Cardiology in the Young最新文献

{"title":"Mannheimer Lecture 2026: paediatric cardiology across the lifespan: building the future of congenital heart care.","authors":"Ornella Milanesi, Alessandro Colombo, Biagio Castaldi, Giovanni Di Salvo","doi":"10.1017/S1047951126123695","DOIUrl":"https://doi.org/10.1017/S1047951126123695","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, pediatric cardiology has been fundamentally reactive: structural abnormalities were diagnosed, symptoms developed, complications occurred, and clinicians responded. Increasingly, however, the field is shifting upstream from reaction to anticipation.</p><p><strong>Objectives: </strong>To highlight the transition from reactive to predictive pediatric cardiology and discuss the implications of integrating molecular and computational approaches into the management of congenital heart disease (CHD).</p><p><strong>Methods: </strong>Narrative review of emerging concepts in precision medicine, focusing on the integration of genomics, transcriptomics, proteomics, other multi-omics technologies, advanced cardiac imaging, and computational analysis.</p><p><strong>Results: </strong>Multi-omics approaches demonstrate that CHD is not solely an anatomical disorder but also a biological disease. Distinct molecular pathways may explain why patients with apparently identical cardiac anatomy experience markedly different clinical trajectories. The combination of molecular profiling, advanced imaging, and computational analysis enables more accurate risk stratification and earlier prediction of disease progression, paving the way for personalized management strategies.</p><p><strong>Conclusion: </strong>The transition from reactive to predictive medicine represents more than a technological advance; it fundamentally redefines the role and responsibilities of pediatric cardiologists. As the ability to anticipate disease progression improves, clinical decisions must increasingly be made before overt manifestations appear, raising new opportunities and responsibilities regarding the timing and appropriateness of intervention.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030025","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":"Extended neurological function monitoring during paediatric cardiac catheterisation.","authors":"Esther Jöbkes, Thilo Fleck, Christoph Zürn, Brigitte Stiller, Rouven Kubicki","doi":"10.1017/S1047951126124020","DOIUrl":"https://doi.org/10.1017/S1047951126124020","url":null,"abstract":"<p><strong>Background: </strong>Patients with complex CHDs are at risk for impaired neurological development. There is too little knowledge about the effects of cardiac catheterisation under conscious sedation on electrocortical activity and cerebral oxygenation. This pilot study describes extended neurological function monitoring during paediatric cardiac catheterisation.</p><p><strong>Methods: </strong>We conducted a prospective single-centre study including 52 patients with a median age and body weight of 3.5 [0-17] years and 15.3 [3.7-69.2] kg. Electrocortical activity and cerebral oxygenation were monitored via amplitude-integrated electroencephalography and near-infrared spectroscopy.</p><p><strong>Results: </strong>The median duration of extended monitoring was 130 [80-275] minutes. After propofol administration, amplitude-integrated electroencephalography amplitudes increased (<i>p</i> < 0.01) with a concomitant change in background patterns from continuous to high voltage in 45 patients (86.5%), while near-infrared spectroscopy decreased in tissue oxygenation index [<i>p</i> < 0.01] as did ΔHb. Propofol in one patient caused a rapidly reversible transition from high voltage to flat tracing and burst-suppression pattern. Cardiac interventions and arrhythmias caused short-term variations in near-infrared spectroscopy but had no significant impact on electrocortical activity.</p><p><strong>Conclusion: </strong>Paediatric cardiac catheterisation under conscious sedation is associated with a high degree of patient safety. Extended monitoring of neurological function may be crucial to minimise risks and adjust conscious sedation levels, especially in high-risk patients.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030047","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":"Change in patient-reported physical and mental health after adult CHD interventions: a prospective cohort study.","authors":"Areeba Asghar, Ella Huszti, Nathan G Best, Kelly Smith, Eduardo Flores-Umanzor, Eric Horlick, Lusine Abrahamyan","doi":"10.1017/S1047951126123993","DOIUrl":"https://doi.org/10.1017/S1047951126123993","url":null,"abstract":"<p><strong>Introduction: </strong>Psychosocial challenges are well-described among adults with CHD. Limited literature explores the impact of adults with CHD interventions on patient-reported outcomes. We examined changes in patient-reported mental and physical health status 30 days after a diagnostic or interventional adult with CHD procedure.</p><p><strong>Methods: </strong>A prospective registry captured patient-reported physical and mental health through the Patient Reported Outcomes Measurement and Information System Global Health Questionnaire before and 30 days after the procedure. Global mental and physical health scores were derived and standardised, with 50 points as the mean of the general U.S. population and a minimal important change of 3 points.</p><p><strong>Results: </strong>In our sample of 160 patients, patent foramen ovale closure and diagnostic catheterisation of complex CHDs were the most common procedures (44.4% and 35.6%, respectively). Palpitations were a commonly reported symptom before the procedure (21.8%), with increasing proportions at 30-days (34.0%, <i>p</i> = 0.003). At baseline, the median global mental health and global physical health scores were 48.3 [IQR = 43.5-53.3] and 47.7 [IQR = 39.8-54.1], respectively, within one standard deviation of the general U.S. population; there were no significant differences from baseline at 30 days. However, these differences were not uniform; approximately 53% and 72% of patients had a clinically meaningful improvement or decline in their global mental health or global physical health score (>minimal important change of 3).</p><p><strong>Conclusion: </strong>In this novel investigation, patients experienced both improvement and decline in mental and physical self-reported health after adults with CHD interventions, indicating considerable variability in short-term outcomes. Future analyses should explore predictors of divergent changes in health scores after procedures, to promote patient-centred care.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015548","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":"Risk factors and long-term outcomes of complete atrioventricular septal defect repair in children.","authors":"Honghao Fu, Zhangwei Wang, Shoujun Li","doi":"10.1017/S1047951126123944","DOIUrl":"https://doi.org/10.1017/S1047951126123944","url":null,"abstract":"<p><strong>Background: </strong>The prognostic determinants following primary biventricular repair for complete atrioventricular septal defect are complex. We describe contemporary surgical outcomes from a large cohort.</p><p><strong>Methods: </strong>We retrospectively enrolled 342 patients who underwent primary biventricular complete atrioventricular septal defect repair between January 2010 and April 2025. Univariable and multivariable Cox regression were used to determine predictors. Reoperation and mortality were described using cumulative incidence functions estimated by Fine-Gray competing-risk models.</p><p><strong>Results: </strong>Median follow-up was 8.3 years. Reoperation occurred in 36 (10.5%) patients and 22 (6.4%) died. Multivariable analysis showed that early post-operative left atrioventricular valve regurgitation > moderate (hazard ratio = 6.03, <i>P</i> < 0.001) and age < 3 months (hazard ratio = 3.80, <i>P</i> = 0.018) were independent risk factors for reoperation. Complete cleft closure (hazard ratio = 0.38, <i>P</i> = 0.032) was protective. Reoperation was strongly associated with mortality (hazard ratio = 3.01, <i>P</i> = 0.023). Competing-risk analysis confirmed trisomy 21 was associated with lower reoperation risk (Fine-Gray, <i>P</i> = 0.015).</p><p><strong>Conclusions: </strong>Patients with complete atrioventricular septal defect have favourable long-term outcomes after primary biventricular repair. Younger age, early post-operative left atrioventricular valve regurgitation > moderate, incomplete cleft closure, and without trisomy 21 are risk factors for reoperation. Reoperation is a significant risk factor for mortality.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015714","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":"The bedside we cannot always reach: Learning and practising medicine in interrupted time. A personal perspective from Palestine.","authors":"Olga Sallam Ramahi, Yousef I Barqawi, Sara Moscatelli","doi":"10.1017/S1047951126123609","DOIUrl":"https://doi.org/10.1017/S1047951126123609","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015701","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":"Machine learning-based assessments of perioperative features in determining long-term conduct block post-transcatheter closure of ventricular septal defect.","authors":"Qirun Wang, Yuting Xia, Li Wei, Penghui Yang, Kaiyu Zhou, Yimin Hua, Weikai Li, Yifei Li","doi":"10.1017/S1047951126123506","DOIUrl":"https://doi.org/10.1017/S1047951126123506","url":null,"abstract":"<p><strong>Background: </strong>Currently, studies have shown that this procedure of transcatheter closure of ventricular septal defect can lead to a range of adverse complications, especially for the threatening heart conduct block. However, it had not been fully analysed that whether early alternations of electrocardiogram, including vectorcardiogram, could determine the long-term persistent heart conduct block.</p><p><strong>Methods: </strong>A retrospective study was conducted to develop a Random Forest-based prediction model for the postoperative of the transcatheter interventional closure. The study encompassed data preprocessing, model training, and assessment of feature importance.</p><p><strong>Result: </strong>We assessed the predictive value of parameters derived from defect anatomical features, interventional closure data, and ECG+VCG changes measured preoperatively, on postoperative days 1 and 3, and at 1 month after closure. The area under receiver operating characteristic curve values of such evaluations on the test sets were 0.9974, 0.9592, 0.9977, 0.9985, 0.9957, and 0.9977, recalls were 98.35%, 83.39%, 99.57%, 98.04%, 97.80%, and 99.58%. In the prediction model, the importance of features was ranked. We found that the diameter and number of occluder used in surgery and the size of left atrium and ventricle were the primary factors for predicting arrhythmia after surgery. For electrocardiogram data, significant parameters include RV5 voltage and the R-T angle of the sagittal plane vectorcardiogram before the treatment, T-wave, R-wave, and QRS duration in early days after operation and RV1 voltage, R-wave axis during 1-month follow-up.</p><p><strong>Conclusion: </strong>Electrocardiogram information during the perioperative period of interventional closure could be used to effectively predict the occurrence and prognosis of postoperative arrhythmia.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011947","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 echocardiography: infection-related pseudoaneurysm in a paediatric patient with repaired tetralogy of Fallot.","authors":"Burak Kocaağa, Nurhayat Yakut, Özge Kaba, Ayse Pervanlar Kakışım, Muhammet Hamza Halil Toprak, Kahraman Yakut","doi":"10.1017/S1047951126124044","DOIUrl":"https://doi.org/10.1017/S1047951126124044","url":null,"abstract":"<p><p>A one-year-old boy with repaired tetralogy of Fallot presented with recurrent fever. Blood cultures grew Streptococcus mitis/oralis, but transthoracic echocardiography showed no infective endocarditis. Cardiac CT angiography revealed an occult right ventricular outflow tract pseudoaneurysm, which was surgically resected. This case highlights CT angiography as a critical diagnostic tool when echocardiography fails to identify infectious sources in CHD.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988145","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":"Patterns of care for single ventricle infants in a home monitoring programme.","authors":"Margaret L Schroeder, Elizabeth Casto, Shannon Engstrand, Erin Keenan, Michelle Hurtig, Rebecca Noymer Matulsky, Jean Anne Connor","doi":"10.1017/S1047951126123841","DOIUrl":"https://doi.org/10.1017/S1047951126123841","url":null,"abstract":"<p><strong>Introduction: </strong>The advanced practice registered nurse-led home monitoring programme has served as an early warning system for the fragile population of single ventricle infants discharged home between their staged interventions. However, patterns of care by the home monitoring team have not been studied.</p><p><strong>Methods: </strong>This retrospective, single-centre review of patients from 2010 to 2020 1) described patient characteristics and significant interstage events and 2) identified themes and patterns of care utilised by the advanced practice registered nurse and registered dietitian through review of communication in the electronic medical record.</p><p><strong>Results: </strong>The inclusion criteria were met by 334 patients. Of these, 55% underwent a Stage I Norwood as their initial intervention. Ten percent had a patent ductus arteriosus stent in the cardiac catheterisation lab, 79% of which occurred 2019 to 2020. Interstage mortality was 4.5%. Sixty-three percent of patients had at least one unplanned admission, while 26% of patients had an early cardiac catheterisation. Three themes were identified in provider-patient encounters: Clinical Management, Care Escalation, and Care Coordination, with two levels of care, standard and advanced. Most encounters (83%) were designated standard level of care. Encounters that required use of an interpreter (<i>n</i> = 204) took twice as long (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>The home monitoring programme supports fragile infants during the interstage period at home. Using the newly developed Patterns of Care framework, most encounters were assessed to be \"standard level of care.\" Encounters utilising an interpreter due to caregiver's limited English proficiency required significantly more time.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988160","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":"Transitional atrioventricular septal defect: diagnostic variability and its clinical significance.","authors":"Aybala Tongut, Zeynep B Eren, Mitchell Haverty, Tonia C Carter, Alyssia Venna, Manan Desai, Susan Cummings, Yue-Hin Loke, Uyen T Truong, Yves D'udekem","doi":"10.1017/S104795112612397X","DOIUrl":"https://doi.org/10.1017/S104795112612397X","url":null,"abstract":"<p><strong>Introduction: </strong>Discrepancies between preoperative echocardiographic diagnosis and intraoperative surgical findings for incomplete atrioventricular septal defects are frequently encountered. We assess the frequency of diagnostic discordance and its impact, focusing on subtype-specific predictors of the postoperative course.</p><p><strong>Methods: </strong>We reviewed 172 patients post repair of incomplete atrioventricular septal defects at a single institution between November 2000-February 2025, including transitional atrioventricular septal defects (<i>n</i> = 74), partial atrioventricular septal defects (<i>n</i> = 71), and primum atrial septal defect with isolated left atrioventricular valve cleft (<i>n</i> = 27). Preoperative echocardiographic diagnoses were compared with intraoperative surgical diagnoses to determine diagnostic discordance and assess impact.</p><p><strong>Results: </strong>Baseline characteristics were similar across subtypes. Transitional atrioventricular septal defects were associated with a higher prevalence of syndromic diagnoses (52.7% versus 33.8% versus 22.2%, <i>p</i> = 0.008) and greater preoperative ventricular dilation (LVIDd <i>Z</i>-score -0.88 versus -1.70 versus -1.70, <i>p</i> = 0.031). Diagnostic discordance occurred most frequently in partial atrioventricular septal defects (74.6%), followed by primum atrial septal defect with isolated left atrioventricular valve cleft (37.0%) and transitional atrioventricular septal defects (13.5%) (<i>p</i> < 0.001). Transitional atrioventricular septal defect repairs were associated with longer cardiopulmonary bypass and cross-clamp times, prolonged ventilation, and longer hospital stays (all <i>p</i> < 0.05). Residual shunt was more frequent in transitional atrioventricular septal defects early postoperatively and at the last follow-up (<i>p</i> < 0.001). One death was observed in the partial atrioventricular septal defects group, reintervention rates were similar across subtypes (<i>p</i> = 0.643), and follow-up duration differed modestly between groups (<i>p</i> = 0.047).</p><p><strong>Conclusion: </strong>The high rate of diagnostic discordance reflects inherent challenges in preoperative classification and suggests that a simplified, clinically oriented nomenclature may improve communication, surgical planning, and outcome prediction.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988070","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":"Ventricular electrical remodelling in children with isolated ventricular septal defects before and after closure.","authors":"Yasemin Özdemir Şahan, Emine Gülşah Torun, Nevin Özdemiroğlu, Atakan Atalay, Ibrahim Ece","doi":"10.1017/S1047951126123919","DOIUrl":"https://doi.org/10.1017/S1047951126123919","url":null,"abstract":"<p><strong>Background: </strong>Children with ventricular septal defects experience chronic left-to-right shunting, resulting in ventricular volume overload and alterations in myocardial electrical properties. Data on ventricular electrical remodelling following closure, particularly regarding closure technique, remain limited.</p><p><strong>Objective: </strong>To evaluate ventricular depolarisation and repolarisation indices in children with isolated ventricular septal defects before and after closure and to compare the outcomes of surgical and transcatheter approaches.</p><p><strong>Methods: </strong>This retrospective, single-centre study included 58 children aged 4-18 months who underwent isolated ventricular septal defect closure (transcatheter, <i>n</i> = 25; surgical, <i>n</i> = 33) and 40 age- and sex-matched healthy controls. Standard 12-lead electrocardiograms recorded before the procedure and at six months after closure were analysed. Multiple ventricular depolarisation and repolarisation indices were assessed.</p><p><strong>Results: </strong>Before closure, children with ventricular septal defects demonstrated significant abnormalities in ventricular depolarisation and repolarisation indices compared with healthy controls (all <i>p</i> < 0.05). Following closure, most repolarisation indices improved in both groups. Improvement was more pronounced after transcatheter closure, whereas QT interval and QT dispersion did not significantly improve following surgical closure. At the six-month follow-up, QRS duration remained significantly longer in both interventions than in controls.</p><p><strong>Conclusion: </strong>Children with isolated ventricular septal defects demonstrate subclinical alterations in ventricular depolarisation and repolarisation. Defect closure is associated with substantial improvement in ventricular repolarisation; however, depolarisation abnormalities may persist during mid-term follow-up irrespective of closure technique.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988105","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}