Pediatric Cardiology最新文献

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Living with Congenital Aortic Stenosis: Exercise Restriction, Patterns of Adherence, and Quality of Life. 先天性主动脉瓣狭窄患者的生活:运动限制、坚持模式和生活质量。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-21 DOI: 10.1007/s00246-023-03165-2
Laura K Mansfield, Jeffrey R Reichman, David I Crowley, Jonathan N Flyer, Kaitlyn Freeman, Kimberlee K Gauvreau, Stewart A Mackie, Bradley S Marino, Jane W Newburger, Sonja I Ziniel, David W Brown
{"title":"Living with Congenital Aortic Stenosis: Exercise Restriction, Patterns of Adherence, and Quality of Life.","authors":"Laura K Mansfield, Jeffrey R Reichman, David I Crowley, Jonathan N Flyer, Kaitlyn Freeman, Kimberlee K Gauvreau, Stewart A Mackie, Bradley S Marino, Jane W Newburger, Sonja I Ziniel, David W Brown","doi":"10.1007/s00246-023-03165-2","DOIUrl":"10.1007/s00246-023-03165-2","url":null,"abstract":"<p><p>Modern consensus panel guidelines recommend restriction from most organized sports for patients with moderate or severe aortic stenosis (AS). However, there is little published data on how frequently physicians deviate from guidelines, how well patients adhere to exercise restrictions, or the effect of restriction on patient-reported quality of life. In this study, we surveyed 93 subjects with AS and their cardiologists regarding participation in organized sports, physical activity, weightlifting, and exercise restriction. Subjects completed the pediatric quality of life inventory (PedsQL) and the pediatric cardiac quality of life inventory (PCQLI). We found that subjects with severe AS (n = 3) were commonly, but not universally, restricted from organized sports (n = 2, 66%). Subjects with moderate AS (n = 40) were rarely restricted from organized sports (n = 6, 17%). No physician-specific characteristics were associated with increased likelihood of recommending exercise restriction. Subjects were more likely to be restricted if they were older (16 years vs. 13 years, p 0.02) and had moderate versus mild AS (p 0.013). PCQLI scores for teens and young adults with AS (age 13-25) were lower than a comparison group of patients with mild congenital heart disease. For all age groups, the PedsQL social functioning score was lower for subjects with exercise restriction (p 0.052). In summary, cardiologists apply consensus guidelines leniently when restricting patients with moderate/severe AS from organized sports and weightlifting. Patients with AS routinely adhere to exercise restriction recommendations. Children and young adults with AS and exercise restriction have lower QOL scores in the social functioning domain.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029795","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
Left Ventricle Size Correlates with Peak Exercise Capacity in Pediatric Cancer Survivors Exposed to Anthracycline Chemotherapy. 左心室大小与接受过蒽环类化疗的小儿癌症幸存者的峰值运动能力有关。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-05-22 DOI: 10.1007/s00246-023-03192-z
Imran Ross Masood, Panteha Hayati Rezvan, Kyuwan Lee, Helena Vervaet, Christopher Kuo, Karla Loss, JonDavid Menteer, Andrew Souza, David Freyer, Jennifer A Su
{"title":"Left Ventricle Size Correlates with Peak Exercise Capacity in Pediatric Cancer Survivors Exposed to Anthracycline Chemotherapy.","authors":"Imran Ross Masood, Panteha Hayati Rezvan, Kyuwan Lee, Helena Vervaet, Christopher Kuo, Karla Loss, JonDavid Menteer, Andrew Souza, David Freyer, Jennifer A Su","doi":"10.1007/s00246-023-03192-z","DOIUrl":"10.1007/s00246-023-03192-z","url":null,"abstract":"<p><p>Cancer survivors exposed to anthracycline chemotherapy are at risk for developing cardiomyopathy, which may have delayed clinical manifestation. In a retrospective cross-sectional study, we evaluated the utility of cardiopulmonary exercise testing (CPET) for detecting early cardiac disease in 35 pediatric cancer survivors by examining the associations between peak exercise capacity (measured via percent predicted peak VO<sub>2</sub>) and resting left ventricular (LV) function on echocardiography and cardiac magnetic resonance imaging (cMRI). We additionally assessed the relationships between LV size on resting echocardiography or cMRI and percent predicted peak VO<sub>2</sub> since LV growth arrest can occur in anthracycline-exposed patients prior to changes in LV systolic function. We found reduced exercise capacity in this cohort, with low percent predicted peak VO<sub>2</sub> (62%, IQR: 53-75%). While most patients in our pediatric cohort had normal LV systolic function, we observed associations between percent predicted peak VO<sub>2</sub> and echocardiographic and cMRI measures of LV size. These findings indicate that CPET may be more sensitive in manifesting early anthracycline-induced cardiomyopathy than echocardiography in pediatric cancer survivors. Our study also highlights the importance of assessing LV size in addition to function in pediatric cancer survivors exposed to anthracyclines.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9503248","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
Echocardiographic Strain to Predict Need for Transplant or Mortality in Fontan Patients with Hypoplastic Left Heart Syndrome. 超声心动图应变预测左心发育不全综合征 Fontan 患者的移植需求或死亡率。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-05-19 DOI: 10.1007/s00246-023-03187-w
Mubeena Abdulkarim, Rohit S Loomba, S Javed Zaidi, Yi Li, Melissa Wilson, David Roberson, Juan S Farias, Saul Flores, Enrique G Villarreal, Tarek Husayni
{"title":"Echocardiographic Strain to Predict Need for Transplant or Mortality in Fontan Patients with Hypoplastic Left Heart Syndrome.","authors":"Mubeena Abdulkarim, Rohit S Loomba, S Javed Zaidi, Yi Li, Melissa Wilson, David Roberson, Juan S Farias, Saul Flores, Enrique G Villarreal, Tarek Husayni","doi":"10.1007/s00246-023-03187-w","DOIUrl":"10.1007/s00246-023-03187-w","url":null,"abstract":"<p><p>Despite recent advances, hypoplastic left heart syndrome (HLHS) patients subsequent to the Fontan still have significant morbidity and mortality. Some require heart transplant due to systemic ventricular dysfunction. Limited data exist on timing for transplant referral. This study aims to correlate systemic ventricular strain by echocardiography to transplant-free survival. HLHS patients who had Fontan palliation at our institution were included. Patients were divided into: 1) Required transplant or experienced mortality (composite end point); 2) Did not require transplant or survived. For those who experienced the composite endpoint, the last echocardiogram prior to the composite outcome was used, while for those who did not experience the composite endpoint the last echocardiogram obtained was used. Several qualitative and quantitative parameters were analyzed with focus on strain parameters. Ninety-five patients with HLHS Fontan palliation were identified. Sixty-six had adequate images and eight (12%) experienced transplant or mortality. These patients had greater myocardial performance index by flow Doppler (0.72 versus 0.53, p = 0.01), higher systolic/diastolic duration ratio (1.51 versus 1.13, p = 0.02), lower fractional area change (17.65 versus 33.99, p < 0.01), lower global longitudinal strain (GLS) (-8.63 versus - 17.99, p < 0.01), lower global longitudinal strain rate (GLSR) (- 0.51 versus - 0.93, p < 0.01), lower global circumferential strain (GCS) (-6.68 versus -18.25, p < 0.01), and lower (GCSR) global circumferential strain rate (-0.45 versus -1.01, p < 0.01). ROC analysis demonstrated predictive value for GLS - 7.6 (71% sensitive, 97% specific, AUC 81%), GLSR -0.58 (71% sensitive, 88% specific, AUC 82%), GCS - 10.0 (86% sensitive, 91% specific, AUC 82%), and GCSR -0.85 (100% sensitive, 71% specific, AUC 90%). GLS and GCS can help predict transplant-free survival in patients with hypoplastic left heart syndrome having undergone Fontan palliation. Higher strain values (closer to zero) may be a helpful tool in determining when transplant evaluation is warranted in these patients.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9489729","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
A Survey on the Management of Anomalous Aortic Origins of the Coronary Arteries. 冠状动脉异常主动脉起源管理调查。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-30 DOI: 10.1007/s00246-023-03206-w
Hareem Rauf, Xiao Zhang, John S Hokanson
{"title":"A Survey on the Management of Anomalous Aortic Origins of the Coronary Arteries.","authors":"Hareem Rauf, Xiao Zhang, John S Hokanson","doi":"10.1007/s00246-023-03206-w","DOIUrl":"10.1007/s00246-023-03206-w","url":null,"abstract":"<p><p>The management of patients with an anomalous aortic origin of a coronary artery (AAOCA) remains controversial despite the publication of the 2017 American Association for Thoracic Surgery (AATS) expert guidelines. We surveyed the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart.net online community regarding their care of patients with anomalous origins of the right or left coronary from the opposite cusp with inter-arterial courses and compared them to the AATS guidelines. We received 111 complete responses. Four notable variations from the AATS recommendations were identified. Respondents were more likely to use ECG exercise testing than the stress imaging recommended in the AATS guidelines. For a 16-year-old with AAOCA, recommendations for surgery generally followed the AATS guidelines. However, for asymptomatic left AAOCA without signs of ischemia on stress imaging, only 69.4% felt surgery was appropriate or somewhat appropriate. In the setting of a 16-year-old with right AAOCA free from signs or symptoms of ischemia, respondents were more likely to recommend surgery if the patient was a competitive athlete, a topic not directly addressed in the AATS guidelines. After surgical treatment of AAOCA, only 24% of respondents recommended lifelong antiplatelet therapy despite recommendations for this in the AATS guidelines. Respondents recommendations were generally consistent with the 2017 AATS guidelines but with important variations in the use of stress imaging, indications for surgery in asymptomatic left AAOCA, the impact of identification as a competitive athlete and duration of postoperative antiplatelet therapy.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752236","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
Competitive Sports Participation is Associated with Decreased Risk of Obesity in Children with Bicuspid Aortic Valve. 参加竞技体育与降低主动脉瓣二尖瓣儿童肥胖风险有关。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-07-29 DOI: 10.1007/s00246-023-03237-3
Marica E Baleilevuka-Hart, Kathryn W Holmes, Ayesha Khader, Cesar E Gonzalez De Alba, Jennifer H Huang
{"title":"Competitive Sports Participation is Associated with Decreased Risk of Obesity in Children with Bicuspid Aortic Valve.","authors":"Marica E Baleilevuka-Hart, Kathryn W Holmes, Ayesha Khader, Cesar E Gonzalez De Alba, Jennifer H Huang","doi":"10.1007/s00246-023-03237-3","DOIUrl":"10.1007/s00246-023-03237-3","url":null,"abstract":"<p><p>Individuals with bicuspid aortic valve (BAV) have historically been advised to avoid contact sports and isometric exercise for risk of increasing aortic dilation and valve disease. There is mounting evidence that current sports participation guidelines qualify children for a high rate of sports exclusion, and that this population is at increased risk of obesity. The primary aim of this study was to evaluate relationship between sports participation and aortic dilation in children with bicuspid aortic valve and secondarily the relationship between competitive sports participation and obesity. We performed a review of children between the ages of 8 and 17 years with isolated BAV followed at Oregon Health & Science University. We excluded those with other congenital heart diseases, genetic conditions, prior cardiac intervention, and inability to ambulate independently. Parents completed a phone survey detailing their child's level of daily activity and participation in competitive sports. Demographic information and most recent echo findings were collected from the electronic medical record. We found no difference between the aortic diameters of athletes vs non-athletes. We also found that sports participation and daily activity were both associated with a decreased likelihood of obesity (OR 0.24, 95% CI 0.078-0.73 and OR 0.24, 95% CI 0.081-0.71 respectively). In summary, in our sample population, competitive sports participation was associated with a decreased risk of obesity. Competitive sports participation does not appear to be associated with an increased risk of aortic dilation in our population.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943614","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
Regional Cerebral Oxygen Saturation and Estimated Oxygen Extraction Ratio as Predictive Markers of Major Adverse Events in Infants with Congenital Heart Disease. 作为先天性心脏病婴儿重大不良事件预测标志的区域脑氧饱和度和估计氧萃取比。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-04-08 DOI: 10.1007/s00246-023-03158-1
Satoshi Kimura, Kazuyoshi Shimizu, Kaoru Izumi, Tomoyuki Kanazawa, Keiichiro Mizuno, Tatsuo Iwasaki, Hiroshi Morimatsu
{"title":"Regional Cerebral Oxygen Saturation and Estimated Oxygen Extraction Ratio as Predictive Markers of Major Adverse Events in Infants with Congenital Heart Disease.","authors":"Satoshi Kimura, Kazuyoshi Shimizu, Kaoru Izumi, Tomoyuki Kanazawa, Keiichiro Mizuno, Tatsuo Iwasaki, Hiroshi Morimatsu","doi":"10.1007/s00246-023-03158-1","DOIUrl":"10.1007/s00246-023-03158-1","url":null,"abstract":"<p><p>Regional cerebral oxygen saturation (ScO<sub>2</sub>) determined by near-infrared spectroscopy, monitoring both arterial and venous blood oxygenation of the brain, could reflect the balance between oxygen delivery and consumption. The aim of this study was to determine the predictabilities of ScO<sub>2</sub> and estimated oxygen extraction ratio (eO<sub>2</sub>ER) with outcomes in infants with congenital heart disease (CHD). This study was a two-center, retrospective study of patients at 12 months of age or younger with CHD who underwent cardiac surgery. The primary outcome was a composite of one or more major adverse events (MAEs) after surgery: death from any cause, circulatory collapse that needed cardiopulmonary resuscitation, and requirement for extracorporeal membrane oxygenation. Based on the assumptions of arterial to venous blood ratio, eO<sub>2</sub>ER was calculated. A total of 647 cases were included in this study. MAEs occurred in 16 patients (2.5%). There were significant differences in post-bypass ScO<sub>2</sub> [46.61 (40.90, 52.05) vs. 58.52 (51.52, 66.08), p < 0.001] and post-bypass eO<sub>2</sub>ER [0.66 (0.60, 0.78) vs. 0.52 (0.43, 0.61), p < 0.001] between patients with MAEs and patients without MAEs. Area under the receiver operating curve (AUROC) of post-bypass ScO<sub>2</sub> was 0.818 (95% confidence interval: 0.747-0.889), AUROC of post-bypass eO<sub>2</sub>ER was 0.783 (0.697-0.870) and AUROC of post-bypass maximum serum lactate level was 0.635 (0.525-0.746). Both ScO<sub>2</sub> and eO<sub>2</sub>ER, especially after weaning off bypass, are acceptable predictive markers for predicting MAEs after cardiac surgery in infants.(227 words).</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9259740","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
Fluid Overload and AKI After the Norwood Operation: The Correlation and Characterization of Routine Clinical Markers. 诺伍德手术后的体液超负荷和 AKI:常规临床指标的相关性和特征。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-05-02 DOI: 10.1007/s00246-023-03167-0
Julia Weld, Erin Kim, Priya Chandra, Fabio Savorgnan, Sebastian Acosta, Saul Flores, Rohit S Loomba
{"title":"Fluid Overload and AKI After the Norwood Operation: The Correlation and Characterization of Routine Clinical Markers.","authors":"Julia Weld, Erin Kim, Priya Chandra, Fabio Savorgnan, Sebastian Acosta, Saul Flores, Rohit S Loomba","doi":"10.1007/s00246-023-03167-0","DOIUrl":"10.1007/s00246-023-03167-0","url":null,"abstract":"<p><p>The purpose of this study was to determine the correlation of different methods of assessing fluid overload and determine which metrics are associated with development of acute kidney injury (AKI) in the period immediately following Norwood palliation. This was a retrospective single-center study of Norwood patients from January 2011 through January 2021. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO). Patients were separated into two groups: those with AKI and those without. A logistic regression analysis was conducted with AKI at any point in the study period as the dependent variable and clinical and laboratory data as independent variables. Analysis was conducted as a stepwise regression. The coefficients from the logistic regression were then used to develop a cumulative AKI risk score. Spearman correlations were conducted to analyze the correlation of fluid markers. 116 patients were included, and 49 (42.4%) developed AKI. The duration of open chest, duration of mechanical ventilation, need for dialysis, need for extracorporeal membrane oxygenation, and inpatient mortality were associated with AKI (p ≤ 0.05). Stepwise logistic regression demonstrated the following significant independent associations AKI: age at Norwood in days (p < 0.01), blood urea nitrogen (p < 0.01), central venous pressure (p = 0.04), and renal oxygen extraction ratio (p < 0.01). The area under the receiver operating characteristic curve for the logistic regression was 0.74. The fluid markers had weak R-value. Urea, central venous pressure, and renal oxygen extraction ratio are associated with AKI after the Norwood operation. Common clinical metrics used to assess fluid overload are poorly correlated with each other for postoperative Norwood patients.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387684","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
Coronary Artery Dimensions on Computed Tomography Following the Neonatal Arterial Switch Operation for the Complete Transposition of the Great Arteries. 新生儿大动脉完全闭锁动脉转换手术后计算机断层扫描显示的冠状动脉尺寸。
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-09-29 DOI: 10.1007/s00246-024-03662-y
Marcell Fontos, Zsolt Nagy, Zsolt Prodán, László Ablonczy, István Kozma, Márton Vértesaljai, Éva Kis, Olga Hajnalka Bálint
{"title":"Coronary Artery Dimensions on Computed Tomography Following the Neonatal Arterial Switch Operation for the Complete Transposition of the Great Arteries.","authors":"Marcell Fontos, Zsolt Nagy, Zsolt Prodán, László Ablonczy, István Kozma, Márton Vértesaljai, Éva Kis, Olga Hajnalka Bálint","doi":"10.1007/s00246-024-03662-y","DOIUrl":"https://doi.org/10.1007/s00246-024-03662-y","url":null,"abstract":"<p><p>Coronary events are life-threatening long-term complications of the arterial switch operation for complete transposition of the great arteries. The aim of our study was to assess the dimensions of the reimplanted coronary arteries and their relationship with the various geometric characteristics to gain a better understanding of the involved mechanisms. Coronary computed tomography angiography (CCTA) scans of 78 asymptomatic pediatric patients were performed at the age of 10.7 (6.3-17.8) years. The position of the ostia, the branching angles, and the diameters of the coronary arteries were determined in a subgroup of 51 patients presenting the usual preoperative coronary anatomy. Mean Z-score of the left main coronary artery (LMCA), left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), and right coronary artery (RCA) diameters were 0.7 ± 1.2, - 0.4 ± 1.1, - 0.3 ± 1.1, and - 0.3 ± 1.1, respectively. The Z-score of the ostial LMCA diameter had a positive correlation with the remoteness from the main pulmonary artery (p < 0.001) and the branching angle (p = 0.001). The ostial diameter Z-score of the LMCA had a negative correlation with the interval between the arterial switch operation and the CCTA (p = 0.004). Even though most of the coronary diameters fell within the accepted range, which suggests normal overall development, acute branching angle and more anterior origin were associated with smaller ostial coronary artery diameter Z-scores. To prove the clinical relevance of the smaller ostial diameter of high-risk left coronary arteries and the decrease of ostial coronary artery Z-scores over time needs further follow-up studies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351620","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
Electrocardiographic Changes in Acute Kawasaki Disease in the Era of Immunoglobulin Therapy. 免疫球蛋白疗法时代急性川崎病的心电图变化
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-09-27 DOI: 10.1007/s00246-024-03648-w
Ryo Nakanishi, Toshiki Nakamura, Yutaro Koyama, Shogo Akahoshi, Hiroshi Hataya, Masaru Miura
{"title":"Electrocardiographic Changes in Acute Kawasaki Disease in the Era of Immunoglobulin Therapy.","authors":"Ryo Nakanishi, Toshiki Nakamura, Yutaro Koyama, Shogo Akahoshi, Hiroshi Hataya, Masaru Miura","doi":"10.1007/s00246-024-03648-w","DOIUrl":"https://doi.org/10.1007/s00246-024-03648-w","url":null,"abstract":"<p><p>Kawasaki disease (KD), an acute, febrile, self-limiting, multisystem vasculitis of unknown etiology, often involves the cardiac complications of coronary artery aneurysm development, myocarditis, pericarditis, and valvulitis. However, there are insufficient epidemiological data on electrocardiographic (ECG) changes in acute KD in the IVIG era, and little is known about the association between ECG changes and the prognosis. The present study aimed to determine the type of ECG changes found in acute KD and to clarify the course of these changes as well as their relationship to disease severity. The present, retrospective, observational study analyzed 201 patients aged < 15 years with Kawasaki disease who received IVIG from April 2021 to March 2023. In the 156 eligible patients analyzed (male: 62.8%; median age on admission: 24 months), the most common abnormalities were T wave changes (n = 141; 90.4%) on any lead followed by T wave inversions (n = 63; 40.4%), tachycardia (n = 36; 23.1%), and a prolonged PR interval (n = 23; 14.7%). PR prolongation, abnormal Q wave, QTc prolongation, and ST changes were less common in the present cohort, and arrhythmia occurred less frequently than in previous studies. No significant association was found between T wave inversion and disease severity. T wave changes occurred frequently in the acute phase ECG in KD but were not associated with clinical features, such as unresponsiveness to IVIG therapy or coronary artery abnormalities.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351621","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
Assessment of B-Natriuretic Peptide Levels After Stage 1 Palliation in Hypoplastic Left Heart Syndrome Patients. 评估左心发育不全综合征患者第一阶段缓解后的 B-Natriuretic Peptide 水平
IF 1.5 4区 医学
Pediatric Cardiology Pub Date : 2024-09-26 DOI: 10.1007/s00246-024-03653-z
Raysa Morales-Demori, Bingrui Chen, Jeffrey Heinle, Meng Li, Marc Anders
{"title":"Assessment of B-Natriuretic Peptide Levels After Stage 1 Palliation in Hypoplastic Left Heart Syndrome Patients.","authors":"Raysa Morales-Demori, Bingrui Chen, Jeffrey Heinle, Meng Li, Marc Anders","doi":"10.1007/s00246-024-03653-z","DOIUrl":"https://doi.org/10.1007/s00246-024-03653-z","url":null,"abstract":"<p><p>We describe the perioperative BNP trends in patients with HLHS from S1P until interstage discharge to home, death, or S2P. This prospective cohort study includes all newborns with hypoplastic left heart syndrome (HLHS) who underwent Norwood procedures (S1P) at Texas Children's Hospital from April 2018 through April 2019. Our study included 19 newborns with HLHS. There was no interstage mortality; 47% were discharged home prior to the S2P procedure. Nine patients (50%) had higher BNP levels immediately after arrival to the cardiac intensive care unit (ICU) after S1P compared to preoperative levels. BNP levels were higher in those with a shorter duration of mechanical intubation (P = 0.02) and those with moderately depressed right ventricular systolic function in the immediate postoperative period (P = 0.02). RVPAs patients had higher BNP levels (median 3357 pg/mL) than mBTTs (median 2862 pg/mL), that was not statistically significant (P = 0.4). Despite higher BNP levels in RVPAs in the early postoperative period, these subjects had shorter mechanical ventilation, ICU, and hospital length of stay duration. BNP trends for HLHS patients vary in the postoperative period after S1P. RVPAs had higher BNP levels than mBTTs in the early postoperative period after S1P; however, this was not associated with worse outcomes.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351618","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}
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