Pediatric Cardiology最新文献_第7页

Benefits of Chronic Atrial Pacing in Fontan Physiology with Sinus Node Dysfunction and Preserved Ejection Fraction: Novel Therapeutic Approach for Failing Fontan.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-07 DOI: 10.1007/s00246-025-03819-3

Hideo Ohuchi, Keita Saku, Aya Miyazaki, Aki Mori, Yoshiaki Kato, Heima Sakaguchi, Isao Shiraishi, Kenichi Kurosaki

{"title":"Benefits of Chronic Atrial Pacing in Fontan Physiology with Sinus Node Dysfunction and Preserved Ejection Fraction: Novel Therapeutic Approach for Failing Fontan.","authors":"Hideo Ohuchi, Keita Saku, Aya Miyazaki, Aki Mori, Yoshiaki Kato, Heima Sakaguchi, Isao Shiraishi, Kenichi Kurosaki","doi":"10.1007/s00246-025-03819-3","DOIUrl":"https://doi.org/10.1007/s00246-025-03819-3","url":null,"abstract":"Increased heart rate (HR) can reduce central venous pressure (CVP) in patients with preserved ventricular systolic function. We aimed to investigate whether this theory works in failing Fontan physiology. Pacemaker implantation (PMI) was performed in six Fontan patients (age: 6-40 years) with sinus node dysfunction (SND) without junctional rhythm (JR). Baseline median (interquartile [IQR]) values of CVP, ventricular end-diastolic pressure (EDP), and ejection fraction (EF) were 12 (11-15) mmHg, 13 (10-16) mmHg, and 57% (53%-64%), respectively. Before PMI, the relationships among HR, cardiac index (L/min/m2), CVP, and EDP were evaluated using atrial pacing. Additionally, we assessed chronic changes in hemodynamics and hepatorenal function after PMI. During baseline catheterization, HR was 51 (40-58) bpm. Atrial pacing was initiated at 60 (60-63) bpm and increased to 85 (80-93) bpm. Reductions were observed in CVP (from 12 [11-15] to 9 [8-11] mmHg, p < 0.05), EDP (from 13 [10-16] to 8 [6-8] mmHg), and an increase in cardiac index (from 2.7 [2.3-3.0] to 3.4 [3.2-4.1] L/min/m2). After 1 year of PMI with HR of 80 (70-83) bpm, sustained improvements were observed, including reductions in CVP (from 12 [11-15] to 10 [9-11] mmHg, p < 0.05), EDP (from 13 [10-16] to 9 [4-9] mmHg, p = 0.06), and ventricular end-diastolic volume index (from 85 [76-98] to 67 [53-76] ml/m2, p < 0.05). Total bilirubin levels and renal resistive index also decreased (both p = 0.06). In conclusion, chronic atrial pacing therapy reduced CVP and ventricular volume in Fontan patients with preserved EF and SND, even in the absence of JR. Proactive PMI may prevent the progression of Fontan-associated end-organ dysfunction in these selected Fontan patients.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573597","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

Correlation of Liver Fibrosis on Ultrasound Elastography and Liver Biopsy After Fontan Operation: Is Non-invasive Always Better?

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-07 DOI: 10.1007/s00246-025-03820-w

Yuen Lo Yau, John-Anthony Coppola, Dalia Lopez-Colon, Matthew Purlee, Himesh Vyas, David M Saulino, Dipankar Gupta

{"title":"Correlation of Liver Fibrosis on Ultrasound Elastography and Liver Biopsy After Fontan Operation: Is Non-invasive Always Better?","authors":"Yuen Lo Yau, John-Anthony Coppola, Dalia Lopez-Colon, Matthew Purlee, Himesh Vyas, David M Saulino, Dipankar Gupta","doi":"10.1007/s00246-025-03820-w","DOIUrl":"https://doi.org/10.1007/s00246-025-03820-w","url":null,"abstract":"Fontan-associated liver disease (FALD) is a common complication after the Fontan procedure. A liver biopsy is the gold standard for assessing liver fibrosis. However, ultrasound (US) elastography has increasingly been used as a non-invasive method to diagnose and monitor liver fibrosis. Nonetheless, a clear correlation of severity of fibrosis between US elastography and liver biopsy in this population has not yet been established. In this single-center retrospective study, we included patients with Fontan physiology who had liver fibrosis evaluation between 2008 and 2022 with both US elastography and liver biopsy. Fibrosis was classified by US elastography and liver biopsy based on the METAVIR scoring system and congestive hepatic fibrosis score, respectively. Overall, 29 patients had both US elastography and liver biopsy with a median age of 17 years (IQR 13-27 years). The median time between Fontan operation and liver biopsy was 14 years (IQR 9-23). Nine patients underwent isolated heart transplantation (31%). The median shear wave elastography was 1.97 m/s (IQR 1.66-2.11) with 86% of patient's METAVIR score being > F2. There was no correlation in the severity of fibrosis between US elastography and liver biopsy (polycor = - 0.021). Findings on US elastography had weak correlation with histological fibrosis severity reported in liver biopsy. Further large-scale studies are necessary to assess optimal protocol for using US elastography for surveillance of FALD in Fontan patients.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586638","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

Virtual Post Mortem in Fetuses and Newborns for the Verification of Congenital Heart Malformations.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-07 DOI: 10.1007/s00246-025-03787-8

Yishay Salem, Eitan Keizman, Jeffrey Jacobson, Orly Goitein, Eldad Katorza, Eran Kassif, David Mishali, Debora Kidron, Alain E Serraf, Eli Konen, Reuven Ahiron, Liat Gindes, Shai Tejman-Yardem

{"title":"Virtual Post Mortem in Fetuses and Newborns for the Verification of Congenital Heart Malformations.","authors":"Yishay Salem, Eitan Keizman, Jeffrey Jacobson, Orly Goitein, Eldad Katorza, Eran Kassif, David Mishali, Debora Kidron, Alain E Serraf, Eli Konen, Reuven Ahiron, Liat Gindes, Shai Tejman-Yardem","doi":"10.1007/s00246-025-03787-8","DOIUrl":"https://doi.org/10.1007/s00246-025-03787-8","url":null,"abstract":"Post-mortem examinations of fetuses and newborns with congenital anomalies pose significant challenges, especially in cases of induced termination of pregnancy. To address this, we explored the use of virtual post-mortem examination (VPM) via computed tomography angiography (CTA) as a potential alternative. The study was conducted at Sheba Medical Center from January 2013 to June 2019. It focused on 20 cases involving severe congenital heart defects or lung malformations affecting the heart. VPM imaging was performed using CTA with contrast medium injected into the umbilical artery and vein. Prenatal sonographic diagnoses were fully concordant with VPM findings, confirmed by authorized invasive autopsies in 7 cases. The standardized injection protocol enabled accurate imaging of the systemic and pulmonary vessels, aiding in the identification of vascular anomalies and the cardiac structures. However, visualization of intra-cardiac anatomy was limited, possibly due to valve competence and post-mortem intra-ventricular Thrombi. Compared to MRI, CT scans this method offers higher spatial resolution at a lower cost, making it a feasible complement to standard medical practice. Despite limitations in visualizing cardiac chambers, VPM with umbilical vessel injection proved highly accurate, particularly in assessing the great vessels. Overall, the findings suggest that VPM may offer a less invasive and acceptable alternative for grieving parents, providing valuable insights into complex congenital cardiac anomalies, while respecting the sensitivity of post-mortem examinations in such cases.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573598","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

Factors Predicting Early Outcome of Aortic Valve Neocuspidization in the Pediatric Population.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-05 DOI: 10.1007/s00246-025-03808-6

Sivakumar Sivalingam, Maruti Yamanappa Haranal, Woan Shiang See

{"title":"Factors Predicting Early Outcome of Aortic Valve Neocuspidization in the Pediatric Population.","authors":"Sivakumar Sivalingam, Maruti Yamanappa Haranal, Woan Shiang See","doi":"10.1007/s00246-025-03808-6","DOIUrl":"https://doi.org/10.1007/s00246-025-03808-6","url":null,"abstract":"Aortic valve reconstruction in the pediatric population presents significant surgical challenges as the ideal repair requires an individualized approach considering various factors. This study aims to analyze the factors influencing outcomes of aortic valve neocuspidization (AV Neo) in pediatric patients. A retrospective cohort study involving pediatric patients who underwent neocuspidization (congenital and acquired) between 2016 and 2023. Clinical outcomes assessed included mortality, reintervention, structural valve degeneration and infective endocarditis. Echocardiographic measurements included peak and mean gradient, indexed vena contracta jet width, annular diameter, and coaptation height. Freedom from events was analyzed using Kaplan-Meier analysis. Outcomes were compared based on congenital or acquired valve lesions. AV neo was performed in 53 patients with a mean age of 10.7 ± 3.91 years, of which 29 had congenital aortic valve disease. There was one early in-hospital mortality. At discharge, the mean coaptation height was 9.9 ± 1.0 mm, the peak gradient was 12.0 mmHg, and less than mild regurgitation was observed. The median follow up period was 27.4 months. Forty-four patients (83%) remained event-free. A Significant aortic annular growth was noted, with rheumatic etiology patients showed the most stable coaptation height over time. Truncus arteriosus patients demonstrated rapid growth of the annulus leading to accelerated truncal valve regurgitation progression. AV Neo is feasible with acceptable short-term results in pediatric patients with congenital and acquired etiology. The procedure allows significant physiological annular growth, particularly benefiting patients with rheumatic aortic valve disease, but less favorable among patients with truncal valve pathology.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557171","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

Severity of Congenital Heart Defects Affects Long-Term Somatic Development.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-05 DOI: 10.1007/s00246-025-03815-7

Alexandra Kiess, Patricia Bimboese, Ruth Gausche, Christoph Beger, Christof Meigen, Mandy Vogel, Roland Pfäffle, Ingo Dähnert, Wieland Kiess

{"title":"Severity of Congenital Heart Defects Affects Long-Term Somatic Development.","authors":"Alexandra Kiess, Patricia Bimboese, Ruth Gausche, Christoph Beger, Christof Meigen, Mandy Vogel, Roland Pfäffle, Ingo Dähnert, Wieland Kiess","doi":"10.1007/s00246-025-03815-7","DOIUrl":"https://doi.org/10.1007/s00246-025-03815-7","url":null,"abstract":"Treatment options and therefore general health in children with congenital heart defects (CHD) improved tremendously over the last decades. Growth is an important marker to evaluate healthy development, especially in patients with chronic diseases. This study aimed to evaluate growth in children with CHD compared to their healthy peers. A retrospective, longitudinal analysis of standardized measurements of height, weight, and head circumference of children with CHD aged 0 to 18 years (n = 18,591) was conducted based on data provided by the German pediatrician network CrescNet. These data were compared to the data of healthy children from the same region. Inclusion was based on the ICD-10 codes for CHD; patients with other growth-altering diseases or medications were excluded. CHD were grouped into mild, moderate, or severe according to their severity. The severity of the CHD influences the height, final height, weight, and head circumference of affected children at birth and in long-term growth. Children with more severe CHD are smaller (- 1 to - 0.7 SDS), lighter (- 1 SDS), and have smaller head circumferences (- 1 SDS) than their healthy peers and children with milder CHD. In a subgroup analysis of children with Down's syndrome (T21), children with T21 and CHD showed significantly smaller measurements than their peers without CHD. In this subgroup, only the presence but not the severity of the CHD mattered. Despite overall good outcomes and better survival rates, growth as a marker of healthy development in children with CHD may be still impacted and should be closely monitored to offer early intervention.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557389","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

Predicting Cardiac Magnetic Resonance-Derived Ejection Fraction from Echocardiogram Via Deep Learning Approach in Tetralogy of Fallot.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-04 DOI: 10.1007/s00246-025-03802-y

Arnav Adhikari, G Vick Wesley, Minh B Nguyen, Tam T Doan, Mounica Y Rao, Anitha Parthiban, Lance Patterson, Kashika Adhikari, David Ouyang, Jeffery S Heinle, Lalita Wadhwa

{"title":"Predicting Cardiac Magnetic Resonance-Derived Ejection Fraction from Echocardiogram Via Deep Learning Approach in Tetralogy of Fallot.","authors":"Arnav Adhikari, G Vick Wesley, Minh B Nguyen, Tam T Doan, Mounica Y Rao, Anitha Parthiban, Lance Patterson, Kashika Adhikari, David Ouyang, Jeffery S Heinle, Lalita Wadhwa","doi":"10.1007/s00246-025-03802-y","DOIUrl":"https://doi.org/10.1007/s00246-025-03802-y","url":null,"abstract":"Systolic function assessment is essential in children with congenital heart disease. Traditional methods of echocardiographic left ventricular ejection fraction (LVEF) estimation might overestimate systolic function compared to the gold standard of cardiac magnetic resonance imaging (CMR), especially in Tetralogy of Fallot (TOF). Deep learning technologies such as EchoNet-Dynamic offer more consistent cardiac evaluations and can potentially accurately predict LVEF using echocardiographic videos. The EchoNet-Dynamic/EchoNet-Peds models predict LVEF using echocardiograms with expert-measured LVEF as the ground truth. Using a transfer learning approach, we fine-tuned this model to predict LVEF with CMR-derived LVEF as ground truth and TOF echocardiograms as input images. For echocardiograms in the PSAX view, the model predicted CMR LVEF with an R2 of 0.79 and an MAE of 4.41. For the A4C view, the model predicted CMR LVEF with an R2 of 0.53 and an MAE of 6.4. Plotted ROC curves indicate that both tuned models differentiated well between normal and reduced LVEF. This study shows the potential of Convolutional Neural Network (CNN) models in transforming the field of cardiac imaging interpretation via a hybrid approach using the CMR labels and echocardiogram videos offering advancements over conventional methods.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557385","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

Contraception Use in Adolescents and Young Adults with Congenital Heart Disease.

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-03 DOI: 10.1007/s00246-025-03791-y

Jaclyn Giafaglione, May Ling Mah, Lydia K Wright

{"title":"Contraception Use in Adolescents and Young Adults with Congenital Heart Disease.","authors":"Jaclyn Giafaglione, May Ling Mah, Lydia K Wright","doi":"10.1007/s00246-025-03791-y","DOIUrl":"https://doi.org/10.1007/s00246-025-03791-y","url":null,"abstract":"Women with congenital heart disease (CHD) are at elevated risk for morbidity and mortality during childbirth. Pediatric cardiologists are in a unique position to provide reproductive counseling to their patients with CHD. We evaluated contraception use in adolescents and young adults with CHD seen in a pediatric cardiology practice. Utilizing retrospective chart review, we evaluated all encounters for female patients aged 14 - 21 years with CHD between January 2017 and June 2023 at a tertiary care center. Female patients without CHD seen over the same period were included as a comparator group. Logistic regression was used to evaluate predictors of contraception use. There were 12, 368 visits included in our study. Of the 9924 visits in patients without CHD, 23% were on contraception, and of the 2444 visits in patients with CHD, 22% were on contraception. There was an increase in contraception use over time. Controlling for age at visit, later visit year was associated with contraception use (OR 1.09 [95% CI 1.04-10.9] per year). CHD was associated with lower likelihood of contraception use [OR 0.79 [95% CI 0.70 - 0.88]). Those with single ventricle (SV) CHD and complex CHD used long-acting reversible contraception more often (54% and 46% respectively) compared to those with simple or moderate CHD (17% and 16% respectively) or no CHD (18%). Patients with CHD are receiving contraception at a lower rate than those without CHD. Given the risks that women with CHD face with pregnancy, there should be a dedicated effort to increase the percentage of women with CHD on contraception.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542761","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 "Comment on: Early Post-operative ECG Changes as a Predictor of Post-pericardiotomy Syndrome Following Atrial Septal Defect Repair". 对 "关于：术后早期心电图变化作为心房室间隔缺损修复术后心包切开综合征的预测指标 "的评论。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1007/s00246-024-03711-6

William Hanna, Kristen Hyberg, Iqbal El-Assad

引用次数: 0

Letter to the Editor: "Risk Factors and Outcomes Associated with Gaps in Care in Children with Congenital Heart Disease". 致编辑的信：“与先天性心脏病患儿护理缺口相关的危险因素和结果”。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2025-03-01 Epub Date: 2024-12-24 DOI: 10.1007/s00246-024-03758-5

Disha Bai, Sonia Kumari, Kanwal Majeed

引用次数: 0

An Infant with High-Output Heart Failure and Pulmonary Hypertension Resulting from a Giant Cutaneous Hemangioma. 巨大皮肤血管瘤导致婴儿高输出性心力衰竭和肺动脉高压。