Cardiology in the Young最新文献

{"title":"The pulmonary valve in tetralogy of Fallot: insights from a necroscopy series.","authors":"Rohit S Loomba, Justin T Tretter, Robert H Anderson, Diane E Spicer","doi":"10.1017/S1047951125001398","DOIUrl":"10.1017/S1047951125001398","url":null,"abstract":"<p><strong>Background: </strong>Tetralogy of Fallot is the most common cyanotic congenital malformation of the heart. The right ventricular outflow tract is of great interest in this setting, but most of the focus on this feature has been on the size of the so-called pulmonary valvar \"annulus\". We aimed to characterise other aspects of the morphology of the pulmonary root in heart specimens with tetralogy of Fallot.</p><p><strong>Methods: </strong>We reviewed archived hearts with tetralogy of Fallot from four registries. The pulmonary root was examined with specific attention to the number of sinuses, the number of leaflets, presence of any fusion of leaflets, and the direction of the zone of apposition between the leaflets. Cluster analyses were then conducted to see if the features permitted segregation into groups.</p><p><strong>Results: </strong>We examined a total of 155 hearts. The pulmonary valve had two leaflets in 62%, three leaflets in 34%, and one leaflet in 3%. Irrespective of leaflet morphology, most hearts had two sinuses. Cluster analysis permitted segregation into three groups, with the direction of the zone of apposition being the most important feature for segregation.</p><p><strong>Conclusion: </strong>In two-thirds of our hearts with tetralogy of Fallot, the pulmonary valve had two leaflets. Most frequently there were three sinuses. In the setting of a valve with two sinuses, the zone of apposition between the leaflets pointing towards the aorta. Cluster analysis permitted statistically sound segregation of the heart and highlights the importance of delineating these features, specifically the leaflet and sinus morphology, with clinical imaging.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"978-984"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662547","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":"Potential role of targeted echocardiography as a screening test for select diagnoses in the paediatric population: bicuspid aortic valve and left ventricular hypertrophy.","authors":"Christina Yang, Lindsay A Edwards, Margaret M Vernon, Jeffrey Conwell, Sujatha Buddhe","doi":"10.1017/S1047951125001490","DOIUrl":"10.1017/S1047951125001490","url":null,"abstract":"<p><strong>Objective: </strong>We explore the role of targeted echocardiography as a screening tool for bicuspid aortic valve and left ventricular hypertrophy, specifically assessing the risk of missing significant cardiac findings that would otherwise be identified by comprehensive echocardiograms.</p><p><strong>Method: </strong>Children < 18 years at initial echocardiogram for indications of \"family history of bicuspid aortic valve\" and \"left ventricular hypertrophy on electrocardiogram\" were queried. Cardiology clinic notes and complete echocardiogram reports were reviewed for additional background histories and incidental findings. Follow-up clinic visits, if any, and management for those with incidental findings were reviewed.</p><p><strong>Results: </strong>Bicuspid aortic valve group included 138 patients, 71 (51%) males and mean age at comprehensive echo was 8.4 ± 4.8 years. Bicuspid aortic valve was found in 3.6%, incidental findings were found in 15 (11%), and follow-up was recommended in 4 (2.8%). Left ventricular hypertrophy group included 70 patients, 58 (83%) males and mean age at echo 10.9 ± 4.7 years. Left ventricular hypertrophy was found in 2.8%, incidental findings were found in 9 (13%), and follow-up was recommended in 2 (2.8%).None of the follow-up group developed symptoms or required cardiac medications, exercise restrictions, or catheter or surgical-based interventions, except for one case of mild aortic root dilation who was restricted from heavy weightlifting.</p><p><strong>Conclusion: </strong>The risk of missing clinically important findings with targeted echocardiography that would have been identified with comprehensive echocardiography is extremely low for screening indications of isolated left ventricular hypertrophy on electrocardiogram or family history of bicuspid aortic valve, suggesting that targeted echocardiography could be an effective screening tool.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"921-925"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966420","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":"High specificity electrocardiogram patterns for parvovirus B19 myocarditis in children: bridging electrocardiogram findings to aetiological diagnosis.","authors":"Roger Esmel-Vilomara, Paola Dolader, Susana Melendo, Ferran Rosés-Noguer, Ferran Gran","doi":"10.1017/S1047951125001878","DOIUrl":"10.1017/S1047951125001878","url":null,"abstract":"<p><strong>Introduction: </strong>Parvovirus B19 (PVB19) myocarditis is a life-threatening condition with high morbidity and mortality in children. While electrocardiograms are commonly used in the early assessment of myocarditis, no specific electrocardiogram pattern has been consistently linked to PVB19. The objective of this study is to identify a distinctive electrocardiogram pattern associated with PVB19 myocarditis and evaluate its diagnostic accuracy.</p><p><strong>Methods: </strong>This retrospective case-control study included 77 paediatric patients diagnosed with acute myocarditis at a single centre in Barcelona over 16 years (August 2008-September 2024). Twenty patients had PVB19 myocarditis, confirmed by polymerase chain reaction in blood or endomyocardial biopsy, while 57 patients had myocarditis caused by other viruses. Electrocardiogram were assessed by three cardiologists blinded to the aetiological diagnosis.</p><p><strong>Results: </strong>A specific electrocardiogram pattern in the limb leads, characterised by peaked P waves, low QRS complex voltages, and altered repolarisation (manifesting as negative or flat T waves, with or without QTc prolongation), was observed in 14 of 20 patients (70%) with PVB19 myocarditis. Two additional patients exhibited low voltages and altered repolarisation without peaked P waves, and all demonstrated repolarisation abnormalities. In contrast, only 1 of 57 patients with myocarditis from other viruses exhibited the full electrocardiogram pattern. The pattern demonstrated a specificity of 98% and a sensitivity of 70% for PVB19 myocarditis.</p><p><strong>Conclusion: </strong>The identified electrocardiogram pattern shows strong diagnostic specificity for PVB19 myocarditis in paediatric patients and may serve as a useful early diagnostic tool. Further multicentre studies are needed to confirm these findings and explore their clinical implications.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1023-1027"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978981","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":"Gabapentin's safety and impact on benzodiazepine exposure post-superior cavopulmonary anastomosis.","authors":"Joshua W Branstetter, Hania Zaki, Samuel Van Horn, Andrew Peter, Maria Cabrera, Susan Hupp, Heather Viamonte","doi":"10.1017/S1047951125001647","DOIUrl":"10.1017/S1047951125001647","url":null,"abstract":"<p><strong>Introduction: </strong>In paediatric cardiac patients requiring staged palliation, superior cavopulmonary anastomosis is common. Pain control is a crucial aspect of postoperative care as agitation, untreated pain, and hypoventilation can cause increased pulmonary vascular resistance reduction and pulmonary blood flow.</p><p><strong>Methods: </strong>This was a large volume single-centre, retrospective cohort study evaluating the impact of gabapentin on opioid and benzodiazepine exposure in infants undergoing superior cavopulmonary anastomosis between January 2018 and December 2022. The primary endpoint was opioid exposure in morphine milligram equivalents per kilogram in infants receiving gabapentin compared to no gabapentin.</p><p><strong>Results: </strong>The study analysed 85 infants, 40 of which received perioperative gabapentin. Other than there being more males in the gabapentin group (70% versus 47%; <i>p</i> = 0.03), there was no difference in baseline characteristics. Opioid use, measured in morphine milligram equivalents per kilogram, was similar in the no gabapentin group compared to the gabapentin group during the first 5 POD's (2.66 (interquartile range1.76, 3.30) versus 2.27 (interquartile range R 1.75, 3.40); <i>p</i> = 0.93. However, there was a lower benzodiazepine exposure, measured in midazolam equivalents per kilogram, in the gabapentin group both on POD 2 (0.05 (interquartile range 0.00, 0.11) versus 0 (interquartile range 0.00, 0.08); <i>p</i> = 0.031) and cumulative (0.15 (interquartile range 0.00, 0.35) versus 0.05 (interquartile range 0.00, 0.15); <i>p</i> = 0.031).</p><p><strong>Conclusions: </strong>Gabapentin did not significantly reduce opioid exposure; however, its use was associated with modest reduction in benzodiazepine exposure. There were no differences in adverse events. Our findings suggest gabapentin is safe in infants undergoing superior cavopulmonary anastomosis; however, additional studies should be conducted to evaluate optimal gabapentin dosing.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"996-1001"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092889","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":"Transcatheter reduction of a large, stented fenestration in a paediatric patient post-Fontan palliation.","authors":"Judyta Szeliga, Maksym Lazu, Sebastian Góreczny","doi":"10.1017/S1047951125001751","DOIUrl":"10.1017/S1047951125001751","url":null,"abstract":"<p><p>Staged Fontan pathway treatment is a recognised surgical approach for managing congenital heart lesions with single ventricle physiology. Some patients necessitate communication between the tunnel and the atrium to maintain circulatory balance. During follow-up, adjustments to fenestration size may be required. While methods for enlarging or completely closing fenestrations are common, partially reducing flow through a fenestration remains challenging. We present an effective technique for partially reducing the size of a large, stented fenestration using a coronary stent and a vascular occluder.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":"35 5","pages":"1082-1084"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332489","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":"Exploring the influence of extra-corporeal membrane oxygenation (ECMO) support on neurodevelopmental outcomes in paediatric cardiac patients: a systematic review.","authors":"Jeevan Francis, Ashwini Chandiramani, Alan George, Joseph George, Tim Jones","doi":"10.1017/S1047951125001635","DOIUrl":"10.1017/S1047951125001635","url":null,"abstract":"<p><strong>Background: </strong>Mechanical circulatory support, and specifically extra-corporeal membrane oxygenation, plays a critical role in managing paediatric cardiac patients with severe heart failure. Whilst these technologies are vital for bridging patients to recovery or heart transplantation, it is imperative to study the influence of extra-corporeal membrane oxygenation on neurodevelopmental outcomes.</p><p><strong>Objectives: </strong>This systematic review aimed to evaluate the influence of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in paediatric cardiac patients, both post-cardiotomy and non-cardiotomy patients were included.</p><p><strong>Methodology: </strong>A comprehensive search was conducted using PubMed, EMBASE, and PsychInfo to identify primary research articles exploring the effects of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in paediatric heart patients from inception to June 2024.</p><p><strong>Results: </strong>Our search yielded 5488 papers of which eight papers were included featuring 302 patients.</p><p><strong>Conclusion: </strong>The discussion highlights the considerable variability in neurodevelopmental outcomes and how they are measured among extra-corporeal membrane oxygenation survivors. Outcomes vary by patient factors, with recovery potential influenced by the duration and timing of follow-up. We emphasised the importance of standardised assessment tools and extended follow-ups to gain a clearer understanding of these outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"888-899"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983174","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":"Congenital Heart Disease transition practices in the United States: a survey of adult Congenital Heart Disease programs.","authors":"Debora Burger, Reem Hasan, Patrick D Evers, Andrew W McHill, Corina Thomet, Philip Moons, Quin E Denfeld","doi":"10.1017/S1047951125001489","DOIUrl":"10.1017/S1047951125001489","url":null,"abstract":"<p><strong>Background: </strong>International organisations recommend that patients with CHD undergo a structured transition process to prepare for lifelong cardiac care. However, there is a limited understanding of current transition practices in the United States (U.S.) from the perspective of adult CHD programs. The purpose of this study was to characterise adult CHD transition practices across the U.S.</p><p><strong>Method: </strong>We conducted a descriptive, cross-sectional survey of adult CHD programs in the U.S., inquiring about transition practices (preparation, transfer, and integration), resources, specialists, and barriers. We used descriptive statistics to analyse the data.</p><p><strong>Results: </strong>We analysed responses from 38 adult CHD programs (37% response rate). Among these, 25 (66%) of adult CHD programs reported formal transition programs and 26 (68%) reported having a transfer process to receive patients from paediatric cardiology. Reported transition program specialists were interdisciplinary. Few programs reported having psychologists or psychiatrists on their teams or offered support for patients with intellectual disability. The main barriers affecting transition were insurance and health care costs.</p><p><strong>Conclusion: </strong>Around two-thirds of respondent adult CHD programs reported the presence of formal transition programs. More resources may be needed within these programmes to support patient psychological well-being and those with intellectual disability and to address barriers related to insurance and health care costs.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"908-914"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978700","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":"Patent ductus arteriosus rupture during percutaneous device closure: a case report.","authors":"Hyun Ho Kim, Jihye You","doi":"10.1017/S1047951125001313","DOIUrl":"10.1017/S1047951125001313","url":null,"abstract":"<p><p>Patent ductus arteriosus is a common condition in preterm neonates, often necessitating medical or surgical intervention. This report presents a case of a preterm neonate born at 27 gestational weeks and who experienced patent ductus arteriosus rupture during a device closure procedure. Patent ductus arteriosus rupturing during device closure is rare and life threatening but can be successfully managed with prompt recognition and intervention.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1040-1042"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647369","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":"Assessment of the relationship between serum magnesium levels, patent ductus arteriosus, and other neonatal morbidities: a retrospective observational study.","authors":"Selma Aktas, Eda Albayrak, Osman Guvenc, Ebru Kazanci, Aysegul Inamlik, Ayse Pelin Ozcan, Ayse Korkmaz, Serdar Beken","doi":"10.1017/S1047951125001568","DOIUrl":"10.1017/S1047951125001568","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between serum magnesium levels and the risk of symptomatic patent ductus arteriosus in premature infants.</p><p><strong>Material and method: </strong>This retrospective single-centre cohort study analysed the medical records of patients. Neonates were categorised into two groups based on the presence or absence of symptomatic patent ductus arteriosus. Demographic factors including gender, gestational age, type of birth, birth weight, multiple pregnancies, medical treatment for duct closure or surgical ligation, length of hospital stay, and mortality and neonatal outcomes were compared between the groups. The relationship between serum magnesium levels at 24 hours of age and the risk of symptomatic patent ductus arteriosus and other neonatal morbidities was assessed.</p><p><strong>Results: </strong>This study found no significant relationship between symptomatic patent ductus arteriosus and serum magnesium levels. Additionally, no significant differences were observed between serum magnesium levels and ductal diameter, nor in the need for medical or surgical intervention for symptomatic patent ductus arteriosus. However, neonates with serum magnesium levels greater than 3 mg/dL exhibited a significantly higher incidence of respiratory distress syndrome. Conversely, the prevalence of bronchopulmonary dysplasia was significantly lower in this group, with both findings reaching statistical significance (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>These results suggest that while serum magnesium levels may not be a reliable marker for symptomatic patent ductus arteriosus, they could have clinical implications in the modulation of neonatal respiratory outcomes. Further research is warranted to explore the underlying mechanisms and assess the potential therapeutic role of magnesium in the management of neonatal morbidities.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"903-907"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973497","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":"Effect of standard intravenous immunoglobulin therapy on Kawasaki disease predicted by long non-coding ribonucleic acid small nucleolar RNA host gene 5 and microRNA-27a.","authors":"Shangming Chen, Haiying Huang","doi":"10.1017/S1047951125001611","DOIUrl":"10.1017/S1047951125001611","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease, an acute systemic small- and medium-vessel vasculitis, is mostly detected in children under 5 years old.</p><p><strong>Objective: </strong>We aimed to explore the predictive value of long non-coding ribonucleic acid small nucleolar RNA host gene 5 (SNHG5) and microRNA (miRNA)-27a for the effect of standard intravenous immunoglobulintherapy on children with Kawasaki disease.</p><p><strong>Methods: </strong>The study included 182 children undergoing standard intravenous immunoglobulin therapy for Kawasaki disease and another 182 healthy children receiving physical examinations as a control group. LncRNA SNHG5 and miRNA-27a expression levels were determined at admission.</p><p><strong>Results: </strong>The ineffective group had higher levels of interleukin-6, C-reactive protein, procalcitonin, lncRNA SNHG5, and miRNA-27a and Kobayashi score than those of the effective group (<i>P</i> < 0.05). Multivariate regression analysis showed that Kobayashi score, interleukin-6, C-reactive protein, procalcitonin, lncRNA SNHG5, and miRNA-27a were associated with the treatment outcomes (<i>P</i> < 0.05). LncRNA SNHG5 and miRNA-27a levels were positively correlated with Kobayashi score, interleukin-6, receiver operating characteristic and procalcitonin levels (<i>r</i> > 0, <i>P</i> < 0.05). High Kobayashi score and levels of interleukin-6, c-reactive roe, procalcitonin, lncRNA SNHG5, and miRNA-27a were influencing factors for treatment failure (odds ratio > 1, <i>P</i> < 0.05). The areas under the curves of lncRNA SNHG5, miRNA-27a, and their combination were 0.757, 0.766, and 0.831, respectively.</p><p><strong>Conclusion: </strong>LncRNA SNHG5 and miRNA-27a are highly expressed in children with Kawasaki disease, and their levels are closely correlated with the efficacy of standard immunoglobulin therapy.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"971-977"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964280","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}