Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-07-24DOI: 10.1007/s00246-023-03238-2
Evangeline G Warmerdam, Jos J M Westenberg, Michiel Voskuil, Friso M Rijnberg, Arno A W Roest, Hildo J Lamb, Bram van Wijk, Gertjan T Sieswerda, Pieter A Doevendans, Henriette Ter Heide, Gregor J Krings, Tim Leiner, Heynric B Grotenhuis
{"title":"Comparison of Four-Dimensional Flow MRI, Two-Dimensional Phase-Contrast MRI and Echocardiography in Transposition of the Great Arteries.","authors":"Evangeline G Warmerdam, Jos J M Westenberg, Michiel Voskuil, Friso M Rijnberg, Arno A W Roest, Hildo J Lamb, Bram van Wijk, Gertjan T Sieswerda, Pieter A Doevendans, Henriette Ter Heide, Gregor J Krings, Tim Leiner, Heynric B Grotenhuis","doi":"10.1007/s00246-023-03238-2","DOIUrl":"10.1007/s00246-023-03238-2","url":null,"abstract":"<p><p>Pulmonary artery (PA) stenosis is a common complication after the arterial switch operation (ASO) for transposition of the great arteries (TGA). Four-dimensional flow (4D flow) CMR provides the ability to quantify flow within an entire volume instead of a single plane. The aim of this study was to compare PA maximum velocities and stroke volumes between 4D flow CMR, two-dimensional phase-contrast (2D PCMR) and echocardiography. A prospective study including TGA patients after ASO was performed between December 2018 and October 2020. All patients underwent echocardiography and CMR, including 2D PCMR and 4D flow CMR. Maximum velocities and stroke volumes were measured in the main, right, and left PA (MPA, LPA, and RPA, respectively). A total of 39 patients aged 20 ± 8 years were included. Maximum velocities in the MPA, LPA, and RPA measured by 4D flow CMR were significantly higher compared to 2D PCMR (p < 0.001 for all). PA assessment by echocardiography was not possible in the majority of patients. 4D flow CMR maximum velocity measurements were consistently higher than those by 2D PCMR with a mean difference of 65 cm/s for the MPA, and 77 cm/s for both the RPA and LPA. Stroke volumes showed good agreement between 4D flow CMR and 2D PCMR. Maximum velocities in the PAs after ASO for TGA are consistently lower by 2D PCMR, while echocardiography only allows for PA assessment in a minority of cases. Stroke volumes showed good agreement between 4D flow CMR and 2D PCMR.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1627-1635"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9868202","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}
Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-09-20DOI: 10.1007/s00246-023-03299-3
Julia E Behrend, Amy S Lay, Nicholas K Brown, Janelle R Bolden, Anna G Joong, Sandhya R Ramlogan
{"title":"Prenatally Diagnosed Interventricular Septal Aneurysm with Associated Ventricular Dysfunction.","authors":"Julia E Behrend, Amy S Lay, Nicholas K Brown, Janelle R Bolden, Anna G Joong, Sandhya R Ramlogan","doi":"10.1007/s00246-023-03299-3","DOIUrl":"10.1007/s00246-023-03299-3","url":null,"abstract":"<p><p>Congenital interventricular septal aneurysms (IVSA) of the muscular septum are rare and can be associated with other familial abnormalities of the ventricular septum, arrhythmias, additional congenital heart disease, and chromosomal abnormalities. IVSA is also linked to ventricular dysfunction and non-compaction, although there are limited reports of this association presenting in utero. We describe a case of fetal ventricular septal aneurysm associated with ventricular dysfunction and pericardial effusion.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1846-1849"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145315","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}
Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-08-06DOI: 10.1007/s00246-023-03248-0
Aditya Sengupta, Kimberlee Gauvreau, Anjali Sadhwani, Samantha C Butler, Jane W Newburger, Pedro J Del Nido, Meena Nathan
{"title":"Impact of Residual Lesion Severity on Neurodevelopmental Outcomes Following Congenital Heart Surgery in Infancy and Childhood.","authors":"Aditya Sengupta, Kimberlee Gauvreau, Anjali Sadhwani, Samantha C Butler, Jane W Newburger, Pedro J Del Nido, Meena Nathan","doi":"10.1007/s00246-023-03248-0","DOIUrl":"10.1007/s00246-023-03248-0","url":null,"abstract":"<p><p>Children with congenital heart disease are at increased risk of neurodevelopmental delay throughout their lifespan. This risk is exacerbated following congenital heart surgery (CHS) in infancy. However, there are few modifiable risk factors for postoperative neurodevelopmental delay. In this study, we assessed the Residual Lesion Score (RLS), a quality assessment metric that evaluates residual lesion severity following CHS, as a predictor of neurodevelopmental delay. This was a single-center, retrospective review of patients who underwent CHS from 01/2011 to 03/2021 and post-discharge neurodevelopmental evaluation from 12 to 42 months of age using the Bayley Scales of Infant Development, 3rd Edition (BSID-III). RLS was assigned per published criteria: RLS 1, no residua; RLS 2, minor residua; and RLS 3, major residua or pre-discharge reintervention. Associations between RLS and BSID-III scores, as well as trends in neurodevelopmental outcomes over time, were evaluated. Of 517 patients with median age at neurodevelopmental testing of 20.0 (IQR 18.0-22.7) months, 304 (58.8%), 146 (28.2%), and 67 (13.0%) were RLS 1, 2, and 3, respectively. RLS 3 patients had significantly lower scaled scores in the cognitive, receptive, and expressive communication, and fine and gross motor domains, compared with RLS 1 patients. Multivariable models accounted for 21.5%-31.5% of the variation in the scaled scores, with RLS explaining 1.4-7.3% of the variation. In a subgroup analysis, RLS 3 patients demonstrated relatively fewer gains in cognitive, expressive communication, and gross motor scores over time (all p < 0.05). In conclusion, RLS 3 patients are at increased risk for neurodevelopmental delay, warranting closer follow-up and greater developmental support for cognitive, language, and motor skills soon after surgery.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1676-1691"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949085","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}
Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-08-06DOI: 10.1007/s00246-023-03247-1
Zane Christmyer, Meghana Pisupati, Maully J Shah, Chandra Srinivasan, Victoria L Vetter, V Ramesh Iyer, Mary Triguba, Christopher M Janson
{"title":"Risk Stratification in Pediatric Wolff-Parkinson-White: Practice Variation Among Pediatric Cardiologists and Electrophysiologists.","authors":"Zane Christmyer, Meghana Pisupati, Maully J Shah, Chandra Srinivasan, Victoria L Vetter, V Ramesh Iyer, Mary Triguba, Christopher M Janson","doi":"10.1007/s00246-023-03247-1","DOIUrl":"10.1007/s00246-023-03247-1","url":null,"abstract":"<p><strong>Background: </strong>Published guidelines provide recommendations for risk stratification in pediatric Wolff-Parkinson-White (WPW). There are no data on provider concordance with these guidelines. We hypothesized that significant practice variation exists between pediatric cardiologists (PC) and electrophysiologists (EP).</p><p><strong>Method: </strong>The records of all patients, age 8 to 21 years, with a new ECG diagnosis of WPW between 1/1/2013 and 12/31/2018, from a single center, were retrospectively reviewed. Subjects were categorized on the basis of symptoms and resting ECG findings as one of the following: asymptomatic intermittent WPW, asymptomatic persistent WPW, or symptomatic WPW. The performance and results of diagnostic testing, including Holter monitor, event monitor, exercise stress test (EST), and electrophysiology study (EPS), were recorded. The primary outcome was concordance with published guidelines. A secondary outcome was documentation of a discussion of sudden cardiac death (SCD) risk.</p><p><strong>Results: </strong>615 patient encounters were analyzed in 231 patients with newly diagnosed WPW pattern on ECG (56% male; mean age at diagnosis 13.9 ± 2.5 years). EP were observed to have a significantly higher rate of guideline concordance than PC (95% vs. 71%, p < 0.001). There was significant practice variation between PC and EP in the documentation of a discussion of SCD risk: 96% in EP vs. 39% in PC (p < 0.001).</p><p><strong>Conclusion: </strong>Significant practice variation exists in the non-invasive and invasive risk stratification of pediatric WPW, with lower concordance to published guidelines amongst PC, when compared to EP. This report highlights the need to promote awareness of current WPW guidelines in the pediatric cardiology community at large.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1668-1675"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949115","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}
Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-08-10DOI: 10.1007/s00246-023-03246-2
Peicheng Ding, Feng Chen, Jirong Qi, Wei Peng, Kaihong Wu, Jie Ding, Mingtang Ye, Liang Hu, Jiali Xu, Xuming Mo
{"title":"Perioperative Brain Injury in Children with Aortic Arch Anomalies: A Retrospective Study of Risk Factors and Outcomes.","authors":"Peicheng Ding, Feng Chen, Jirong Qi, Wei Peng, Kaihong Wu, Jie Ding, Mingtang Ye, Liang Hu, Jiali Xu, Xuming Mo","doi":"10.1007/s00246-023-03246-2","DOIUrl":"10.1007/s00246-023-03246-2","url":null,"abstract":"<p><p>Complex pediatric cardiac disease is associated with brain impairment and neurodevelopmental disorders, particularly in patients requiring cardiac surgery for aortic arch anomalies. This study examines the incidence, risk factors, and outcomes of perioperative brain injury in children undergoing aortic arch repair who had aortic arch anomalies. A total of 145 children with aortic arch anomalies in our center undergoing aortic arch repair between January 2014 and December 2022 were enrolled. There were 129 (89.0%) with coarctation of the aorta (COA) and 16 (9.7%) with interrupted aortic arch (IAA). Risk factor analysis of brain injuries was done using perioperative imaging and included symptoms of hemorrhagic stroke, arterial ischemic stroke, white matter injury, cerebral sinus venous thrombosis, and other pathologies. Preoperatively, 50/145 (34.5%) patients had brain injuries. Multivariate analysis showed that an increased risk of hemorrhagic stroke was associated with newborns (odds ratio [OR], 2.09 [95% CI 0.08-3.50]), isolated COA (OR, 3.69 [95% CI 1.23-7.07]), mechanical ventilation (MV) ([OR, 2.56 [95% CI 1.25-4.03]), and sepsis (OR, 1.73 [95% CI 0.46-3.22]). Newborns ([OR, 1.91 [95% Cl 0.58-3.29]) and weight-for-age z score ([OR, -0.45 [95% CI -0.88 to -0.1]) were associated with an increased risk of white matter injury. New postoperative brain injuries were present in 12.9% of the patients (16/124). Deep hypothermic circulatory arrest (DHCA) was associated with new postoperative brain injuries compared with deep hypothermic low-flow (DHLF) plus antegrade cerebral perfusion (ACP) (([OR, 2.67 [95% CI, 0.58-5.75])). Isolated COA was almost associated with new postoperative brain injuries (OR, 1.13 [95% CI, -0.04 to 2.32]). Children diagnosed with isolated COA appeared to have a higher risk of perioperative brain injury, but the underlying mechanisms are still unclear. We focused on the intrinsic mechanism by which changes in hemodynamics caused by COA result in perioperative brain injury. Further research will be needed to optimize the personalized treatment and cerebral perfusion techniques for complex pediatric cardiac surgery.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1659-1667"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10320978","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":"A Case of Successful Biventricular Repair of the Transposition of the Great Arteries with a Coronary Anomaly Associated with an Atrioventricular Septal Defect.","authors":"Hisayuki Hongu, Koji Nomura, Izumi Hamaya, Shinya Ugaki, Toshikazu Shimizu, Makiko Nisioka, Kenji Hoshino","doi":"10.1007/s00246-023-03276-w","DOIUrl":"10.1007/s00246-023-03276-w","url":null,"abstract":"<p><p>The transposition of the great arteries (TGA) associated with a complete atrioventricular septal defect is a rare and serious congenital cardiac anomaly. In this report, we describe the successful biventricular repair of a TGA with a complete atrioventricular septal defect in an infant. Due to the low body weight of the patient and a complex coronary pattern anomaly, an arterial switch operation was executed, with the Mee procedure and pulmonary arterial banding as initial palliative measures when the infant was 22 days old and weighed 2.5 kg. Subsequently, atrioventricular septal defect repair using the modified one-patch method was performed when the patient was 1.3 years old and weighed 8.8 kg. Remarkably, the postoperative course of the patient demonstrated no notable incidents. To our knowledge, this is the first time a two-stage strategy was applied to repair these complex defects, presenting a promising approach for managing similar cases in future medical practice.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1841-1845"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423677","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}
Pediatric CardiologyPub Date : 2024-12-01Epub Date: 2023-09-12DOI: 10.1007/s00246-023-03282-y
Richard U Garcia, Asaad Beshish, Arene Butto, Usama Kanaan, Kevin Maher
{"title":"Continuous Prostanoid Initiation in Severe Pulmonary Hypertension in the Pediatric Cardiac Intensive Care Unit.","authors":"Richard U Garcia, Asaad Beshish, Arene Butto, Usama Kanaan, Kevin Maher","doi":"10.1007/s00246-023-03282-y","DOIUrl":"10.1007/s00246-023-03282-y","url":null,"abstract":"<p><strong>Objective: </strong>Limited data exists regarding prostanoid (PGI2) use in critically ill patients with pulmonary hypertension. (PH) in the pediatric cardiac intensive care unit (CICU) setting.</p><p><strong>Materials and methods: </strong>Single center, retrospective study of patients with diagnosis of PH who received continuous PGI2 and were admitted to CICU from January/2015 to April/2022. Data collected included patient demographics and clinical characteristics including diagnosis, etiology of PH, vasoactive and ventilatory support, length of stay, and survival. Type, initial, maximum, and final dose of PGI2 as well as hemodynamic data was obtained. Data reported as mean ± standard deviation. Significance taken p value < 0.05.</p><p><strong>Results: </strong>24 patients received PGI2 therapy at a mean age of 3.1 years, range (0-16.6 years). PGI2 was in the form of IV epoprostenol in 12 patients, IV treprostinil in 6, and SQ treprostinil in 6 patients. Mean initial dose was 2.79 ng/kg/min, max dose 18.75 ng/kg/min, and mean duration of therapy was 38.5 days. At PGI2 initiation, 21 (87.5%) were on vasoactive infusions, 19 (79.2%) mechanically ventilated (MV), and 6 (25%) were on extracorporeal membrane oxygenation (ECMO). The in-hospital mortality rate was 37.5% (n = 9). Patients MV and on ECMO support had higher risk of death (p = 0.04, and < 0.01, respectively).</p><p><strong>Conclusion: </strong>PGI2 therapy was tolerated in approximately 50% of patients with the most common side effect being hypotension leading to discontinuation in 1/3rd of patients. Ongoing evaluation of the benefits of PGI2 for patients in the CICU setting will help better identify patient selection, type, and dosing of PGI2.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1798-1803"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10580942","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}
Rohit S Loomba, Riddhi Patel, Amanda Miceli, Oung Savly, Joshua Wong
{"title":"Acute Effects of Aminophylline Effects on Hemodynamic Parameters and Fluid Balance in Pediatric Cardiac Intensive Care Patients: Machine Learning Insights Using High Fidelity Data.","authors":"Rohit S Loomba, Riddhi Patel, Amanda Miceli, Oung Savly, Joshua Wong","doi":"10.1007/s00246-024-03716-1","DOIUrl":"https://doi.org/10.1007/s00246-024-03716-1","url":null,"abstract":"<p><p>Fluid overload is associated with increased morbidity and mortality after pediatric cardiac surgery. Management of fluid overload can be difficult and conventional tools may increase the risk of acute kidney injury. This study aimed to study the effects of aminophylline on fluid balance, urine output, blood urea nitrogen, and serum creatinine. Pediatric cardiac surgical patients who received aminophylline between September 2022 and December 2023 were identified. Data for various clinical parameters before and after an aminophylline dose were collected. Paired univariable analyses and a random forest classifier were conducted to help characterize the effects of aminophylline. A total of 169 aminophylline administrations in 72 unique patients were included in the final analyses. Fluid balance decreased by 115% in the 24 h after aminophylline administration compared to the 24 h preceding. Urine output peaked at 2 h after administration and increased 100% from baseline. Heart rate increased by 5% after administration and peaked between 2 and 4 h after. In pediatric patients after cardiac surgery, a 5 mg/kg dose of aminophylline is safe and is associated with a reduction in fluid balance and increase in urine output without significantly changing blood urea nitrogen or serum creatinine levels.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731212","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}
Brock A Karolcik, Michael J Calcaterra, Kevin L Smith, Mary D Schiff, Maya I Ragavan, Tarek Alsaied, Christopher W Follansbee, Lee B Beerman, Gaurav Arora
{"title":"Association of Child Opportunity Index with Outcomes in Pediatric Supraventricular Tachycardia.","authors":"Brock A Karolcik, Michael J Calcaterra, Kevin L Smith, Mary D Schiff, Maya I Ragavan, Tarek Alsaied, Christopher W Follansbee, Lee B Beerman, Gaurav Arora","doi":"10.1007/s00246-024-03723-2","DOIUrl":"https://doi.org/10.1007/s00246-024-03723-2","url":null,"abstract":"<p><p>To assess the relationship between the Child Opportunity Index (COI), a validated measure that uses 29 indicators of social determinants of health linked to the US Census, and pediatric supraventricular tachycardia (SVT) management and outcomes, specifically looking at utilization of ablation. A retrospective, single-center study was performed evaluating pediatric SVT patients from January 2018 to July 2023. Patients diagnosed at < 5 years old, with pre-excitation, and with hemodynamically significant congenital heart disease were excluded. Characteristics were compared among low, moderate, and high COI categories using Kruskal-Wallis tests for continuous variables, and chi-square or Fisher's exact tests for categorical variables. Logistic regression and log-normal regression models were used to assess the relationship between COI category and primary outcomes of interest among SVT patients. A cohort of 306 patients met inclusion criteria. 45% had a high COI, 29% a moderate COI, and 26% a low COI. The odds of having one or more SVT-related hospital admissions were 3.88 times greater for the low COI patients compared to high COI patients (95% CI 1.39-10.8, p = 0.010). COI was not found to be associated with any other primary outcomes of interest, including utilization of ablation. Lower COI was associated with greater odds of admission in SVT patients but did not differ in rates of ablation or outcomes. This suggests social factors may affect resource utilization while having limited impact on treatments like ablations.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731252","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}
Mary C First, Keegan J Reilly, Xiao Zhang, Amy L Peterson
{"title":"Cardiometabolic Health in Children with Pre-existing Dyslipidemia: Trends and Disparities.","authors":"Mary C First, Keegan J Reilly, Xiao Zhang, Amy L Peterson","doi":"10.1007/s00246-024-03718-z","DOIUrl":"https://doi.org/10.1007/s00246-024-03718-z","url":null,"abstract":"<p><p>In order to evaluate the impact of a child's proximity to an urban center on their cardiometabolic health status and their response to treatment of cardiometabolic risk factors, retrospective review of the institutional pediatric lipid clinic database was conducted for all subjects receiving care from 1/1/2011 to 12/31/2023, with subgroup analysis of subjects with ≥ 2 clinical encounters and/or set of laboratory values. Subjects were classified as rural/urban and advantaged/middle/underserved based on their zip code using the Wisconsin Collaborative for Healthcare Quality classification system. Multivariate linear regression was used to examine disparities in baseline cardiometabolic health parameters by urban/rural groupings. Among subjects with multiple encounters, baseline and final available values were analyzed using paired t tests. 2419 subjects were included in the initial analysis with 75.4% living in urban environments and 51.9% having advantaged status. Urban advantaged children had lower BMI percentiles and waist circumference, but higher LDL-C values compared to other urban groups (p < 0.05). Rural advantaged and middle groups had higher TC, non-HDL-C, and LDL-C than the urban groups (p < 0.05). 1522 subjects had ≥ 2 encounters, with significant decreases in all lipid parameters (p < 0.006 for all). There was no change in fasting glucose, HbA1c, or ALT. Disparities in cardiometabolic parameters were seen at time of presentation based on rural/urban and advantaged/middle/underserved status, but all groups had similar improvements in cardiometabolic parameters throughout the course of treatment.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731383","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}