Cardiology in the Young最新文献

{"title":"Blood pressure in adults with a functionally univentricular circulation who underwent either a Fontan procedure or a total cavo-pulmonary connection in childhood. A systematic review and meta-analysis.","authors":"Rajendra P Raghuraman, Armia Ebeid, Radek Debiec, Aidan Bolger, Iain Squire, Alison Harte, Amitha Puranik, Frances Bu'Lock","doi":"10.1017/S1047951126123579","DOIUrl":"https://doi.org/10.1017/S1047951126123579","url":null,"abstract":"<p><strong>Background: </strong>Adults with a Fontan procedure or total cavo-pulmonary connection (TCPC) have been shown to have abnormalities in their microcirculation (capillary rarefaction) and increased aortic stiffness. These are also a hallmark of essential hypertension. It remains unclear whether the blood pressure of Fontan patients differs from the general population. Therefore, we undertook a systematic review and meta-analysis in Fontan patients comparing blood pressure against healthy controls.</p><p><strong>Methods: </strong>A systematic search of peer-reviewed publications for \"Fontan adults\" studies, including patients >=16 years of age, with a previous Fontan/TCPC and containing blood pressure data for both Fontan adults and controls, was included. The trial strategy was registered in PROSPERO (CRD42022355781). MEDLINE, Embase, and Cochrane (CENTRAL) database searches yielded 2168 records. Heterogeneity was assessed with Higgins <i>I</i>² statistic with a value >50% indicative of high heterogeneity and <i>P</i> values based on Cochran's Q test. A random-effects model was used to calculate the pooled effect size.</p><p><strong>Results: </strong>Eleven studies contained sufficient blood pressure data from 544 Fontan/TCPC adults. Their weighted mean systolic and diastolic blood pressure was 114 ± 14 mmHg and 69 ± 9 mmHg. Only four (130 patients) studies, were suitable for meta-analysis. Weighted mean difference in systolic BP was -1.36 mmHg (95% CI, -9 to 6.38) and in diastolic BP was +0.89 mmHg (95% CI, -2.92 to 4.70) between Fontan/TCPC patients and controls. A high level of heterogeneity in both SBP (<i>P</i> < 0.00001) and DBP (<i>P</i> < 0.003) was noted.</p><p><strong>Conclusion: </strong>Neither systolic nor diastolic blood pressure in adults with a Fontan circulation differ from healthy controls. Overall weighted means of blood pressure were comparable for similar age groups. Arterial hypertension does not appear to explain the capillary rarefaction and aortic stiffness found in adults with a Fontan procedure or total cavo-pulmonary connection. Further studies are required to explore other causes of their vascular remodelling.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079725","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":"Effectiveness of ivabradine in a paediatric case of cardiomyopathy secondary to a noradrenaline-producing paraganglioma.","authors":"Yu Tanaka, Kiyotaka Go, Shuichiro Yoshida","doi":"10.1017/S1047951126124184","DOIUrl":"https://doi.org/10.1017/S1047951126124184","url":null,"abstract":"<p><p>A boy with heart failure and mechanical pulsus alternans was treated with enalapril malate and carvedilol; however, left ventricular contraction did not improve. After treatment with ivabradine, the pulsus alternans disappeared, and left ventricle contraction improved. Thorough evaluation revealed an abdominal paraganglioma producing noradrenaline, and excision of the tumor normalised the left ventricle contraction. Catecholamine-induced cardiomyopathy caused by paragangliomas is an extremely rare but important differential diagnosis of dilated cardiomyopathy. Thus, ivabradine is a good candidate for the treatment of heart failure, even in the presence of catecholamine-producing tumours.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079655","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":"Beyond the obvious in childhood obesity: exploring cardiac electrophysiological balance index and subclinical risk.","authors":"Özlem Hilal Çağlayan Bozlak, Şule Arıcı, Selen Karagözlü, Figen Akalın","doi":"10.1017/S1047951126124275","DOIUrl":"https://doi.org/10.1017/S1047951126124275","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is associated with adverse cardiovascular outcomes, including increased risk of arrhythmias and subclinical myocardial dysfunction. However, its impact on cardiac electrophysiological balance remains underexplored. The index of cardiac electrophysiological balance, calculated as QT/QRS ratio and corrected form of index of cardiac electrophysiological balance, emerged as novel electrocardiographic markers of ventricular arrhythmia risk. Although these parameters have been investigated in adult populations, data in obese children are lacking. This study aimed to evaluate the effects of obesity on index of cardiac electrophysiological balance and corrected form of index of cardiac electrophysiological balance in children and explore their associations with metabolic and anthropometric measures.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 50 obese, 23 healthy children aged 10-18 years. Demographic, metabolic, electrocardiographic, and echocardiographic data were retrieved from hospital records. Index of cardiac electrophysiological balance, corrected form of index of cardiac electrophysiological balance, and repolarisation indices (QTc dispersion, Tp-e dispersion, and P-wave dispersion) were manually measured from 12-lead electrocardiograms. Associations with metabolic and anthropometric parameters were analysed using linear regression.</p><p><strong>Results: </strong>Index of cardiac electrophysiological balance and corrected form of index of cardiac electrophysiological balance values were significantly lower in obese children than in controls (<i>p</i> < 0.001). QTc, Tp-e, and P-wave dispersions were also increased, indicating greater electrical heterogeneity. Index of cardiac electrophysiological balance showed negative correlations with LDL and total cholesterol levels. Tp-e duration and Tp-e/QTc ratio were inversely associated with hip circumference z-scores, possibly reflecting protective effects of gluteofemoral fat distribution.</p><p><strong>Conclusion: </strong>Childhood obesity may disrupt cardiac electrophysiological balance and repolarisation, even in the absence of overt cardiovascular disease. Index of cardiac electrophysiological balance and corrected form of index of cardiac electrophysiological balance could serve as early markers of arrhythmia risk. Prospective studies are needed to validate their prognostic significance.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079699","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":"Test characteristics of cardiac point-of-care ultrasound in paediatric shock: insights from multisystem inflammatory syndrome in children.","authors":"Bethsabee S Stone, Kiyetta H Alade, Stephanie K Leung, Elizabeth A Camp, Alan F Riley","doi":"10.1017/S1047951126124196","DOIUrl":"https://doi.org/10.1017/S1047951126124196","url":null,"abstract":"<p><p>Cardiac point-of-care ultrasound may serve as a bedside screening tool for the early identification of left ventricular systolic dysfunction in children, but paediatric data remain limited in clinical practice. In a retrospective cohort study of children with multisystem inflammatory syndrome in children undergoing cardiac point-of-care ultrasound at presentation, qualitative assessments of left ventricular systolic function by credentialed paediatric emergency medicine physicians were obtained and demonstrated high sensitivity for detecting dysfunction across the spectrum of left ventricular systolic failure.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079718","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":"Post Atrial Septal Defect Device Closure Acute Severe Haemolysis: one hole closed, one valve leaked-A Rare Case Report.","authors":"Saurabhi Das, Shantanu Jain, Faruk Abdullah","doi":"10.1017/S1047951126124305","DOIUrl":"https://doi.org/10.1017/S1047951126124305","url":null,"abstract":"<p><p>Acute severe haemolysis following atrial septal defect(ASD) device closure is extremely rare, where precise incidence, underlying aetiologies, and optimal management strategies remain inadequately understood. We report a case of significant haemolysis after transcatheter atrial septal defect closure in 10 year old female, possibly related to the interface between the device surface and the high-velocity jet of valvular regurgitation resulting from the abnormal configuration of the device. The presence of a residual shunt, combined with atrioventricular valve regurgitation flow, places pressure on the occluder's discs, leading to increased erythrocyte fragility and subsequent rupture. In our case, haemolysis was initially conservatively managed with fluids, diuresis, and sodium bicarbonate, and the patient was discharged successfully on the 6^th post-procedure day. Surgical retrieval was advised; however, the patient was subsequently lost to follow-up. In this case report, we aim to showcase the pathophysiology, technical pitfalls regarding the procedure and management of acute severe haemolysis that occurred after atrial septal defect device closure. In conclusion, by sharing our clinical experiences and addressing misconceptions and potential risk factors for this serious complication, we aim to provide insights that may enhance future clinical practice and preventive strategies.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079728","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":"From detection to retention: redefining success in screening for rheumatic heart disease in Sub-Saharan Africa.","authors":"Miguel Bernardino Antunes Vicente, Elsa Fernandes, Domingos Ramos, Lino Gonçalves","doi":"10.1017/S1047951126124226","DOIUrl":"https://doi.org/10.1017/S1047951126124226","url":null,"abstract":"<p><p>Rheumatic heart disease remains a leading cause of preventable cardiovascular morbidity and premature mortality among children and young adults in Sub-Saharan Africa. Advances in portable echocardiography, standardised World Heart Federation diagnostic criteria, and task-sharing strategies have substantially expanded the detection of latent rheumatic heart disease. However, increased diagnostic capacity has not consistently translated into improved long-term clinical outcomes. This viewpoint argues that the principal challenge in rheumatic heart disease control has shifted from underdiagnosis to the inability of health systems to provide sustained longitudinal care after screening. Although the GOAL Trial demonstrated that secondary prophylaxis with benzathine penicillin reduces echocardiographic progression of latent disease, robust evidence that screening alone decreases heart failure, stroke, need for valve surgery, or mortality remains limited. Furthermore, recurrent shortages of benzathine penicillin, fragmented follow-up, weak referral pathways, and socioeconomic barriers continue to undermine the effectiveness of screening programmes across Sub-Saharan Africa. We propose a paradigm shift in the evaluation of rheumatic heart disease screening initiatives: programme success should no longer be measured primarily by the number of cases detected but by the proportion of patients retained in continuous care and protected from major cardiovascular outcomes. Future rheumatic heart disease programmes should integrate early diagnosis with reliable access to secondary prophylaxis, structured follow-up, timely referral for specialist and surgical care, and outcome-based evaluation. Redefining screening success around care retention rather than diagnostic yield may substantially improve the long-term impact of rheumatic heart disease control strategies in resource-limited settings.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079705","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":"Beyond anticoagulation: a surgical rescue guided by multimodal imaging for mobile right heart thrombi in an adolescent.","authors":"Yanfang Wu, Jingjing Zhang","doi":"10.1017/S1047951126124251","DOIUrl":"https://doi.org/10.1017/S1047951126124251","url":null,"abstract":"<p><p>Right heart thrombus is rare and high-risk in paediatrics. A 14-year-old boy presented with dizziness and leg numbness. Imaging revealed mobile right ventricular thrombi and massive pulmonary embolism. Despite therapeutic anticoagulation, respiratory failure ensued. Emergency surgical thrombectomy and pulmonary endarterectomy were lifesaving. This case highlights that for high-risk right heart thrombi, multimodal imaging is key, and timely surgery is critical.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079858","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":"Massive cardiomegaly in a neonate: pericardial teratoma as an unusual and surgically correctable cause.","authors":"Jose Ugarriza Mendoza, Daniela Benitez, Himanshu Meena, David Kalfa, Sanjiv Gandhi, Gabriel Chamyan, Julio D Egusquiza, Utkarsh Kohli","doi":"10.1017/S1047951126124135","DOIUrl":"https://doi.org/10.1017/S1047951126124135","url":null,"abstract":"<p><p>Term neonate with respiratory distress had a giant cystic intrapericardial mass causing cardiopulmonary compression and effusion. Echocardiography and chest tomographic defined the anatomy; surgical resection confirmed an immature pericardial teratoma with a favourable diagnosis.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073467","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":"Physical activity and quality of life among children with CHD: a cross-sectional analysis.","authors":"Tyrell C Sideroff, Jennifer A Collins, Nurin Izzati Binti Saiful Baharin, Julia H Crowther, Kevin Harris, Christine Voss","doi":"10.1017/S104795112612410X","DOIUrl":"https://doi.org/10.1017/S104795112612410X","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the quality of life and moderate-to-vigorous physical activity level among children with CHD compared to children without CHD and to examine whether the association between these variables is modified by CHD or gender.</p><p><strong>Methods: </strong>This cross-sectional analysis draws from a larger longitudinal study and included participants aged 5-10 years with or without any CHD and living in British Columbia, Canada. Parents/guardians completed the parent-proxy PedsQL 4.0 Generic Core Scales, providing a PedsQL Total Score out of 100. Children wore an Ametris GT3X accelerometer for 7 consecutive days to measure moderate-to-vigorous physical activity (min/day). Generalised linear regression models were used for group and gender comparisons. An adjusted linear regression model was used to examine the association between physical activity and quality of life.</p><p><strong>Results: </strong>166 children (41% girls; <i>n</i> = 78 CHD, <i>n</i> = 88 non-CHD) were included in the analysis. Children with CHD had poorer PedsQL Total Scores (<i>p</i> = 0.002) and accumulated less moderate-to-vigorous physical activity than the non-CHD group (<i>p</i> = 0.008). Among children with CHD, girls accumulated less moderate-to-vigorous physical activity than boys (<i>p</i> < 0.001) and had poorer PedsQL Total Scores than boys (<i>p</i> = 0.035). The association between moderate-to-vigorous physical activity (min/day) and PedsQL Total Score was significantly modified by CHD (<i>p</i> = 0.012), with a positive association found for children with CHD (<i>β</i> = 0.17 [95% confidence interval: 0.04, 0.29], <i>p</i> = 0.011), which was not modified by gender (<i>p</i> = 0.241).</p><p><strong>Conclusions: </strong>These findings highlight the need to support the physical and psychosocial health of children with CHD, particularly girls with CHD.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073501","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":"Human milk and breastfeeding support in United States paediatric cardiac ICUs: a multicentre cohort and survey study.","authors":"Kristin M Elgersma, Brian F Joy, Zuofu Huang, Monique R Radman, Kimberly I Mills, Jennifer E Schramm, Joshua H Wong, Meghan M Chlebowski, Asaad G Beshish, Raya Safa, Dana Mueller, Brittany L Shutes, Saul Flores, Jamie M Furlong-Dillard, Sukumar Suguna Narasimhulu, Andrea Beach, Stephanie Goldstein, K Sofia Mendieta, Reshma Reddy, Nimrod Goldshtrom, Jordan Schneider, Grace Liao, Ahmed Asfari, Karan B Karki, Robert Marcel T Huibonhoa, Christopher W Mastropietro, Katherine Cashen","doi":"10.1017/S1047951126124093","DOIUrl":"10.1017/S1047951126124093","url":null,"abstract":"<p><p>Human milk and direct breastfeeding are recommended for all infants, but rates are low in CHD with limited data on institutional lactation support. We aimed to describe lactation-supportive practices within US paediatric cardiac ICUs and to determine associations between these practices and human milk/breastfeeding outcomes. This retrospective cohort study and site survey included centres from Collaborative Research from the Pediatric Cardiac Intensive Care Society. Linear regression assessed associations between the total number of lactation-supportive practices and sites' human milk and breastfeeding percentages, during the neonatal period and at discharge. Potentially strong clinical practices were identified through a phased analysis. Survey respondents represented 34 sites, with detailed data for 832 patients from 24 sites. Implementation of 22 lactation-supportive practices varied (median: 10; range: 2-20); smaller sites reported fewer practices (<i>p</i> = 0.006). Common practices included in-room breast pumps (100%), feeding protocols (91%), and staff training (79%), while skin-to-skin protocols (41%) and automatic lactation orders (44%) were underutilised. While total practices did not correlate with outcomes, sites with high versus low implementation of \"strongest\" practices demonstrated generally better lactation outcomes, especially at discharge: 11.7% higher human milk volume (95% CI: 0.1%-23.3%); 8.2% higher breastfeeding rate (95% CI: -0.3%-16.6%). These strongest practices involved institutional formalisation of lactation support. Lactation-supportive practices varied among sites. Findings suggest formalisation of practices including a developmental care protocol, comprehensive parent education/support, and protocols recommending human milk/breastfeeding may improve lactation outcomes in critical CHD.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}