Cardiology in the Young最新文献

{"title":"Characterisation of whole-blood extrachromosomal circular DNAs in Kawasaki disease complicated by coronary artery aneurysm.","authors":"Yan Lin Wu, Yusheng Pang, Danyan Su","doi":"10.1017/S1047951126123865","DOIUrl":"https://doi.org/10.1017/S1047951126123865","url":null,"abstract":"<p><strong>Background: </strong>Extrachromosomal circular DNAs are critical regulators of stress responses, immunity, and inflammation pathways. However, their role and underlying mechanisms in Kawasaki disease complicated by coronary artery aneurysm remain poorly understood.</p><p><strong>Methods: </strong>Whole blood samples from six children with Kawasaki disease, including three with coronary artery aneurysm group and three without coronary artery aneurysm (control group), were subjected to extrachromosomal circular DNA sequencing. Putative extrachromosomal circular DNAs were identified using Circle-Map. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on genes associated with upregulated extrachromosomal circular DNAs, and an exploratory immune-signature profiling was performed using the single-sample gene set enrichment analysis algorithm.</p><p><strong>Results: </strong>We identified 4,790 differential extrachromosomal circular DNAs between the coronary artery aneurysm and control groups, of which 4,789 were upregulated in the CAA group. The extrachromosomal circular DNAs in the coronary artery aneurysm group were more concentrated and shorter in length than those in the control group. Upregulated extrachromosomal circular DNAs were mainly derived from autosomes, particularly chromosomes 3, 4, and 7. Functional enrichment analysis indicated that genes associated with upregulated extrachromosomal circular DNAs were mainly involved in response to stimulus-related terms and pathways, including chemokine signalling, cGMP-PKG signalling, and calcium signalling. Immune-signature analysis suggested that the coronary artery aneurysm group exhibited more specific immune responses, whereas the control group tended towards broader immune regulatory processes.</p><p><strong>Conclusions: </strong>Coronary artery aneurysm and control groups exhibited distinct extrachromosomal circular DNA profiles. These findings suggest that extrachromosomal circular DNA alterations are associated with coronary artery aneurysm in Kawasaki disease and may provide new insights into the molecular features underlying this condition.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988137","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":"Combination therapy and formulation challenges in paediatric hypertension: an unmet need.","authors":"Emre Leventoğlu, Sevcan A Bakkaloğlu","doi":"10.1017/S1047951126124007","DOIUrl":"https://doi.org/10.1017/S1047951126124007","url":null,"abstract":"<p><p>Hypertension is an increasingly prevalent condition in both adults and children and is associated with significant long-term cardiovascular and renal morbidity. Current paediatric guidelines recommend a stepwise pharmacological approach, initiating treatment with a single antihypertensive agent at a low dose, followed by gradual titration up to the maximum tolerated dose and the addition of a second agent only if blood pressure control is not achieved. In contrast, adult hypertension guidelines increasingly support early combination therapy, particularly in patients with stage 2 hypertension, to achieve faster and more consistent blood pressure control and improve medication adherence. Given that blood pressure regulation involves multiple physiological systems, combining agents with complementary mechanisms of action may enhance antihypertensive efficacy while reducing dose-dependent adverse effects. Although the use of fixed-dose combination therapies is well established in adults, their application in paediatric populations remains limited due to regulatory-, clinical-, and formulation-related challenges. We propose that, in selected paediatric patients with an anticipated inadequate response to monotherapy, early combination therapy may be considered as an alternative to strict stepwise escalation. Expanding paediatric clinical research and developing age-appropriate formulations are essential to optimise hypertension management and improve long-term outcomes in this population.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982471","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":"Incidentally diagnosed severe pulmonary valvar stenosis complicated by secondary cardiac hepatopathy in an adolescent: balloon valvoplasty as a bridge to surgery.","authors":"Bihter Karabacak, Ayşe Ünal Yüksekgönül, Utku Pamuk, Ahmet Kuddusi İrdem, Alper Hazım Gürsü","doi":"10.1017/S1047951126124019","DOIUrl":"https://doi.org/10.1017/S1047951126124019","url":null,"abstract":"<p><p>Severe pulmonary valvar stenosis may remain silent into adolescence. A 17-year-old girl attended with vaginal bleeding; the diagnosis rested on a grade 6/6 murmur found on examination. Aminotransferases rose despite correction of anaemia and hypotension and fell only after balloon valvoplasty relieved the obstruction. The valve being dysplastic, valvoplasty was not curative, but it reversed the hepatic injury and allowed valve replacement to proceed safely.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975956","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":"Strain before the storm: looking beyond ejection fraction in severe rheumatic carditis.","authors":"Murtaza Kamal","doi":"10.1017/S104795112612407X","DOIUrl":"https://doi.org/10.1017/S104795112612407X","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1"},"PeriodicalIF":0.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975984","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 effect of area deprivation on missed cardiology appointments and subsequent acute hospital visits.","authors":"Julia Selwyn, Jennifer Shores","doi":"10.1017/S1047951126123877","DOIUrl":"https://doi.org/10.1017/S1047951126123877","url":null,"abstract":"<p><strong>Introduction: </strong>Children with CHD require long-term follow-up, but missed visits among patients are common. Missed appointments likely contribute to excess morbidity and mortality. Our study seeks to identify social factors that could predict patients at risk of missing cardiology visits and to determine if missed visits and these social factors contribute to increased emergency department utilisation.</p><p><strong>Materials and methods: </strong>We conducted a single-centre chart review of CHD patients seen from 2012-2024 and analysed trends in paediatric cardiology clinic attendance, particularly the number of missed appointments. We also looked at emergency department visits and subsequent admissions among these groups. The primary exposure was the area deprivation index, a composite measure of neighbourhood disadvantage based on income, education, employment, and housing quality. We also compared the number of acute visits between patients with more missed visits.</p><p><strong>Results: </strong>We included 1,060 patients with CHD, and 46% of our population had ≥2 missed clinic visits, 31% had ≥5 emergency department visits, and 32% had ≥2 admissions. The number of missed visits increased across area deprivation index quartiles, though the number of emergency department visits and admissions was not significantly affected by area deprivation index. Patients with more missed visits were more likely to have more emergency department visits and admissions.</p><p><strong>Discussion: </strong>Our data suggest a relationship between community deprivation and missed clinic visits, and missed clinic visits seem to confer a greater risk of emergency department visits and unplanned admissions. Area deprivation index is a parameter available in major electronic health records and could be used to identify patients at risk for missed visits.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976007","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":"Timing and safety of prone positioning following median sternotomy in infants with single-ventricle physiology.","authors":"Amanda Clifton, Noelle Milnamow, David Kalfa, Lawrence P Cahalin","doi":"10.1017/S1047951126124068","DOIUrl":"https://doi.org/10.1017/S1047951126124068","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning is an essential component of early rehabilitation and motor development in infants following cardiac surgery involving median sternotomy; however, restrictions remain variable due to concerns regarding sternal healing and safety. Due to a lack of guiding evidence, many institutions implement a time-based restriction to prone positioning.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of infants with single-ventricle physiology undergoing cardiac surgery via median sternotomy at a single paediatric centre between 2022 and 2025. Data collected included time to physical therapy evaluation, time to initiation of prone positioning, clinical factors influencing positioning, and sternal healing outcomes after discharge. Descriptive statistics were used to summarise timing and outcomes.</p><p><strong>Results: </strong>A total of 37 patients were included with 46 surgical encounters. The median age at first surgery was 65 days (interquartile range: 6-204). Physical therapy evaluation occurred at a median of 9 days post-operatively (interquartile range: 7-15; range: 3-29), and prone positioning was initiated at a median of 15 days (interquartile range: 10-22; range: 4-115). Timing differed by surgical stage, with earlier initiation following Glenn compared to Norwood procedures. Delays in prone positioning were associated with medical instability, delayed sternal closure, and the presence of invasive lines and devices. No cases of sternal dehiscence, infection, or adverse healing outcomes were identified at outpatient follow-ups.</p><p><strong>Conclusions: </strong>Prone positioning following infant cardiac surgery demonstrates variability in timing but appears safe when guided by clinical stability and patient-specific factors. These findings support a shift from time-based restrictions to individualised, criteria-driven approaches.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975945","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":"Left ventricular rotational mechanics in children with dilated cardiomyopathy: reverse apical rotation indicates a poor prognosis.","authors":"Andrea E Montero, Dhiran Sivasubramanian, Matthew O'Connor, Anirban Banerjee","doi":"10.1017/S1047951126123920","DOIUrl":"https://doi.org/10.1017/S1047951126123920","url":null,"abstract":"<p><p>Twenty-three patients with dilated cardiomyopathy were recruited and compared with 10 age-and sex-matched controls using 2D-speckle tracking images of the apex and base of the left ventricle. Follow-up was performed after a period of 6 years. Ten patients with dilated cardiomyopathy presented with diminished rotation and 13 patients presented with reverse apical rotation, which was associated with poorer outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905099","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":"A coil is not a cure: what remains unanswered in paediatric cardiac haemangioma.","authors":"Murtaza Kamal","doi":"10.1017/S1047951126123968","DOIUrl":"https://doi.org/10.1017/S1047951126123968","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886624","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":"Exercise stress echocardiographic assessment of myocardial function in paediatric patients with Kawasaki disease.","authors":"Alan P Wang, Cassandra Polsen, Christina Laternser, Pei-Ni Jone, Rocio Gissel Gutierrez Rojas, Nagib Dahdah","doi":"10.1017/S1047951126123786","DOIUrl":"https://doi.org/10.1017/S1047951126123786","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease is an acute childhood vasculitis that may cause coronary artery aneurysms, raising concern for long-term myocardial dysfunction. Exercise stress echocardiography provides a noninvasive assessment of systolic and diastolic reserve, yet data comparing exercise responses in Kawasaki disease patients with contemporary coronary risk stratification are limited.</p><p><strong>Materials and methods: </strong>We retrospectively analysed exercise stress echocardiograms in patients with a history of Kawasaki disease-related coronary artery aneurysm (maximum coronary artery <i>z</i>-score ≥2.5) and age-matched controls without cardiac disease. Two-dimensional echocardiography was performed at rest and during early recovery following a standardised ergometer exercise test. Left ventricular and left atrial strain and mitral inflow velocities were measured. Within-group pre- and post-exercise changes were assessed using paired <i>t</i>-tests. Linear mixed-effects models evaluated differences in the magnitude of exercise-induced change between groups.</p><p><strong>Results: </strong>There were 34 and 27 patients in the Kawasaki disease and control cohorts, respectively. The Kawasaki disease cohort had a mean maximal coronary <i>z</i>-score of 3.8 ± 2.1. Both groups demonstrated significant pre- to post-exercise changes in left ventricular longitudinal strain and mitral A velocity. Additional systolic and diastolic parameter changes were observed within the Kawasaki disease cohort. Mixed-effects modelling revealed no significant differences in the magnitude of exercise-induced change between Kawasaki disease patients and controls.</p><p><strong>Conclusions: </strong>In paediatric patients with a remote history of Kawasaki disease and mild to moderate coronary artery aneurysms, exercise stress echocardiography demonstrated no differences in the magnitude of exercise-induced changes in systolic and diastolic indices compared to controls.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811987","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":"Atypical common arterial trunk with neonatal cyanosis caused by truncal valve-related obstruction of a sinus-origin pulmonary trunk.","authors":"Eléonore Héreau, Oscar Werner, Alban-Elouen Baruteau","doi":"10.1017/S1047951126123816","DOIUrl":"https://doi.org/10.1017/S1047951126123816","url":null,"abstract":"<p><p>A neonate with common arterial trunk presented with severe cyanosis rather than pulmonary overcirculation. Echocardiography, cardiac CT, catheterisation, and surgery showed a pulmonary trunk arising from a truncal valvar sinus, with systolic obstruction by a dysplastic truncal cusp. Staged palliation restored antegrade pulmonary flow, allowed pulmonary arterial growth, and enabled successful complete repair.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812036","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}