Cardiology in the Young最新文献

{"title":"Relationship-centred care in CHD: promoting belonging, psychosocial adaptation, and family well-being.","authors":"Colin J McMahon, Ciara Ryan","doi":"10.1017/S1047951126124160","DOIUrl":"https://doi.org/10.1017/S1047951126124160","url":null,"abstract":"<p><strong>Background: </strong>CHD is the most common congenital anomaly worldwide. Advances in paediatric cardiology and cardiac surgery have transformed survival, shifting attention towards long-term psychosocial adaptation, neurodevelopment, quality of life, and relational well-being for children and their families.</p><p><strong>Methods: </strong>This narrative review examines the psychosocial, developmental, familial, and relational dimensions of childhood CHD. Literature was identified through PubMed, Scopus, and Google Scholar, with thematic synthesis of evidence relating to psychosocial adaptation, parental mental health, neurodevelopment, resilience, belonging, peer relationships, and models of family- and relationship-centred care.</p><p><strong>Results: </strong>Childhood CHD is associated with repeated hospitalisation, developmental disruption, emotional distress, and lifelong uncertainty, with psychosocial effects extending beyond the child to parents, siblings, grandparents, peers, schools, and healthcare professionals. Families frequently experience anxiety, depression, chronic vigilance, and posttraumatic stress symptoms, while children and adolescents face challenges related to identity, belonging, and social participation. Supportive relationships, multidisciplinary psychosocial care, educational integration, peer support, and developmentally informed interventions may strengthen resilience and improve long-term adaptation. Patients with advanced heart failure requiring ventricular assist devices or heart transplantation, and their families experience additional uncertainty and psychological burden that warrant dedicated psychosocial support.</p><p><strong>Conclusion: </strong>Psychosocial outcomes in CHD are shaped not only by medical care but also by the quality of the relationships surrounding the child. Relationship-centred care builds upon established family-centred care by recognising the broader relational ecosystem that influences development, resilience, participation, and quality of life. Future paediatric cardiology care should integrate longitudinal psychosocial, developmental, educational, and relational support alongside advances in medical treatment.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164032","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}

{"title":"Joining forces in paediatric cardiology: from fragmented expertise to shared learning systems.","authors":"Domenico Sirico, Sara Moscatelli, Alessia Callegari, Ornella Milanesi, Merja Kallio, Skaiste Sendzikaite, Ina Michel-Behnke, Colin J McMahon, Ruth Heying","doi":"10.1017/S1047951126124354","DOIUrl":"https://doi.org/10.1017/S1047951126124354","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126582","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}

{"title":"Artificial intelligence in paediatric cardiac critical care: from predictive analytics to continuous physiologic intelligence.","authors":"Fabio Savorgnan, Pranathi Pilla, Rohit Loomba, Saul Flores","doi":"10.1017/S1047951126124342","DOIUrl":"https://doi.org/10.1017/S1047951126124342","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence is increasingly applied in paediatric cardiology and cardiac intensive care, where CHD, postoperative physiologic instability, and continuous bedside monitoring generate complex datasets. This review summarises current applications of artificial intelligence in paediatric cardiology and the cardiac ICU, focusing on cardiac imaging, electrocardiography, predictive analytics, waveform intelligence, and postoperative outcome prediction.</p><p><strong>Data sources: </strong>A narrative review of PubMed, MEDLINE, and Scopus was performed for studies published from 2018 through 2026 evaluating artificial intelligence, machine learning, or deep learning in paediatric cardiology, CHD, congenital heart surgery, and cardiac critical care.</p><p><strong>Study selection: </strong>Studies addressing paediatric or CHD-focused applications in echocardiography, cardiac MRI, electrocardiography, cardiac ICU monitoring, waveform analytics, or postoperative complication prediction were included, together with relevant reviews.</p><p><strong>Data extraction: </strong>Information was extracted on study population, artificial intelligence method, clinical task, model inputs, outcomes, validation strategy, and major limitations.</p><p><strong>Data synthesis: </strong>Artificial intelligence is most developed in imaging and electrocardiography, while paediatric and complex CHD evidence remains less mature. In cardiac ICU, models using electronic health record variables, high-frequency physiologic data, and risk indices have been evaluated for cardiac arrest, low cardiac output physiology, hyperlactatemia, extubation failure, and vasoactive de-escalation. External validation, prospective deployment, calibration, and workflow-safe implementation remain major gaps.</p><p><strong>Conclusions: </strong>Artificial intelligence may improve diagnostic consistency, risk stratification, and early recognition of deterioration, but prospective validation and measurable clinical benefit are needed before autonomous use.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126625","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}

{"title":"Cinematic rendering for characterization of anomalous coronary origins: visualization of interarterial courses and post-surgical assessment.","authors":"Yael Sarig, Amy Avakian, Muhammad Umair","doi":"10.1017/S1047951126124391","DOIUrl":"https://doi.org/10.1017/S1047951126124391","url":null,"abstract":"<p><p>Cinematic rendering is an advanced three-dimensional post-processing technique that applies Monte Carlo-based global illumination to CT datasets, producing photorealistic volumetric reconstructions that enhance depth perception and tissue-plane visualization compared with conventional greyscale imaging. In this pictorial essay, cinematic rendering was applied to coronary CT angiography examinations demonstrating anomalous coronary artery origins, including interarterial trajectories and post-surgical anatomy following unroofing procedures. Using illustrative cases, we describe how cinematic rendering's depth cues and soft-tissue contrast can complement standard two-dimensional reconstructions when characterizing vessel course relative to the great vessels-an anatomic distinction relevant to risk stratification and surgical planning. These observations are qualitative and drawn from our experience with the cases presented rather than from a blinded reader study or quantitative comparison; we discuss this limitation further below. Through representative imaging examples, cinematic rendering helped reestablish volumetric context and enabled continuous tracking of coronary vessels in the cases presented.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126594","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}

{"title":"Bilateral vs unilateral pleural drains in tetralogy of Fallot repair.","authors":"Kim Geckt, Rachel Sion-Sarid, Oren Zipper, Liron Talmi, Yuval Ziv, Yair Erell","doi":"10.1017/S1047951126124123","DOIUrl":"https://doi.org/10.1017/S1047951126124123","url":null,"abstract":"<p><strong>Objectives: </strong>To compare postoperative outcomes after tetralogy of Fallot repair in patients managed with unilateral versus bilateral pleural drains.</p><p><strong>Methods: </strong>In this single-centre retrospective cohort study, patients undergoing complete tetralogy of Fallot repair between 2020 and 2025 were included. Patients with previous complete repair, extracorporeal membrane oxygenation, delayed sternal closure, or chylothorax were excluded. The primary outcome was undrained postoperative pleural effusion on routine chest radiographs. Secondary outcomes were postoperative pleural drain insertion, duration of invasive mechanical ventilation, diuretic score, ICU length of stay, and pleural drain-related complications. Multivariable regression adjusted for repair type, bypass duration, cross-clamp duration, and surgeon.</p><p><strong>Results: </strong>Of 180 patients, 122 (68%) underwent unilateral pleural drain placement and 58 (32%) bilateral placement. Complex repairs were more common in the bilateral group. Undrained pleural effusion was more frequent after unilateral than bilateral pleural drain placement (42.6% vs 5.2%; <i>p</i> < 0.001). Postoperative pleural drain insertion was required in 9 patients (7.4%) in the unilateral group and in none in the bilateral group (<i>p</i> = 0.06). Pleural drain-related complications were more frequent with bilateral pleural drains, with 4 pneumothoraces requiring intervention versus 1 self-resolving subcutaneous emphysema in the unilateral group (<i>p</i> = 0.01). In multivariable analysis, bilateral pleural drain placement remained independently associated with lower odds of undrained pleural effusion, but not with duration of mechanical ventilation, diuretic score, or ICU length of stay.</p><p><strong>Conclusions: </strong>Bilateral pleural drains were associated with fewer radiographic pleural effusions but no measurable short-term clinical advantage. Placement should therefore be individualised according to intraoperative findings and local practice.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126623","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}

{"title":"Genetic predisposition to Kawasaki disease and the risk of coronary atherosclerosis: a Mendelian randomisation study.","authors":"MingYue Leng, Li Ming","doi":"10.1017/S1047951126124111","DOIUrl":"https://doi.org/10.1017/S1047951126124111","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease is linked to coronary artery abnormalities, yet whether this reflects a direct causal relationship with atherosclerosis remains unclear due to potential confounding factors. This study aimed to investigate, using two-sample Mendelian randomisation, whether a genetic predisposition to Kawasaki disease is associated with subsequent atherosclerosis.</p><p><strong>Methods: </strong>Instrumental variables were single-nucleotide polymorphisms significantly associated with Kawasaki disease from a large-scale genome-wide association study (119 cases, 6071 controls). Summary data for coronary atherosclerosis (the primary outcome), cerebral atherosclerosis, peripheral atherosclerosis, and three non-invasive surrogates (brachial-ankle pulse wave velocity, carotid intima-media thickness, and pulse wave arterial stiffness index) were obtained from independent European and African cohorts. The inverse variance weighted method served as the primary analysis, supported by four sensitivity analyses.</p><p><strong>Results: </strong>Genetically predicted Kawasaki disease showed a suggestive association with an increased risk of coronary atherosclerosis (inverse variance-weighted: odds ratio = 1.0213; 95% confidence interval = 1.0050 to 1.0379; <i>P</i> = 0.01), This direction was consistent across all sensitivity methods, with no evidence of pleiotropy or heterogeneity. No associations were observed for the remaining outcomes. Reverse analysis did not support reverse causality.</p><p><strong>Conclusions: </strong>This study provides evidence that genetic predisposition to Kawasaki disease may be associated with coronary atherosclerosis. Given the limited cohorts, the null findings for other vascular territories are inconclusive. Larger independent Kawasaki disease genome-wide association studies are needed for replication.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104427","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}

{"title":"Regional neurodevelopmental and psychosocial encounters for children with CHD: an updated validation cohort from Northern New England.","authors":"Thomas Miller, Anya Cutler, Brooke Davey, Jonathan Flyer","doi":"10.1017/S1047951126124469","DOIUrl":"https://doi.org/10.1017/S1047951126124469","url":null,"abstract":"<p><p>We have previously described how children with complex CHD access developmental and psychosocial services in Maine, most often beyond the reach of the surgical centre. In this follow-up study, we describe a similar pattern for children in Vermont. Of 406 at-risk children between 2017 and 2019, 37% had an encounter. Very few individuals underwent developmental assessment or psychological or neuropsychological testing (1-4%). Visit volume was highest for mental health assessments in children older than 5 years and occurred predominately in community clinics and private practices close to home.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104454","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}

{"title":"Myocardial dysfunction during sepsis in children with cancer: a scoping review across paediatric cardio-oncology and critical care.","authors":"Weerapong Lilitwat, Neha Mahindrakar, Prakreeti Bhandari, Ramya Yedatore, Yuttiwat Vorakunthada","doi":"10.1017/S104795112612424X","DOIUrl":"https://doi.org/10.1017/S104795112612424X","url":null,"abstract":"<p><strong>Background: </strong>Children with cancer may develop cardiac dysfunction during sepsis or severe infection due to prior cardiotoxic therapy, fluid exposure, systemic inflammation, and critical illness. We aimed to map evidence on myocardial dysfunction and related cardiac involvement during sepsis or severe infection in this population.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library through June 2026. Eligible studies included pediatric patients with cancer or hematopoietic stem cell transplantation who developed sepsis, septic shock, febrile neutropenia, bacteremia, bloodstream infection, or invasive fungal infection and underwent cardiac or hemodynamic assessment.</p><p><strong>Results: </strong>Of 874 records identified, 749 remained after deduplication and 11 studies were included. Evidence consisted mainly of observational studies, case reports, case series, and conference abstracts. Cardiac findings included acute systolic dysfunction, myocarditis-like presentations, elevated B-type natriuretic peptide, transient bradycardia, abnormalities in echocardiographic assessment of fluid responsiveness, and endocarditis. Children with leukemia, particularly those exposed to anthracyclines, were most frequently represented. Cardiac recovery was reported in several cases, although mortality was high when sepsis and progressive cardiac dysfunction coexisted. No study directly compared incidence between children with and without cancer.</p><p><strong>Conclusion: </strong>Cardiac involvement during sepsis in children with cancer is recognized but remains under-studied and inconsistently defined. Existing evidence does not establish a higher incidence than in children without cancer or an oncology-specific syndrome. Standardized definitions, baseline characterization, and prospective multicenter comparative studies are needed to clarify phenotype, recovery, and outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104490","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}

{"title":"Infective endocarditis after transcatheter versus surgical pulmonary valve replacement in CHD: absolute risk translation and device-material context.","authors":"Andrey Semyashkin, Alina Sandica, Leonid Gherta, Lotfi Ben Mime","doi":"10.1017/S104795112612438X","DOIUrl":"https://doi.org/10.1017/S104795112612438X","url":null,"abstract":"<p><strong>Background: </strong>As transcatheter pulmonary valve replacement becomes increasingly adopted in children and young adults, concerns regarding infective endocarditis remain a major limitation of this strategy. We performed a systematic review and meta-analysis comparing the risk of infective endocarditis after transcatheter and surgical pulmonary valve replacement.</p><p><strong>Material and methods: </strong>Comparative studies evaluating infective endocarditis after transcatheter versus surgical pulmonary valve replacement were systematically reviewed. The primary outcome was cumulative infective endocarditis during follow-up; early infective endocarditis was analysed separately. Random-effects models were used to pool odds ratios and absolute risk differences.</p><p><strong>Results: </strong>Nineteen comparative cohort studies met the inclusion criteria. Fifteen studies contributed long-term data and six reported early events. In the primary long-term analysis (13 studies; 3,917 procedures), transcatheter pulmonary valve replacement was associated with a significantly higher risk of infective endocarditis than surgical pulmonary valve replacement (odds ratio 3.18, 95% confidence interval 2.25-4.49; <i>I</i>² = 0%). The pooled absolute excess risk was 39.2 cases per 1,000 procedures (95% confidence interval 22.7-55.6), corresponding to one additional case for every 26 procedures. Early infective endocarditis did not differ significantly between approaches (odds ratio 1.11, 95% confidence interval 0.33-3.69). Sensitivity analyses yielded consistent results.</p><p><strong>Conclusions: </strong>Transcatheter pulmonary valve replacement is associated with a higher long-term risk of infective endocarditis than surgical pulmonary valve replacement, whereas evidence for early events remains inconclusive. The observed association is best interpreted in the context of prosthetic material, conduit characteristics, residual haemodynamics, and patient selection rather than as evidence of a purely procedural mechanism.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104443","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}

{"title":"Unique coexistence of tetralogy of Fallot and congenital heart block linked to maternal autoantibodies in a Down syndrome fetus: a case report.","authors":"Wisit Chankhunaphas, Narisra Srikureja Firer, Sanitra Anuwutnavin","doi":"10.1017/S104795112612441X","DOIUrl":"https://doi.org/10.1017/S104795112612441X","url":null,"abstract":"<p><p>We report a rare fetal presentation of tetralogy of Fallot and complete atrioventricular block linked to maternal anti-Ro antibodies. However, trisomy 21 was confirmed postnatally. Despite pacemaker implantation, the neonate died on day 55 due to pulmonary complications. This complex case highlights diagnostic and management challenges involving tetralogy of Fallot, Down syndrome, and complete heart block associated with maternal autoantibodies.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104441","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}