart. The isovolumetric relaxation time (IVRT) was prolonged in both the left and right ventricles, and the E/A ratio decreased in the left ventricle. The myocardial performance index (MPI), indicating both systolic and diastolic dysfunction, increased in both ventricles. Additionally, the aortic stiffness index, aortic elastic modulus (Ep), and left carotid intima-media thickness (CIMT) significantly increased, while distensibility decreased in pediatric patients with primary RP compared to the control group. The cardiovascular evaluation of pediatric patients with primary RP revealed that diastolic dysfunction is likely present in both the left and right heart. Additionally, based on the aorta and carotid intima measurements, it is suggested that pediatric patients with primary RP are at risk for developing atherosclerosis.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"908-913"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912706","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}

引用次数: 0

Perspectives of Challenges in Counseling for Congenital Heart Defects. 先天性心脏缺陷咨询挑战的视角。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-06-22 DOI: 10.1007/s00246-024-03520-x

Joyce L Woo, Rupali Gandhi, Shelvonne Burton, Adithya Sivakumar, Sarah Spiewak, Renee Wakulski, William A Grobman, Matthew M Davis, Angira Patel, Joyce T Johnson, Stefani Samples, Lynn M Yee

{"title":"Perspectives of Challenges in Counseling for Congenital Heart Defects.","authors":"Joyce L Woo, Rupali Gandhi, Shelvonne Burton, Adithya Sivakumar, Sarah Spiewak, Renee Wakulski, William A Grobman, Matthew M Davis, Angira Patel, Joyce T Johnson, Stefani Samples, Lynn M Yee","doi":"10.1007/s00246-024-03520-x","DOIUrl":"10.1007/s00246-024-03520-x","url":null,"abstract":"Prior work regarding counseling patients about congenital heart defects (CHD) has focused on their perceptions about accurate communication of cardiac anatomy, and the emotional support received from the provider. The objectives of this study were to identify the additional CHD counseling-specific challenges and areas for future intervention, using a practical communication framework. This is a secondary analysis of qualitative data provided by caretakers of infants who received congenital heart surgery from 2019 to 2020 in the Chicagoland area. While the survey in the primary study pertained to barriers in obtaining prenatal diagnosis, respondents with both prenatal and postnatal diagnosis reported challenges to effective counseling. Qualitative data measuring counseling challenges were collected from semi-structured phone interviews. Thematic analysis was performed using an inductive approach. Themes were organized into five domains using SPIKES (Setting, Perception, Invitation, Knowledge, Empathy, and Summarize/Strategy), a previously validated framework to help clinicians effectively break bad news. Among 160 survey respondents, 35 (21.9%) reported a challenge during CHD counseling that they received. In total, 12 challenges were identified and spanned all six SPIKES domains. The three most common challenges were as follows: perception of repeated imaging studies for accurate diagnosis or management (n = 19, Knowledge), the lack of cardiologist presence at the time of initial CHD detection (n = 8, Setting), and insufficient information provided about the CHD diagnosis (n = 7, Knowledge). Patients perceive counseling as a key component of prenatal diagnosis of CHD and identify the challenges that exist at all stages of the counseling process. These findings suggest that effective counseling extends beyond conveying information about anatomy and prognosis.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"947-955"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440747","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}

引用次数: 0

Quantitative Evaluation of Right Ventricular Workload Based on the Stroke Work Index in Patients after Right Ventricular Outflow Tract Reconstruction. 根据右心室流出道重建术后患者卒中负荷指数对右心室负荷进行定量评估

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-01 DOI: 10.1007/s00246-024-03499-5

Takashi Honda, Manabu Takanashi, Atsushi Kitagawa, Sumito Kimura, Fumiaki Shikata, Yoichiro Hirata, Kagami Miyaji, Kenji Ishikura

{"title":"Quantitative Evaluation of Right Ventricular Workload Based on the Stroke Work Index in Patients after Right Ventricular Outflow Tract Reconstruction.","authors":"Takashi Honda, Manabu Takanashi, Atsushi Kitagawa, Sumito Kimura, Fumiaki Shikata, Yoichiro Hirata, Kagami Miyaji, Kenji Ishikura","doi":"10.1007/s00246-024-03499-5","DOIUrl":"10.1007/s00246-024-03499-5","url":null,"abstract":"The evaluation of right ventricular workload is sometimes complicated in patients after right ventricular outflow tract reconstruction (RVOTR) because both stenotic and regurgitation lesions are involved. In this study, we modified the right ventricular stroke work index (RVSWI) and evaluated the relationship between the modified RVSWI (mRVSWI) and patient prognosis after RVOTR.We enrolled 69 patients who underwent RVOTR (the RVOTR group), including those who needed early reoperation (early reoperation subgroup) and those who did not (follow-up subgroup), and 13 age-matched control participants (control group). Based on the catheterization results 1 year after RVOTR, we compared the mRVSWI between these groups. Additionally, we evaluated the influence of the mRVSWI on the reoperation avoidance rate and survival.The mRVSWI in the RVOTR group was significantly greater than that in the control group (17.7 ± 8.6 vs. 11.0 ± 2.7 g·m/m2, p = 0.008). The mRVSWI in the early reoperation subgroup was significantly greater than that in the follow-up subgroup (32.5 ± 11.1 vs. 15.8 ± 6.0 g·m/m2, p < 0.0001). In the follow-up subgroup, patients with an mRVSWI higher than the upper limit of normal (16.4 g·m/m2) had a greater rate of reoperation than did the other patients (p = 0.0013). One patient died suddenly, and her mRVSWI was consistently high throughout her life.We established the mRVSWI as an index that integrates the pressure and volume load on the right ventricle. Our results indicate the utility of the mRVSWI for predicting patient prognosis after RVOTR.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"804-812"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867823","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}

引用次数: 0

Assessing the State of Training in Congenital Interventional Cardiology: A Global Survey of Program Directors. 评估先天性介入心脏病学的培训状况：项目主任全球调查。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-10 DOI: 10.1007/s00246-024-03501-0

Varun Aggarwal, Gianfranco Butera, Brian Boe, Ahmet Celebi, Tacy Downing, Raul Filho Rossi, Damien Kenny, Norm Linsky, Xiangbin Pan, Kothandam Sivakumar, Wendy Whiteside, Ziyad M Hijazi, Aimee K Armstrong

{"title":"Assessing the State of Training in Congenital Interventional Cardiology: A Global Survey of Program Directors.","authors":"Varun Aggarwal, Gianfranco Butera, Brian Boe, Ahmet Celebi, Tacy Downing, Raul Filho Rossi, Damien Kenny, Norm Linsky, Xiangbin Pan, Kothandam Sivakumar, Wendy Whiteside, Ziyad M Hijazi, Aimee K Armstrong","doi":"10.1007/s00246-024-03501-0","DOIUrl":"10.1007/s00246-024-03501-0","url":null,"abstract":"This study aimed to evaluate the current state of congenital interventional cardiology training worldwide, with a focus on case volumes, competency assessment, and the need for ongoing mentorship during early career stages. A survey was conducted among program directors (PDs) of congenital interventional training programs across the globe. The survey gathered data on training pathways, case volumes, types of procedures performed, trainee competency assessment, and the role of ongoing mentorship. Of the 79 PDs who completed the survey, it was observed that training pathways and case volumes varied significantly, particularly between the United States and other countries. Most PDs reported an annual laboratory case volume of >500 congenital cardiac cases, with most cases being interventional. While trainees demonstrated competency in simple procedures (diagnostic cases, simple ASD closure), complex interventions (such as patent ductus arteriosus closure in premature infants) require ongoing mentorship for graduates. PDs recommended a minimum case volume of 400 total cases for trainees, including 250 interventional cases. In addition to case volumes, assessing trainee competency was deemed important, with clinical reasoning, judgment, skillset, teamwork, and complication management being key areas of evaluation. The study highlights the variability in congenital interventional cardiology training and the need for ongoing mentorship during the early career years. External mentorship programs, facilitated by national and international societies, are proposed to provide critical support for early career interventionalists thus enhancing patient care for congenital heart disease. Ultimately, the findings of this survey may serve as a framework for future training standards and guidelines in this specialized field.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"819-827"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898644","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}

引用次数: 0

Machine Learning to Predict Outcomes of Fetal Cardiac Disease: A Pilot Study. 机器学习预测胎儿心脏疾病的结果：一项试点研究

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-09 DOI: 10.1007/s00246-024-03512-x

L E Nield, C Manlhiot, K Magor, L Freud, B Chinni, A Ims, N Melamed, O Nevo, T Van Mieghem, D Weisz, S Ronzoni

{"title":"Machine Learning to Predict Outcomes of Fetal Cardiac Disease: A Pilot Study.","authors":"L E Nield, C Manlhiot, K Magor, L Freud, B Chinni, A Ims, N Melamed, O Nevo, T Van Mieghem, D Weisz, S Ronzoni","doi":"10.1007/s00246-024-03512-x","DOIUrl":"10.1007/s00246-024-03512-x","url":null,"abstract":"Prediction of outcomes following a prenatal diagnosis of congenital heart disease (CHD) is challenging. Machine learning (ML) algorithms may be used to reduce clinical uncertainty and improve prognostic accuracy. We performed a pilot study to train ML algorithms to predict postnatal outcomes based on clinical data. Specific objectives were to predict (1) in utero or neonatal death, (2) high-acuity neonatal care and (3) favorable outcomes. We included all fetuses with cardiac disease at Sunnybrook Health Sciences Centre, Toronto, Canada, from 2012 to 2021. Prediction models were created using the XgBoost algorithm (tree-based) with fivefold cross-validation. Among 211 cases of fetal cardiac disease, 61 were excluded (39 terminations, 21 lost to follow-up, 1 isolated arrhythmia), leaving a cohort of 150 fetuses. Fifteen (10%) demised (10 neonates) and 65 (48%) of live births required high acuity neonatal care. Of those with clinical follow-up, 60/87 (69%) had a favorable outcome. Prediction models for fetal or neonatal death, high acuity neonatal care and favorable outcome had AUCs of 0.76, 0.84 and 0.73, respectively. The most important predictors for death were the presence of non-cardiac abnormalities combined with more severe CHD. High acuity of postnatal care was predicted by anti Ro antibody and more severe CHD. Favorable outcome was most predicted by no right heart disease combined with genetic abnormalities, and maternal medications. Prediction models using ML provide good discrimination of key prenatal and postnatal outcomes among fetuses with congenital heart disease.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"895-901"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898769","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}

引用次数: 0

Transitional Hemodynamics in Neonates Born Through Meconium-Stained Amniotic Fluid: A Prospective Observational Study. 通过含羊水蜕膜出生的新生儿的过渡血流动力学：前瞻性观察研究

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-04-01 Epub Date: 2024-05-23 DOI: 10.1007/s00246-024-03521-w

Kamal Joshi, Mayank Priyadarshi, Yash Shrivastava, Suman Chaurasia, Poonam Singh, Nowneet Kumar Bhat, Sriparna Basu

{"title":"Transitional Hemodynamics in Neonates Born Through Meconium-Stained Amniotic Fluid: A Prospective Observational Study.","authors":"Kamal Joshi, Mayank Priyadarshi, Yash Shrivastava, Suman Chaurasia, Poonam Singh, Nowneet Kumar Bhat, Sriparna Basu","doi":"10.1007/s00246-024-03521-w","DOIUrl":"10.1007/s00246-024-03521-w","url":null,"abstract":"Neonates born through meconium-stained amniotic fluid (MSAF) are at increased risk of altered cardiopulmonary transition at birth. There is a paucity of literature evaluating the transitional hemodynamics in these neonates. We aimed to evaluate transitional hemodynamics via echocardiography in neonates born through MSAF, compared to healthy neonates. The primary objective was to assess pulmonary vascular resistance using left pulmonary artery-velocity time integral (LPA-VTI). The secondary objectives were to assess other pulmonary vascular parameters and myocardial function. We enrolled 35 MSAF-born and 35 healthy neonates. Echocardiography was performed at 24 and 48 h of life by a pediatric cardiologist. Echocardiographic parameters were compared between MSAF-born and healthy neonates, and between MSAF-born neonates who developed meconium aspiration syndrome (MAS) and who did not (non-MAS). Among 35 MSAF-born neonates, 14 (40%) were non-vigorous, 18 (51%) required admission to neonatal intensive care unit, 8 (23%) developed MAS, 3 (9%) pulmonary hypertension and 1 (3%) air leak. On echocardiography, LPA-VTI (cm; mean ± SD) was significantly decreased at 24 and 48 h in MSAF-born neonates (14.38 ± 2.48; 15.55 ± 2.48), compared to healthy neonates (16.60 ± 2.14; 17.66 ± 2.71), respectively. Further, LPA-VTI was significantly reduced at 24 and 48 h among MAS (11.81 ± 3.0; 12.43 ± 2.5), compared to non-MAS neonates (15.15 ± 1.72; 16.48 ± 1.55), respectively. Other pulmonary vascular and myocardial function parameters were comparable between the two groups. Pulmonary adaptation was significantly delayed in neonates with MSAF, which was more pronounced in MAS neonates. Further studies should explore the utility of these parameters for early prediction of cardiorespiratory morbidities in this population.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"956-965"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088459","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}

引用次数: 0