PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

{"title":"Relation between global longitudinal strain and acute rejection in pediatric patients within the first-year post heart transplant","authors":"Rod Ghassemzadeh ,&nbsp;Suzanne Golz ,&nbsp;Lu Wang ,&nbsp;Sarah Worley ,&nbsp;Francine Erenberg ,&nbsp;Gerard Boyle ,&nbsp;Adriana Carolina Prada-Ruiz ,&nbsp;Rukmini Komarlu","doi":"10.1016/j.ppedcard.2023.101681","DOIUrl":"10.1016/j.ppedcard.2023.101681","url":null,"abstract":"<div><h3>Background</h3><p>Acute rejection leading to graft dysfunction remains a major cause of morbidity and mortality. In adults, assessment of global longitudinal strain (GLS) using speckle tracking echocardiography (STE) has been used as an early marker for graft dysfunction. Studies evaluating GLS in a sizable pediatric transplant population are scarce.</p></div><div><h3>Objectives</h3><p>We sought to determine association between GLS and acute rejection within first-year post-transplantation in pediatric patients.</p></div><div><h3>Methods</h3><p>Patients 0 to 18 years old who received heart transplants (HT) at Cleveland Clinic Children's Hospital after April 2013 were identified. Clinical data was collected from pre-transplant evaluation and post-transplant surveillance endomyocardial biopsy (EMB) visit from time of transplantation to one-year post-transplantation. Left ventricular (LV) GLS was measured retrospectively using vendor independent software. Significant rejection was defined by escalation in immunosuppression therapy due to pathology or clinical diagnosis. Trends of GLS were compared between patients with (Group 1) and without (Group 2) rejection, controlled for age. At the visit of rejection diagnosis, GLS rejection measurements were compared to the range of “normal”, non-rejection measurements.</p></div><div><h3>Results</h3><p>Twenty-seven patients met inclusion criteria. Eight patients (29.6 %) had at least one clinically significant rejection episode. There was no significant difference in GLS at the first endomyocardial biopsy visit between groups. At last biopsy visit, subjects with rejection had significantly worse GLS (p ≤ 0.001). In a mixed effect model, average global, 3-chamber, and 4-chamber systolic strain had significant interaction of group and time (<em>p</em> = 0.016, 0.033, 0.003, respectively). Systolic strain in those views significantly worsened over time in rejection group while remaining stable in non-rejection group. GLS of subjects with rejection were worse and out of the range of “normal” by the time of the third EMB visit.</p></div><div><h3>Conclusions</h3><p>There was a trend toward worse GLS in those who developed acute rejection within first year post-transplant compared to those without rejection.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388095","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":"Ventricular septal rupture in a premature infant with incomplete Kawasaki disease: An unusual complication","authors":"Anis Munirah MK ,&nbsp;Nor Fadhilah Zahari ,&nbsp;Noraihan Ibrahim ,&nbsp;Farohah CMZ ,&nbsp;Abdul Rahim Wong","doi":"10.1016/j.ppedcard.2023.101680","DOIUrl":"https://doi.org/10.1016/j.ppedcard.2023.101680","url":null,"abstract":"<div><p><span>Kawasaki disease<span> and the associated complication of Ventricular Septal Rupture are extremely rare in neonates, particularly among premature infants. We report a case of a premature infant who was diagnosed with incomplete Kawasaki disease after an </span></span>echocardiogram<span> incidentally demonstrated a coronary artery aneurysm<span>. The patient developed Ventricular Septal Rupture secondary to myocardial infarction seven months after the onset of the disease. This case highlighted the importance of coronary artery<span> screening in a febrile neonatal patient who did not respond to multiple courses of antibiotics. Due to the rarity of the disease in neonates and the complications, the management of Ventricular Septal Rupture postneonatal Kawasaki disease is challenging as there is no consensus regarding treatment.</span></span></span></p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49763163","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":"Aerosolized lidocaine to reduce tracheal suction-associated pain after pediatric congenital heart surgery: A randomized, double-blind, placebo-controlled trial","authors":"Thalis Henrique da Silva ,&nbsp;Fabio Carmona","doi":"10.1016/j.ppedcard.2023.101679","DOIUrl":"10.1016/j.ppedcard.2023.101679","url":null,"abstract":"<div><h3>Background</h3><p><span><span>In children undergoing heart surgery for congenital heart disease<span> (CHD), postoperative pain is associated with changes in the respiratory system that can lead to complicated courses and poor outcomes. </span></span>Respiratory therapy<span> (RT) can restore respiratory function<span><span> through manual techniques and tracheal suction (TS). However, TS itself can cause pain, leading to hemodynamic and respiratory manifestations, such as </span>tachycardia, hyper- or hypotension, </span></span></span>tachypnea<span>, increased work-of-breathing, patient-ventilator asynchrony, among others.</span></p></div><div><h3>Objectives</h3><p>The aim of this study was to investigate whether RT/TS increases pain and whether inhaled lidocaine can attenuate pain increase in infants and children undergoing surgery for CHD.</p></div><div><h3>Methods</h3><p>Double-blind, randomized, placebo-controlled trial at a pediatric intensive care unit<span> in a Brazilian tertiary-care university hospital. Patients &lt;18 years submitted to open-heart surgery for CHD were included and randomized to receive either aerosolized lidocaine (1 mg/kg) or placebo before RT/TS. Pain was assessed by the Face, Legs, Activity, Cry, Consolability pain scale – revised (FLACC-R), along with hemodynamic and ventilatory parameters, before and 10 min after RT/TS start on postoperative days 1, 3, and 7 given they were on mechanical ventilation.</span></p></div><div><h3>Results</h3><p>119 patients were included. RT/TS induced minor changes in pain, which were not attenuated by lidocaine (confirmed in multivariate analysis). RT/TS also caused minor, clinically not relevant effects in hemodynamic and ventilatory parameters, which were also not modified by lidocaine.</p></div><div><h3>Conclusion</h3><p>Respiratory therapy with tracheal suction did not increase postoperative pain in ventilated children after congenital heart surgery until the 7th day, nor did aerosolized lidocaine exhibit any clinically significant effect on pain or other hemodynamic or ventilatory parameters.</p><p><strong>Registered at REBEC:</strong> RBR-10vtd55m.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248711","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":"Transcatheter pulmonary flow restrictors in a 2.4 kg neonate with complex truncus arteriosus as long-term bridge to primary infant heart transplant","authors":"Damien Schaffner ,&nbsp;Michael J. Shorofsky ,&nbsp;Jenny E. Zablah ,&nbsp;Gareth J. Morgan","doi":"10.1016/j.ppedcard.2023.101668","DOIUrl":"10.1016/j.ppedcard.2023.101668","url":null,"abstract":"<div><p>In recent years, the use of modified Micro Vascular Plugs (MVP) (Medtronic, Galway, Ireland) as branch pulmonary artery flow<span><span> restrictors has been reported in different congenital cardiac pathologies with </span>single ventricle physiology as part of a transcatheter stage I procedure.</span></p><p><span>To our knowledge, we report for the first time successful transcatheter implantation of modified Micro Vascular Plugs as pulmonary flow restrictors in a small-for-gestational-age neonate with truncus arteriosus and a hypoplastic right ventricle to create stable physiology and facilitate eligibility for a </span>heart transplant.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44821604","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":"Myocardial functions by 3D speckle tracking echocardiography in pediatric acute kidney injury patients undergoing peritoneal versus hemodialysis","authors":"Antoine F. AbdelMassih ,&nbsp;Yara Salah Shaheen ,&nbsp;Eman Ismail ,&nbsp;Mohamed Gameel ,&nbsp;Nourine Diab ,&nbsp;Mohamed Samir ,&nbsp;Emad E. Ghobrial","doi":"10.1016/j.ppedcard.2023.101663","DOIUrl":"10.1016/j.ppedcard.2023.101663","url":null,"abstract":"<div><h3>Background</h3><p><span>Acute kidney injury (AKI) is known to induce </span>myocardial injury<span> by the combined effect of volume load and uremic toxins<span><span>. No study has compared to date the differential effect of peritoneal vs. hemodialysis in </span>myocardial protection in the context of AKI.</span></span></p></div><div><h3>Objective</h3><p><span>3D speckle tracking Echocardiography is a new sensitive marker for detection of subclinical myocardial dysfunction. The aim of this study was to evaluate presence of myocardial dysfunction </span>in patients<span> undergoing acute peritoneal dialysis (PD) versus hemodialysis (HD) in cases of acute kidney injury (AKI).</span></p></div><div><h3>Methods</h3><p>This study included pediatric patients diagnosed with AKI that have undergone HD or PD. It included 50 children; 25 of them were cases that suffered from AKI compared to 25 healthy children. Each patient was subjected to 3D speckle tracking and tissue doppler echocardiography.</p></div><div><h3>Results</h3><p><span>Cases with AKI showed evident systo-diastolic biventricular dysfunction. Parameters of LV<span><span> and RV systolic functions<span> were more impaired in HD group compared to PD group: LV GLS (HD: 13 ± 1, PD: 15 ± 1) and RV GLS (HD: 12 ± 1, PD: 16 ± 2) respectively, LV E/E' (ratio of the peak early mitral inflow velocity to the average of peak early mitral annular and basal septal diastolic velocities) (HD:13 ± 1, PD: 9 ± 1) and RV E/E' (ratio of peak early tricuspid inflow velocity to the peak early tricuspid annular diastolic velocity) (13 ± 1, PD: 9 ± 0.9). LV and RV diastolic dysfunction were more pronounced in HD group compared to PD group. </span></span>Multivariate analysis<span> showed that the best predictor of LV systolic dysfunction was the mode of dialysis, with a </span></span></span><em>P</em> value of 0.04.</p></div><div><h3>Conclusion</h3><p>Hemodialysis modality in AKI seems to be less protective to the myocardium<span> than Peritoneal dialysis. This might be attributed to rapid reduction in fluid load, which is reported to damage endothelial glycocalyx, thereby causing myocardial edema.</span></p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46643630","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":"Parental perceptions of the effect of the COVID-19 pandemic on outpatient services for patients with single ventricle congenital heart disease","authors":"D. J. Donovan, Matthew Theoharakis, A. Rose, R. Epstein, Adam Butensky, Michael A. Fremed, Sophia Chrisomalis-Dring, Anne M. Ferris","doi":"10.2139/ssrn.4493954","DOIUrl":"https://doi.org/10.2139/ssrn.4493954","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46958987","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":"Giant right atrial appendage aneurysm successfully managed in a newborn: A rare case report","authors":"Sudipta Bandyopadhyay ,&nbsp;Swaminathan Vaidyanathan ,&nbsp;C.S. Muthukumaran ,&nbsp;Neville Solomon","doi":"10.1016/j.ppedcard.2023.101661","DOIUrl":"10.1016/j.ppedcard.2023.101661","url":null,"abstract":"<div><p><span>A right atrial appendage aneurysm is an extremely rare cardiac anomaly. According to the literature, so far, 10 cases have been detected in pediatric populations. A very small number of cases have so far undergone surgical repair in the </span>newborn period<span><span><span><span><span>. It can be asymptomatic or may be associated with arrhythmia or right heart failure. Here we are presenting a case of a </span>newborn<span> with a giant right atrial appendage aneurysm, arrhythmia, and mild respiratory distress. The aneurysm was diagnosed by transthoracic echocardiography and confirmed by a cardiac </span></span>CT scan. It was resected surgically under </span>cardiopulmonary bypass. Postoperatively, the baby was extubated on the 2nd postoperative day and discharged on the 7th postoperative day. Because of its rare occurrence, diagnosis is sometimes difficult, and it may be confused with the </span>Ebstein anomaly.</span></p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41706621","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":"Clinical course after Fontan palliation: Single center experience","authors":"Benjamin J. Smith ,&nbsp;Derek M. Norton ,&nbsp;Michael Evans ,&nbsp;Shanti Narasimhan","doi":"10.1016/j.ppedcard.2023.101662","DOIUrl":"10.1016/j.ppedcard.2023.101662","url":null,"abstract":"<div><h3>Background</h3><p>The Fontan procedure<span> has been the standard palliation for single-ventricle patients. We aimed to investigate the short- and midterm outcomes of patients who underwent Fontan palliation.</span></p></div><div><h3>Objectives</h3><p>To assess and analyze the clinical course, including length of stay, complications, and mortality of single ventricle patients undergoing Fontan Palliation.</p></div><div><h3>Methods</h3><p>Retrospective review of all patients who underwent Fontan palliation at the University of Minnesota, 2006–2020. The primary outcomes measured were length of stay, complications, and Fontan failure.</p></div><div><h3>Results</h3><p><span>Of the 55 patients the median age of Fontan was 3.9 yrs [2.63, 4.19] and the most common diagnoses were hypoplastic left heart syndrome (</span><em>n</em><span> = 20, 36 %), double inlet left ventricle (</span><em>n</em><span> = 11, 20 %) and double outlet right ventricle (</span><em>n</em><span><span> = 8, 15 %). Twenty-Seven were right ventricle<span> dominant, 23 were left ventricle dominant, and 5 had biventricular morphology. The median hospital stay was 11 days [8, 17.5], an </span></span>ICU<span> stay of 6.5 days [4,9]. Fourteen late complications occurred in 10 patients. Three, all with HLHS, had Fontan failure leading to heart transplant. Four died: two prior to hospital discharge, one 6.7 yrs post-Fontan, and one 27 days after transplantation. Right ventricle morphology was associated with prolonged ICU (P 0.05), prolonged hospital stay (</span></span><em>P</em> &lt; 0.01), and complications resulting in Fontan failure (P &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>The survival following Fontan completion in the current era is excellent, with an overall and transplant-free survival at 5 and 10 years were at 96 % and 93 %. However, it is clear that univentricular physiology continues to present challenges, and patients remain at risk for morbidity, especially for patients with right ventricle morphology.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42831626","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":"Outcomes following implementation of a pediatric cardio-oncology program","authors":"Zachary Daniels ,&nbsp;Randal Olshefski ,&nbsp;Lydia Wright ,&nbsp;Stephen Hart ,&nbsp;Robert Gajarski ,&nbsp;Kan Hor ,&nbsp;Deipanjan Nandi","doi":"10.1016/j.ppedcard.2023.101664","DOIUrl":"10.1016/j.ppedcard.2023.101664","url":null,"abstract":"<div><h3>Background</h3><p>With improved survival following childhood cancer, cardiovascular disease has emerged as a significant source of long-term morbidity and mortality. Oncology<span> patients require comprehensive cardiac screening and monitoring throughout their treatment<span> and beyond. The complexity of these patients has led to increasing numbers of pediatric cardio-oncology specialty clinics.</span></span></p></div><div><h3>Objectives</h3><p>To describe the characteristics and 1-year outcomes following cardio-oncology clinic implementation at a large pediatric quaternary care institution.</p></div><div><h3>Methods</h3><p>Patients with history of chest radiation, high-dose anthracycline<span>, or decreased left ventricular function were referred and reviewed. Initiation of oral heart failure therapy or advanced cardiac therapies within 1 year following referral were identified, and risk factors for these were evaluated.</span></p></div><div><h3>Results</h3><p><span>Ninety-seven patients aged 5 days to 21 yrs. old were referred from 2017 to 2021. Average age at cancer diagnosis was 8.1 ± 5.5 years, with 48 % receiving high-dose anthracycline and 36 % chest radiation. Left ventricular dysfunction was present in 28 % at presentation. Oral heart failure therapy was initiated in 31 %, and none required advanced cardiac therapies. Patients who required oral heart failure therapy were more likely to be older at the age of cancer diagnosis, 10.8 ± 5.1 vs. 7.0 ± 5.3 yrs. (</span><em>p</em> = 0.001). A higher proportion of patients who received both high-dose anthracycline and chest radiation were on oral heart failure therapy (4/8, 50 %) compared to patients with high-dose anthracycline (18/46, 39 %) or chest radiation (9/35, 26 %) exposure alone, although not statistically significant.</p></div><div><h3>Conclusion</h3><p>Implementation of a pediatric cardio-oncology clinic led to increased referrals, appropriate assessment, and initiation of oral heart failure therapy. Patients older at the time of cancer diagnosis were more likely to require treatment. However, it does remain unclear if starting a COC provides long-term benefits for this particularly high-risk patient population.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45574864","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":"Holistic situs identification","authors":"William N. Evans","doi":"10.1016/j.ppedcard.2023.101643","DOIUrl":"10.1016/j.ppedcard.2023.101643","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46800645","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}