PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

{"title":"Accidental destruction of fungal vegetation in the right atrium after new central line placement in a premature infant: A case report","authors":"Zahra Akbarian-rad ,&nbsp;Mohsen Haghshenas-Mojaveri ,&nbsp;Samira Pournajaf ,&nbsp;Kazem Babazadeh ,&nbsp;Hamidreza Mirzaei Ilali","doi":"10.1016/j.ppedcard.2026.101909","DOIUrl":"10.1016/j.ppedcard.2026.101909","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal fungal endocarditis is uncommon, yet it remains one of the most lethal infections seen in preterm infants, particularly those with extremely low birth weight. Mortality and morbidity remain high, underscoring the need for vigilant monitoring and swift, targeted therapy.</div></div><div><h3>Case presentation</h3><div>A preterm girl by gestational age 27 wks^+5d and birth weight 1040 g was admitted due to respiratory distress and prematurity. At the 4th week, she presented with high procalcitonin despite sterile blood cultures and received 2 weeks of broad-spectrum antibiotics. Sepsis workup and echocardiograms were done. A right-atrial mass (3.7 × 3.9 mm) was shown, and catheter tip culture grew <em>Candida albicans</em>, while blood cultures remained negative. Another peripherally inserted central catheter (PICC) was fixed, and liposomal amphotericin B was administered for four weeks. Following new PICC insertion from the lower extremity, the patient presented with fever, tachycardia, respiratory distress, and vomiting. Fluconazole was added upon clinical deterioration. Subsequent echocardiography showed no vegetations at that site, and inflammatory markers normalized after transient elevation.</div></div><div><h3>Conclusion</h3><div>In VLBW infants, catheter placement should be performed cautiously and carefully with adequate care and monitoring. It may be necessary to give prophylaxis for fungal infection for weights greater than 1000 g.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101909"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic dysfunction in the patients with failing Fontan circulation: New insights and future directions","authors":"Ashish H. Shah","doi":"10.1016/j.ppedcard.2026.101914","DOIUrl":"10.1016/j.ppedcard.2026.101914","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101914"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow acceleration and dynamic left ventricular outflow tract obstruction in neonatal warm shock: Echocardiographic phenotyping and management implications","authors":"Benjamim Ficial ,&nbsp;Beatrice Allena ,&nbsp;Ilaria Boffa ,&nbsp;Arianna Zuccato ,&nbsp;Daniele Mosolo ,&nbsp;Martina Ciarcià ,&nbsp;Federica Runfola ,&nbsp;Silvia Nogara ,&nbsp;Iuri Corsini ,&nbsp;Willem P. de Boode","doi":"10.1016/j.ppedcard.2026.101908","DOIUrl":"10.1016/j.ppedcard.2026.101908","url":null,"abstract":"<div><div>Echocardiography is increasingly used to assess hemodynamics in critically ill neonates. We describe a novel echocardiographic phenotype associated with warm shock in preterm neonates with late-onset sepsis, ranging from left ventricular outflow tract (LVOT) acceleration to dynamic LVOT obstruction, with systolic anterior motion (SAM) of the mitral valve and secondary mitral regurgitation (MR).</div><div>We retrospectively reviewed six consecutive preterm neonates with late-onset sepsis admitted between June 2024 and June 2025. All underwent neonatologist performed echocardiography (NPE) at the time of clinical deterioration.</div><div>All neonates presented with signs of warm shock, including tachycardia and hyperdynamic circulation. NPE demonstrated aliasing across the LVOT on color Doppler and a dagger-shaped spectral Doppler profile, indicative of LVOT acceleration. In three cases, dynamic LVOT obstruction with SAM and MR was demonstrated. Management included fluid boluses and vasopressors (norepinephrine); two cases required β-blockade (esmolol), resulting in resolution of obstruction and MR.</div><div>This case series describes a previously unreported echocardiographic phenotype associated with warm shock in preterm neonates, characterized by a spectrum ranging from LVOT flow acceleration to dynamic LVOT obstruction with SAM and secondary MR. NPE enabled early identification and pathophysiological understanding, and tailored management. Prospective studies are needed to validate these findings.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101908"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normothermia versus hypothermia in neonatal arterial switch operation: Implications for myocardial preservation and clinical outcomes","authors":"Brijesh Sathian ,&nbsp;Javed Iqbal ,&nbsp;Syed Muhammad Ali ,&nbsp;Muhammad mohsin khan","doi":"10.1016/j.ppedcard.2025.101880","DOIUrl":"10.1016/j.ppedcard.2025.101880","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101880"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Predictors of nonelective removal of peripherally inserted central catheters in children with heart disease”","authors":"Ashish Moudgil ,&nbsp;Prashant Ramdas Kokiwar ,&nbsp;Rhushvi Thakkar ,&nbsp;Ankita Kalra","doi":"10.1016/j.ppedcard.2026.101906","DOIUrl":"10.1016/j.ppedcard.2026.101906","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101906"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global scientometric analysis of prenatal diagnosis of congenital heart disease: Trends in imaging research","authors":"Derren D.C.H. Rampengan ,&nbsp;Nuril Farid Abshori ,&nbsp;Sri Andala ,&nbsp;Michael Owen Hogipranata ,&nbsp;Muhammad Iqhrammullah","doi":"10.1016/j.ppedcard.2026.101903","DOIUrl":"10.1016/j.ppedcard.2026.101903","url":null,"abstract":"<div><h3>Background</h3><div>Prenatal diagnosis of congenital heart disease (CHD) relies on imaging, yet its global research landscape remains unmapped.</div></div><div><h3>Objective</h3><div>To conduct a global scientometric analysis of prenatal CHD diagnosis, emphasizing imaging-related trends, hotspots, and collaborations.</div></div><div><h3>Methods</h3><div>Publications from January 1st, 2000, to November 23rd, 2025, were retrieved from Scopus. Bibliometric data, such as annual number of publications, document types, publication venues, diagnostic modalities, lesion focus, keywords, thematic evolution, and international collaborations were assessed. Polynomial modeling and Bradford's Law were used to evaluate growth and journal concentration.</div></div><div><h3>Results</h3><div>A total of 7312 publications were identified, peaking at 544 in 2023, with a third-order polynomial showing excellent trend fit (R² = 0.983). Original research dominated (75.1%), followed by reviews (13.2%). Fetal echocardiography emerged as the dominant modality, with diagnostic interest largely driven by hypoplastic left heart syndrome and a steadily increasing focus on coarctation, alongside intermittent attention to single-ventricle physiology. A broad shift in the research hotspots was observed from structural imaging toward genomics, functional prognostication, and AI-supported decision making. Thematic evolution confirmed this transition, highlighting growing integration of genetic risk profiling, physiological assessment, and precision planning for in-utero intervention. Global collaboration patterns were dominated by high-income countries, particularly New Zealand, Japan, Australia, and Korea.</div></div><div><h3>Conclusion</h3><div>Imaging research on prenatal CHD has experienced significant progress, with fetal echocardiography becoming the central diagnostic platform and recent shifts toward genomics, physiological prognostication, and emerging AI-assisted decision tools. Although global collaboration is strong, it remains dominated by high-income hubs, with LMIC participation growing but still peripheral.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101903"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive nomogram for hemodynamically significant patent ductus arteriosus within the first week of life in very low birth weight infants","authors":"Manapat Praditaukrit ,&nbsp;Anucha Thatrimontrichai ,&nbsp;Gunlawadee Maneenil ,&nbsp;Supaporn Dissaneevate ,&nbsp;Tippawan Liabsuetrakul","doi":"10.1016/j.ppedcard.2025.101874","DOIUrl":"10.1016/j.ppedcard.2025.101874","url":null,"abstract":"<div><h3>Background</h3><div>Hemodynamically significant patent ductus arteriosus (hsPDA) leads to several complications in very low birth weight (VLBW) infants.</div></div><div><h3>Objective</h3><div>To develop a predictive nomogram using perinatal factors for predicting hsPDA within the first week of life in VLBW infants.</div></div><div><h3>Methods</h3><div>This was a 9-year retrospective study conducted at a university hospital in Southern Thailand. hsPDA predictors were identified and included in a prediction model, which was presented as a nomogram to estimate the risk of hsPDA. The areas under the receiver operating characteristic curve and mean absolute calibration error were calculated to evaluate the model's performance.</div></div><div><h3>Results</h3><div>A total of 265 neonates were included in the final analysis. The median (interquartile range) gestational age and birth weight were 29 (27–30) weeks and 1085 (860–1300) g, respectively. hsPDA was diagnosed in 172 infants (65 %). The significant factors used to create the model were severe respiratory distress syndrome (adjusted odds ratio [aOR] 2.73; 95 % confidence interval [CI]: 1.28–5.81), invasive mechanical ventilation within 24 h after birth (aOR 2.10; 95 % CI: 1.03–4.29), pregnancy-induced hypertension (aOR 1.93; 95 % CI: 1.01–3.67), gestational age (aOR 0.76; 95 % CI: 0.65–0.88), and completion of an antenatal corticosteroid course (aOR 0.48; 95 % CI: 0.27–0.86). The model's discrimination and mean absolute error were 0.76 and 0.031, respectively.</div></div><div><h3>Conclusion</h3><div>The predictive nomogram developed in this study is applicable in clinical settings to identify VLBW infants at risk of hsPDA and may assist physicians in deciding whether to perform echocardiography.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101874"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is one more year – or two – worth it? A net present value analysis of career earnings for physicians pursuing academic pediatric cardiac critical care","authors":"Benjamin W. Theisen ,&nbsp;Daniel J. Fiedorek ,&nbsp;Tyler W. Cunningham ,&nbsp;Scott W. Gatlin ,&nbsp;Parthak Prodhan ,&nbsp;Joshua A. Daily","doi":"10.1016/j.ppedcard.2026.101912","DOIUrl":"10.1016/j.ppedcard.2026.101912","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric cardiac critical care has emerged as a distinct field at the intersection of the broader fields of pediatric cardiology and pediatric critical care, and the training for this field requires one or more additional year of training after a usual 3-year fellowship training period in pediatric critical care or pediatric cardiology, but also has multiple pathways through this training. The long-term financial outcomes of this additional training have not been evaluated and may be useful in mentorship and career planning for trainees interested in this field.</div></div><div><h3>Objectives</h3><div>To determine whether additional cardiac intensive care unit (CICU) training is financially beneficial compared with standard pediatric critical care medicine (PCCM) or diagnostic cardiology pathways.</div></div><div><h3>Methods</h3><div>Economic modeling study using net present value analysis of lifetime earnings for physicians in cardiac critical care through one- or two-year training pathways, pediatric critical care, and diagnostic pediatric cardiology utilizing the 2024–2025 Association of Administrators of Academic Pediatrics Faculty Compensation and Productivity Survey data, incorporating training duration, promotion trajectory and salary percentile, and applying a 3% real discount rate with sensitivity analyses from 0 to 5%.</div></div><div><h3>Results</h3><div>Using the 50th salary percentile and standard promotion trajectory, cardiac critical care lifetime earnings surpassed other fields. Lifetime net present values were: pediatric critical care - $7.19 million; diagnostic pediatric cardiology - $7.36 million; 1-year cardiac critical care pathways - $7.84 million; 2-year dual-board cardiac critical care pathways - $7.52 million. The range in lifetime net present value across salary percentiles exceeded $3 million, and variation by promotion trajectory exceeded $1.5 million, indicating that these exert greater influence than training pathways alone.</div></div><div><h3>Conclusions</h3><div>Despite requiring one to two additional years of training, CICU specialization is financially comparable to, and in many cases slightly more favorable than, standard PCCM or diagnostic cardiology careers. These findings suggest that CICU training provides meaningful career flexibility without sacrificing long-term financial outcomes, while salary percentile and academic advancement remain the strongest determinants of overall lifetime earnings.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101912"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric cardiology fellowship applicant score analysis: Is this Lake Wobegon?","authors":"William Kyle,&nbsp;Tam Doan,&nbsp;Jolie Britt,&nbsp;Deidra Ansah,&nbsp;Lindsay Eilers,&nbsp;James Wilkinson","doi":"10.1016/j.ppedcard.2026.101905","DOIUrl":"10.1016/j.ppedcard.2026.101905","url":null,"abstract":"<div><h3>Background</h3><div>Letter of Recommendation (LOR) writers for pediatric cardiology fellowship applicants submit a scorecard rating the applicant. In this study, we analyze those scores, compare the differences between subsets, and suggest a framework for interpretation.</div></div><div><h3>Objective</h3><div>To analyze score distributions and differences based on author type, candidate quality, and demonstrated research performance.</div></div><div><h3>Methods</h3><div>This was a retrospective quantitative study. We quantified individual scorecard values and perfect scores. We compared residency Program Director (PD) and non-PD scores using the Wilcoxon signed-rank test. We used Mann-Whitney U testing to compare top-tier applicants to bottom-tier, males to females, and international medical graduates (IMGs) to US medical graduates. We used ordinal logistic regression to determine how the number of peer-reviewed articles/abstracts and poster presentations influenced the “Potential for Research” domain score.</div></div><div><h3>Results</h3><div>We reviewed 138 applications containing 460 scorecards and 2680 individual scores. Letter writers selected “Below average” only twice (0.07%) in the entire cohort. 94 scorecards had all “superlative” scores (20.4%). The median applicant score was 4.3 (IQR 4.1–4.6). PDs rated applicants significantly lower than non-PDs, with a median score of 4 (IQR 3.9–4.4) and 4.3 (IQR 4.0–4.6), respectively (<em>p</em> = 0.001). Top-tier applicants had higher median scores than bottom-tier applicants (4.7 (IQR 4.5–4.8) vs 4.3 (IQR 4.0–4.5); <em>p</em> &lt; 0.001). Each additional peer-reviewed publication/abstract correlated with increased odds of receiving a higher “Potential for Research” score by 17% (OR 1.17, 95% CI 1.11–1.24, <em>p</em> &lt; 0.001), while each poster increased odds by 6% (OR 1.06, 95% CI 1.01–1.12, <em>p</em> = 0.025). There were no statistical differences between scores when comparing males to females or IMGs to US medical graduates.</div></div><div><h3>Conclusion</h3><div>Despite a marked leftward skew of scores, alignment between the scorecard values and trainee performance suggests that the scorecard provides credible data. Likely resulting from a greater exposure to trainees, PD scores demonstrate less inflation and may represent more informed values. Scorecards are a valuable component of the pediatric cardiology fellowship application and should continue to be utilized.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101905"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance characteristics of electrocardiography in detecting critical congenital heart defects in newborns","authors":"Steven E. Lipshultz ,&nbsp;Robert C. O'Brien ,&nbsp;Elliot J. Pearson ,&nbsp;William G. Harmon ,&nbsp;Christopher Ratnasamy","doi":"10.1016/j.ppedcard.2026.101911","DOIUrl":"10.1016/j.ppedcard.2026.101911","url":null,"abstract":"<div><h3>Background</h3><div>Echocardiography is the definitive diagnostic test for neonates when pre- and post-natal assessments indicate critical congenital heart defects (CCHDs), but it is not practical for surveillance screening of all neonates. Pulse-oximetry is routinely used for newborn screening for heart defects.</div></div><div><h3>Objective</h3><div>To determine the value of additional information beyond pulse-oximetry provided by an electrocardiogram (ECG) in identifying and managing neonates with CCHDs.</div></div><div><h3>Methods</h3><div>We retrospectively compared pulse-oximetry and ECGs from 56 neonates with CCHD who received neonatal cardiovascular surgery to 56 demographically-matched neonates with normal echocardiograms. Conduction intervals, QRS axis, QRS and P-wave durations, and P, QRS, and T-wave voltages were quantified. Classification and Regression Tree (CART) and random forest analyses were used to explore the additional utility of ECG information beyond that provided by prenatal ultrasound and pulse-oximetry and to determine the most informative predictors.</div></div><div><h3>Results</h3><div>There were twenty-three neonates with CCHD (78% with left obstructive defects) and a negative pulse-oximetry screen. Among the neonates with a negative pulse-oximetry screen, the T-wave and R-wave voltages in lead V6 and the presence of a prenatal diagnosis excluded 54/56 (96%) of controls and correctly identified 17/23 (74%) of neonates with CCHD in the CART analysis. Random forests correctly classified 54/56 neonates with CCHD and 52/56 controls and determined the variables most important for predicting CCHD were in descending order: pulse-oximetry, presence of a prenatal diagnosis of heart disease, T-wave voltage in V6, QTc interval, P-wave voltage in V2, R-wave voltage in V6, T-wave voltage in V2, R-wave voltage in V5, and atrial enlargement.</div></div><div><h3>Conclusions</h3><div>In neonates who have negative prenatal ultrasound or postnatal pulse-oximetry screening for CCHD, the R- and T-wave amplitudes in V6 are discriminating factors for the presence or absence of CCHD. Electrocardiography may help guide the urgency of further diagnostic interventions.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"81 ","pages":"Article 101911"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}