PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

{"title":"Persistent pulmonary hypertension of the newborn","authors":"Jordan P. Priya Cooper ,&nbsp;Ahzam Budhwani ,&nbsp;Leah S. Kunneth ,&nbsp;Isha A. Patel ,&nbsp;Allison Omohundro ,&nbsp;Olumayowa B. Sholola ,&nbsp;Induja Gajendran ,&nbsp;Michael Zayek ,&nbsp;Diksha Shrestha","doi":"10.1016/j.ppedcard.2024.101777","DOIUrl":"10.1016/j.ppedcard.2024.101777","url":null,"abstract":"<div><h3>Background</h3><div>Persistent pulmonary hypertension in the newborn is associated with increased risk of cardiorespiratory failure, neurodevelopmental delay, and death.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review normal and abnormal perinatal pulmonary vasculature adaptation and persistent pulmonary hypertension of the newborn, including etiology, pathophysiology, clinical manifestations, diagnostic methods, and treatment.</div></div><div><h3>Key scientific concepts of review</h3><div>Persistent pulmonary hypertension of the newborn is characterized by failure of the pulmonary vasculature in the newborn to adapt after birth, resulting in sustained high pulmonary vascular resistance, abnormal extrapulmonary right-to-left shunting of deoxygenated blood, and refractory hypoxemia. The etiology and pathophysiology of persistent pulmonary hypertension of the newborn may be classified into four broad categories, including maladaptation of a structurally normal cardiopulmonary system, underdevelopment of the lungs, maldevelopment of pulmonary vasculature in the absence of pulmonary parenchymal disease, and intravascular obstructions associated with increased blood viscosity from polycythemia. Infants with persistent pulmonary hypertension of the newborn may present with labile hypoxemia, with or without respiratory distress. Evaluation may include simultaneous pre- and post-ductal oxygen saturation measurements, chest radiography, echocardiography, and arterial blood gas analysis. The hyperoxia test may be useful when echocardiography is unavailable. The main goal in treating persistent pulmonary hypertension of the newborn is to reverse pulmonary vasoconstriction, optimize cardiac function, and improve systemic oxygen delivery. Treatment may include supportive measures such as sedation, correction of metabolic disturbances, management of polycythemia, oxygen therapy, and mechanical ventilation. Targeted therapy, depending on the underlying cause of disease, may include surfactant therapy, pulmonary vasodilator therapy, and optimization of hemodynamic status. Infants with refractory PPHN may require extracorporeal membrane oxygenation. Survivors of moderate to severe disease should be monitored for neurologic abnormalities, hearing loss, and cognitive delay.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101777"},"PeriodicalIF":0.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171152","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":"Consequences and complications of un-intervened congenital heart defects in children: A retrospective cross-sectional study","authors":"Tesfaye Taye Gelaw,&nbsp;Belaynew Zemed Alebachew","doi":"10.1016/j.ppedcard.2024.101776","DOIUrl":"10.1016/j.ppedcard.2024.101776","url":null,"abstract":"<div><h3>Background</h3><div>Children with unrepaired congenital heart defects (CHDs) are at risk of developing complications related to the scarcity of interventions, delayed diagnosis, financial constraints, and difficulty reaching facilities in low-and middle-income countries.</div></div><div><h3>Objective</h3><div>Describe the frequency of complications by age and CHD type in children with un-intervened CHDs seen at Bahir Dar University Tibebe-Ghion Specialized Teaching Hospital.</div></div><div><h3>Method</h3><div>We conducted a retrospective cross-sectional study on children with un-intervened CHDs seen from September 01, 2021, to August 31, 2024. Data were collected from September 20 to 30, 2024, retrospectively. Categorical variables were analyzed in the form of proportions. Discrete variables were summarized as means (SD). Binary logistic regression was performed with 95 % confidence interval. <em>P</em>-value &lt;0.05 was considered significant. Data were analyzed using SPSS version 27.</div></div><div><h3>Result</h3><div>Of the 310 children with un-intervened CHDs, 47 % were female. The mean (SD) age was 28 months (42). Wasting (46 %) is the most common complication in children with CHD, followed by congestive heart failure (41 %), and recurrent respiratory tract infection (30 %). Seventy percent of children with un-intervened CHDs have at least one complication (68 % of acyanotic and 77 % of cyanotic CHDs). After adjusting for covariates, one month increase in age of children with un-intervened CHD increases the proportion of complications by 2 % {AOR = 1.019, 95 % CI = (1.007, 1.031)}.</div></div><div><h3>Conclusion</h3><div>A higher proportion of children with CHD had at least one or more complications. A one month delay in intervention of children with un-intervened CHDs has a 2 % increase in the occurrence of complications.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101776"},"PeriodicalIF":0.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171124","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":"Conservative management of patent ductus arteriosus in preterm infants: A systematic review and meta-analysis of randomized controlled trials","authors":"Rajanikant Kumar ,&nbsp;Efeoghene Praise Epia ,&nbsp;Mark W. Abdelnour ,&nbsp;Joo Young Belen Kim Kim ,&nbsp;Anne Boakyewaa Anokye-Kumatia ,&nbsp;Rimmo Loyi Lego ,&nbsp;Vrunda Kulkarni ,&nbsp;Syed Ali Farhan Abbas Rizvi ,&nbsp;Maryam Asif ,&nbsp;Huzaifa Ahmad Cheema ,&nbsp;Adeel Ahmad ,&nbsp;Wajeeh Ur Rehman ,&nbsp;Raheel Ahmed ,&nbsp;Sourbha S. Dani","doi":"10.1016/j.ppedcard.2024.101774","DOIUrl":"10.1016/j.ppedcard.2024.101774","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, there has been a rise in the adoption of conservative approaches to managing patent ductus arteriosus (PDA) in preterm infants. Systematic appraisal of the clinical evidence supporting this approach is essential for guiding guideline recommendations.</div></div><div><h3>Aim of review</h3><div>This systematic review and meta-analysis aims to investigate a strategy of conservative management in comparison to active treatment in preterm infants with PDA.</div></div><div><h3>Key scientific concepts of review</h3><div>From inception to April 2024, we conducted a comprehensive search of MEDLINE, Embase, the Cochrane Library, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> to identify relevant randomized controlled trials (RCTs) that evaluated conservative management versus active treatment of PDA in preterm infants. We used RevMan 5.4 to pool risk ratios (RRs).</div><div>Our review included 6 RCTs. There was no difference in the risk of mortality (RR 0.83; 95 % CI: 0.64–1.08) and BPD (RR 0.89; 95 % CI: 0.76–1.03) between the conservative management and active treatment groups. The rates of necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, sepsis, pulmonary hemorrhage, and the need for surgical ligation or transcatheter occlusion were similar between the two groups. In conclusion, our analysis showed no difference in the risk of all-cause mortality, BPD, or other clinical outcomes between a strategy of conservative management compared to active treatment. Further, large-scale RCTs focusing on targeted therapy for infants at the highest risk of complications from PDA are required.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101774"},"PeriodicalIF":0.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171149","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 Hypertension: definitions, evaluation, and treatment","authors":"Shaira Bedi ,&nbsp;Tania Raygoza ,&nbsp;Josephine Jalkh ,&nbsp;Jumoke Adelabu ,&nbsp;Taryn Hartley ,&nbsp;Rachel Lusk ,&nbsp;Kevin Wong ,&nbsp;Uzoma Obiaka ,&nbsp;Dunya Mohammad","doi":"10.1016/j.ppedcard.2024.101778","DOIUrl":"10.1016/j.ppedcard.2024.101778","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric hypertension affects 3 % to 5 % of children and adolescents between ages 1 year to 18 years and may have long-term health consequences.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review pediatric hypertension, including screening, methods of blood pressure measurement, etiology, evaluation, and treatment of patients with or without end-organ damage.</div></div><div><h3>Key scientific concepts of review</h3><div>In children, blood pressure levels are interpreted based on age, sex, and height to avoid misclassification. Blood pressure measurements at three separate visits are required to diagnose hypertension. Routine screening begins at age 3 years, but blood pressure is measured during each health visit in patients who have body mass index ≥95 %, take medications that increase blood pressure, or have health issues that may increase the risk of developing hypertension. The auscultatory method is preferred for blood pressure measurement in the right arm. A 24-h ambulatory blood pressure monitor is used to confirm hypertension and differentiate it from white-coat or masked hypertension. Primary (essential) hypertension is multifactorial and may be associated with overweight and obesity, genetic predisposition, premature birth, low birth weight, increased sodium intake, sedentary lifestyle, and obstructive sleep apnea. Secondary hypertension may be caused by specific diseases such as kidney disease, cardiovascular disease, endocrine abnormalities, adverse events from medication, and monogenic causes. Treatment for pediatric hypertension includes nonpharmacologic and pharmacologic therapies, including diet and lifestyle modification. Children with hypertension are more likely to have hypertension in adulthood and develop targeted end-organ injury of the brain, cardiovascular system, or kidneys. It is important to accurately diagnose and treat hypertension early in childhood to avoid long-term complications.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101778"},"PeriodicalIF":0.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171151","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":"Corrigendum to “Vitamin D and morbidity in children with Multisystem inflammatory syndrome related to Covid-19” [Progress in Pediatric Cardiology 66 (2019) 101507]","authors":"Diana Torpoco Rivera ,&nbsp;Amrit Misra ,&nbsp;Yamuna Sanil ,&nbsp;Natalie Sabzghabaei ,&nbsp;Raya Safa ,&nbsp;Richard U. Garcia","doi":"10.1016/j.ppedcard.2024.101782","DOIUrl":"10.1016/j.ppedcard.2024.101782","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101782"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094857","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":"Corrigendum to “A perinatal cardiology network review: The Nemours Children's health system approach in the state of Florida” [Progress in Pediatric Cardiology volume (2022) 101527]","authors":"Katherine Braley ,&nbsp;Thinh Nguyen ,&nbsp;Kathryn Douglas ,&nbsp;Gul Dadlani","doi":"10.1016/j.ppedcard.2024.101789","DOIUrl":"10.1016/j.ppedcard.2024.101789","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101789"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095122","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":"Corrigendum to “Evaluation of heart murmurs in children” [Prog. Pediatr. Cardiol. 65 (2022) 101493]","authors":"Anevea Tinnery ,&nbsp;Peace C. Madueme","doi":"10.1016/j.ppedcard.2024.101790","DOIUrl":"10.1016/j.ppedcard.2024.101790","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101790"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095123","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":"Cardiomyopathy in childhood cancer survivors: Etiology, pathophysiology, diagnosis, treatment, and screening","authors":"Pedro Ricardo Cabrera ,&nbsp;Isabella Dinelli ,&nbsp;Noah Baker ,&nbsp;Ashley Bates ,&nbsp;Ashleigh Torrance ,&nbsp;Induja Gajendran ,&nbsp;Hamayun Imran","doi":"10.1016/j.ppedcard.2024.101766","DOIUrl":"10.1016/j.ppedcard.2024.101766","url":null,"abstract":"<div><h3>Background</h3><div>There is an increase in childhood cancer survivors because of advancements in cancer treatment. Current overall survival of childhood cancer in developed nations is &gt;80 %. Increased survival is associated with an increase in long-term therapy-related adverse events. Cardiotoxicity from exposure to chemo- and radiation therapy may cause major short- and long-term sequelae.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review current concepts about cardiotoxicity associated with pediatric cancer therapy including etiology, pathophysiology, diagnosis, treatment, and screening.</div></div><div><h3>Key scientific concepts of review</h3><div>Anthracycline drugs produce reactive oxygen species that cause damage to myocytes. Radiation therapy causes collagen replacement and fibrosis in the pericardium and myocardium. Acute complications include arrhythmias, decreased left ventricle (LV) function, and heart failure. Chronic complications occurring &gt;1 year after treatment initiation include coronary artery disease, valvular disease, and cardiomyopathy. These adverse events are observed mostly with high cumulative doses of anthracyclines (&gt;250 mg/m²) or radiation therapy (&gt;30 Gy). Additional risk factors such as preexisting cardiac illness, hypertension, dyslipidemia, and diabetes may contribute to adverse outcomes. Echocardiography is the most commonly used method of screening and diagnosis of cardiac dysfunction. In contrast, cardiac magnetic resonance imaging is more precise but also costly and requires sedation. Prevention of cardiotoxicity includes the use of dexrazoxane, enalapril, and methods to modify the dosage and delivery of chemo- and radiation therapy. Treatment of established cardiomyopathy may include interventions for LV preload and afterload reduction, implantable devices, and heart transplant. With emphasis on prevention, current guidelines recommend frequent screening echocardiography and individualized multimodal care for each patient. Further studies are justified to develop safe and effective alternatives to cardiotoxic cancer therapy regimens and improved treatments for established cardiomyopathy.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101766"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745126","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":"Corrigendum to “Analysis of buccal mucosa as a prognostic tool in children with arrhythmogenic cardiomyopathy” [Progress in Pediatric Cardiology 64 (2022) 101458]","authors":"Carlos Bueno-Beti ,&nbsp;Ella Field ,&nbsp;Adalena Tsatsopoulou ,&nbsp;Gregory Perry ,&nbsp;Mary N. Sheppard ,&nbsp;Elijah R. Behr ,&nbsp;Jeffrey E. Saffitz ,&nbsp;Juan Pablo Kaski ,&nbsp;Angeliki Asimaki","doi":"10.1016/j.ppedcard.2024.101783","DOIUrl":"10.1016/j.ppedcard.2024.101783","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101783"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium thiopental-induced atrial flutter","authors":"Nihal Akçay ,&nbsp;Helen Bornaun ,&nbsp;Demet Tosun ,&nbsp;İlyas Bingöl","doi":"10.1016/j.ppedcard.2024.101769","DOIUrl":"10.1016/j.ppedcard.2024.101769","url":null,"abstract":"<div><h3>Background</h3><div>Convulsive status epilepticus (CSE) is a critical neurological emergency that requires immediate intervention. Sodium thiopental is frequently used to induce coma in cases of refractory CSE; however, its use can be complicated by severe cardiac side effects.</div></div><div><h3>Case presentation</h3><div>We report a case of a 7-year-old female with super-refractory status epilepticus secondary to West syndrome, who developed supraventricular tachycardia (SVT) and atrial flutter during a thiopental infusion. Despite receiving multiple anti-seizure medications, including midazolam, ketamine, and thiopental, the patient exhibited persistent seizures. On the fourth of thiopental infusion, she developed SVT and atrial flutter, which resolved following the administration of beta-blockers and the discontinuation of thiopental. Continuous monitoring and prompt intervention led to the successful restoration of sinus rhythm. The patient was discharged on the 28th day of hospitalization.</div></div><div><h3>Discussion</h3><div>This case underscores the critical importance of vigilant cardiac monitoring during thiopental infusion due to its potential to induce severe arrhythmias. The pathophysiology of thiopental-induced cardiac complications involves its negative inotropic and chronotropic effects, necessitating careful patient selection and proactive management.</div></div><div><h3>Conclusion</h3><div>Sodium thiopental remains a viable option for managing refractory CSE, but its use requires careful consideration of cardiac risks. Continuous cardiac monitoring and a multidisciplinary approach are essential for optimizing patient outcomes. Further research is needed to elucidate the mechanisms underlying thiopental-induced cardiac complications and to develop preventive strategies.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"75 ","pages":"Article 101769"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103905","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}