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Rascher W, Kiess W, Körner A. Bluthochdruck bei Adipositas im Kindes- und Jugendalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:492-9. [DOI: 10.1007/s00103-012-1638-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Brands MMMG, Frohn-Mulder IM, Hagemans MLC, Hop WCJ, Oussoren E, Helbing WA, van der Ploeg AT. Mucopolysaccharidosis: cardiologic features and effects of enzyme-replacement therapy in 24 children with MPS I, II and VI. J Inherit Metab Dis 2013; 36:227-34. [PMID: 22278137 PMCID: PMC3590414 DOI: 10.1007/s10545-011-9444-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 12/16/2011] [Accepted: 12/20/2011] [Indexed: 10/27/2022]
Abstract
We determined the cardiologic features of children with MPS I, II and VI, and evaluated the effect of enzyme-replacement therapy (ERT) on cardiac disease. Twenty-four children aged 1-18 years with MPS I, II or VI were prospectively evaluated with echocardiogram and electrocardiogram from the start of enzyme-replacement therapy up to 6 years of treatment. At start of therapy, 66% had abnormal cardiac geometric features. Left-ventricular mass index (LVMI) was increased in half of the patients, due mainly to concentric hypertrophy in MPS I and II and to eccentric hypertrophy in MPS VI. Regurgitation was most severe in a subgroup of young MPS VI patients (<5 years) at the mitral valve. At baseline, all patients had abnormal valves. The ECG showed no clear rhythm or conduction abnormalities; neither, in most patients, did it reflect the hypertrophy. After ERT, the LVMI Z-score normalized in 70% of the patients who had a Z-score > 2. LVMI Z-scores decreased significantly in patients with MPS I and MPS II (p = 0.04 and p = 0.032). Despite ERT, valve regurgitation increased in 60% of the patients. We conclude that all our MPS patients have cardiac abnormalities. The most severe cardiac disease was observed in a subgroup of young MPS VI patients. While ERT had an effect on LVMI and IVSd, it apparently had little or none on valve regurgitation.
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Affiliation(s)
- Marion M. M. G. Brands
- Department of Pediatrics, division of Metabolic Diseases and Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center Sophia’s Children’s Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Ingrid M. Frohn-Mulder
- Department of Pediatrics, Division of Cardiology, Erasmus MC – Sophia’s Children’s Hospital, Rotterdam, the Netherlands
| | - Marloes L. C. Hagemans
- Department of Pediatrics, division of Metabolic Diseases and Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center Sophia’s Children’s Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Wim C. J. Hop
- Department of Biostatistics, Erasmus MC, Rotterdam, the Netherlands
| | - Esmee Oussoren
- Department of Pediatrics, division of Metabolic Diseases and Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center Sophia’s Children’s Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Wim A. Helbing
- Department of Pediatrics, Division of Cardiology, Erasmus MC – Sophia’s Children’s Hospital, Rotterdam, the Netherlands
| | - Ans T. van der Ploeg
- Department of Pediatrics, division of Metabolic Diseases and Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center Sophia’s Children’s Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
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203
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Braunlin E, Rosenfeld H, Kampmann C, Johnson J, Beck M, Giugliani R, Guffon N, Ketteridge D, Sá Miranda CM, Scarpa M, Schwartz IV, Leão Teles E, Wraith JE, Barrios P, Dias da Silva E, Kurio G, Richardson M, Gildengorin G, Hopwood JJ, Imperiale M, Schatz A, Decker C, Harmatz P. Enzyme replacement therapy for mucopolysaccharidosis VI: long-term cardiac effects of galsulfase (Naglazyme®) therapy. J Inherit Metab Dis 2013; 36:385-94. [PMID: 22669363 PMCID: PMC3590402 DOI: 10.1007/s10545-012-9481-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/07/2012] [Accepted: 03/14/2012] [Indexed: 12/21/2022]
Abstract
Characteristic cardiac valve abnormalities and left ventricular hypertrophy are present in untreated patients with mucopolysaccharidosis type VI (MPS VI). Cardiac ultrasound was performed to investigate these findings in subjects during long-term enzyme replacement therapy (ERT) with recombinant human arylsulfatase B (rhASB, rhN-acetylgalactosamine 4-sulfatase, galsulfase, Naglazyme®). Studies were conducted in 54 subjects before ERT was begun and at specific intervals for up to 96 weeks of weekly infusions of rhASB at 1 mg/kg during phase 1/2, phase 2, and phase 3 trials of rhASB. At baseline, mitral and aortic valve obstruction was present and was significantly greater in those ≥12 years of age. Mild mitral and trace aortic regurgitation were present, the former being significantly greater in those <12 years. Left ventricular hypertrophy, with averaged z-scores ranging from 1.6-1.9 SD greater than normal, was present for ages both <12 and ≥12 years. After 96 weeks of ERT, ventricular septal hypertrophy regressed in those <12 years. For those ≥12 years, septal hypertrophy was unchanged, and aortic regurgitation increased statistically but not physiologically. Obstructive gradients across mitral and aortic valves remained unchanged. The results suggest that long-term ERT is effective in reducing intraventricular septal hypertrophy and preventing progression of cardiac valve abnormalities when administered to those <12 years of age.
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Affiliation(s)
- E. Braunlin
- Pediatric Cardiology, University of Minnesota, Minneapolis, MN USA
| | - H. Rosenfeld
- Cardiology, Children’s Hospital & Research Center Oakland, Oakland, CA USA
| | - C. Kampmann
- Department of Congenital Heart Diseases / Pediatric Cardiology / GUCH, University Medicine, Center for Diseases in Childhood and Adolescence, Mainz, Germany
| | - J. Johnson
- Gastroenterology, Children’s Hospital & Research Center Oakland, Oakland, CA USA
| | - M. Beck
- Centre for Lysosomal Storage Diseases, University Children’s Hospital, Mainz, Germany
| | - R. Giugliani
- Department of Genetics, UFRGS, Porto Alegre, RS Brazil
- Medical Genetics Service, HCPA, Porto Alegre, RS Brazil
- INAGEMP – Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS Brazil
| | - N. Guffon
- Hôpital Femme Mère Enfant, Lyon, France
| | - D. Ketteridge
- Metabolic Unit, SA Pathology at Women’s and Children’s Hospital, Adelaide, Australia
| | - C. M. Sá Miranda
- Instituto de Biologia Molecular e Celular, Unidade de Biologia do Lisossoma e Peroxisoma, Porto, Portugal
| | - M. Scarpa
- Department of Pediatrics, University of Padova, Padova, Italy
| | - I. V. Schwartz
- Department of Genetics, UFRGS, Porto Alegre, RS Brazil
- Medical Genetics Service, HCPA, Porto Alegre, RS Brazil
| | - E. Leão Teles
- Unidade de Doenças Metabólicas, Departmento de Pediatria, Hospital S. João, Porto, Portugal
| | - J. E. Wraith
- Genetic Medicine, St. Mary’s Hospital, Manchester, M13 9WL UK
| | - P. Barrios
- Department of Genetics, UFRGS, Porto Alegre, RS Brazil
- Medical Genetics Service, HCPA, Porto Alegre, RS Brazil
| | - E. Dias da Silva
- Cardiologia Pediatrica, Departamento de Pediatria, Hospital de S. João, Porto, Portugal
| | - G. Kurio
- Cardiology, Children’s Hospital & Research Center Oakland, Oakland, CA USA
| | - M. Richardson
- Cardiology Department, Women’s and Children’s Hospital, Adelaide, Australia
| | - G. Gildengorin
- Pediatric Clinical Research Center, Children’s Hospital & Research Center Oakland, Oakland, CA USA
| | - J. J. Hopwood
- Lysosomal Diseases Research Unit, SA Pathology at Women’s and Children’s Hospital Adelaide, North Adelaide, Australia
| | | | - A. Schatz
- BioMarin Pharmaceutical, Inc., Novato, CA USA
| | - C. Decker
- BioMarin Pharmaceutical, Inc., Novato, CA USA
| | - P. Harmatz
- Gastroenterology, Children’s Hospital & Research Center Oakland, Oakland, CA USA
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204
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Miller RF, Kaski JP, Hakim J, Matenga J, Nathoo K, Munyati S, Desai SR, Corbett EL, Ferrand RA. Cardiac disease in adolescents with delayed diagnosis of vertically acquired HIV infection. Clin Infect Dis 2013; 56:576-82. [PMID: 23097588 PMCID: PMC3552526 DOI: 10.1093/cid/cis911] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND At least one-third of human immunodeficiency virus (HIV)-infected infants survive to adolescence even without antiretroviral therapy (ART), but are at high risk of complications including cardiac disease. We investigated the characteristics of cardiac disease among adolescents with HIV infection diagnosed in late childhood who were receiving ambulatory HIV care in Harare, Zimbabwe. METHODS Consecutive adolescents with vertically acquired HIV attending 2 HIV outpatient treatment clinics were studied. Assessment included clinical history and examination, and 2-dimensional, M-mode, pulsed- and continuous-wave Doppler echocardiography. RESULTS Of 110 participants (47% male; median age, 15 years; interquartile range, 12-17 years), 78 (71%) were taking ART. Exertional dyspnea, chest pain, palpitations, and ankle swelling were reported by 47 (43%), 43 (39%), 10 (9%), and 7 (6%), respectively. The New York Heart Association score was ≥ 2 in 41 participants (37%). Echocardiography showed that 74 participants (67%) had left ventricular (LV; septal and/or free wall) hypertrophy and 27 (24%) had evidence of impaired LV relaxation or restrictive LV physiology. The estimated pulmonary artery systolic pressure (ePASP) was >30 mm Hg in 4 participants (3.6%); of these 2 also had right ventricular (RV) dilatation. Another 32 participants (29%), without elevated ePASP, had isolated RV dilatation. CONCLUSIONS A significant burden of cardiac disease was seen among adolescents with vertically acquired HIV infection. More than half were asymptomatic yet had significant echocardiographic abnormalities. These findings highlight the need to screen this population in order to better define the geography, natural history, etiopathogenic mechanisms, and management (including the timing and choice of optimal therapeutic ART and cardiac drug interventions) to prevent development and/or progression of HIV-associated cardiac disease.
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Affiliation(s)
- Robert F Miller
- Research Department of Infection and Population Health, Institute of Epidemiology and Healthcare, University College London, Mortimer Market Centre, London WC1E 6JB, United Kingdom.
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Mueller GC, Stark V, Steiner K, Weil J, von Kodolitsch Y, Mir TS. The Kid-Short Marfan Score (Kid-SMS) - an easy executable risk score for suspected paediatric patients with Marfan syndrome. Acta Paediatr 2013; 102:e84-9. [PMID: 23110520 DOI: 10.1111/apa.12072] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 10/24/2012] [Indexed: 12/01/2022]
Abstract
AIM Due to age-dependent manifestations, diagnosis of Marfan syndrome (MFS) in children and adolescents is sophisticated. Although revised Ghent criteria is a major step forward, its utility in children is still restricted due to expensive and technically advanced diagnostics. As early diagnosis submits long-term benefits concerning prognosis, the need of an appropriate diagnostic tool for risk stratification of suspected paediatric patients with Marfan is justified. METHODS AND RESULTS Sixty paediatric patients with Marfan were subject to a standardized diagnostic programme. All clinical symptoms of the revised Ghent nosology were analysed concerning age at first clinical manifestation, prevalence and likelihood ratio for MFS. Symptoms with early onset, high prevalence and high positive likelihood ratio were identified and combined for a risk score called Kid-Short Marfan Score (Kid-SMS). Three risk categories for suspicion of Marfan syndrome were developed. Finally, the Kid-SMS was operated in 130 paediatric patients with suspected MFS. Kid-SMS identified significantly more suspected patients with Marfan compared with Ghent nosology, revised Ghent and genetics alone without oversensitivity. CONCLUSION Whereas diagnosis of MFS in childhood is sophisticated, Kid-SMS is a useful tool for risk stratification of suspected paediatric patients with Marfan by easy executable diagnostics, especially for paediatricians and paediatric cardiologists.
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Affiliation(s)
- Goetz C Mueller
- Clinic for Paediatric Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
| | - Veronika Stark
- Clinic for Paediatric Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
| | - Kristoffer Steiner
- Clinic for Paediatric Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
| | - Jochen Weil
- Clinic for Paediatric Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
| | - Yskert von Kodolitsch
- Clinic for Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
| | - Thomas S Mir
- Clinic for Paediatric Cardiology; University Heart Centre; University of Hamburg-Eppendorf; Hamburg; Germany
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207
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Echocardiographic Evaluation of Ventricular Assist Devices in Pediatric Patients. J Am Soc Echocardiogr 2013; 26:41-9. [DOI: 10.1016/j.echo.2012.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Indexed: 11/23/2022]
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208
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Kwinta P, Jagła M, Grudzień A, Klimek M, Zasada M, Pietrzyk JJ. From a regional cohort of extremely low birth weight infants: cardiac function at the age of 7 years. Neonatology 2013; 103:287-92. [PMID: 23548517 DOI: 10.1159/000348251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 01/21/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The long-term impact of prematurity on cardiac structure and function has not yet been fully discovered. OBJECTIVES To assess long-term cardiac complications in the regional cohort of extremely low birth weight (ELBW) children born in 2002-2004. MATERIAL AND METHODS Eighty-one children born as ELBW infants (91% of the available cohort) with a median birth weight of 890 g (25-75th percentile: 760-950) were evaluated at the mean age of 6.7 years. The control group included 40 children born full-term, selected from one general practice in the district. Echocardiography and 24-hour ambulatory blood pressure measurements (ABPM) were performed. The primary outcome variable was the presence of cardiac complications such as left ventricular hypertrophy (LVH), diastolic dysfunction or systolic dysfunction. RESULTS LVH was diagnosed in 4/81 ELBW children and 2/40 control children (p = 1.0). Concentric remodeling was detected in 8 (10%) subjects from the ELBW group and in 2 (5%) from the control group (p = 0.49). There were no patients with diastolic or systolic dysfunction in either group. After having expressed the results of M-mode echocardiography as z-scores for body surface area (BSA), statistically significant differences were observed for right-ventricle dimension in diastole (-1.49 ± 1.25 vs. -0.31 ± 0.91; p < 0.001), LV inner dimension in diastole (-0.53 ± 1.26 vs. 0.13 ± 0.94; p = 0.01) and left atrium (-0.93 ± 1.07 vs. -0.15 ± 1.02; p < 0.01). Heart rate (HR) was significantly faster in ELBW children (92.9 ± 8.4 vs. 86.7 ± 7.4 bpm; p = 0.01 adjusted for BSA) and they also had significantly higher night-time blood pressure [mean (z-score): 1.15 vs. 0.2; p = 0.02] without nocturnal dipping (night-time dipping <10%: 13 (16.7%) vs. 2 (5.2%), p = 0.13). CONCLUSIONS No differences were found between the groups in the occurrence of cardiac complications. Ex-preterm ELBW children at age 6 may have a faster HR, smaller cardiac dimensions on echocardiography and higher nocturnal blood pressure. The clinical relevance of these findings is unknown.
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Affiliation(s)
- Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
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209
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Will JC, Liu TL, Panagiotou E, Opgen-Rhein B, Schmitz L, Berger F. Nonsymptomatic myocardial injury after radiofrequency and cryoablation: a study of children and patients with congenital heart disease. Pediatr Cardiol 2012; 33:1348-54. [PMID: 22592443 DOI: 10.1007/s00246-012-0343-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 04/25/2012] [Indexed: 10/28/2022]
Abstract
The aim of this study was to investigate the degree of myocardial injury following catheter radiofrequency (RF) ablation (RFA) or cryoablation and its clinical significance in children and patients with congenital heart disease. Cardiac troponin T (cTnT) or cardiac troponin I (cTnI), creatine kinase (CK), and its cardiac isoenzyme MB (CK-MB) were measured in 269 patients who underwent catheter ablation (216 RFA, 53 cryoablation) just before the procedure and again 6 hours after the end of the procedure. Follow-up studies included echocardiography and 12 lead electrocardiographics (ECGs). No clinical, ECG, nor ECG signs of ischemia were detected. Biomarkers were increased in 57.7-75.5 %. A linear regression analysis illustrated the ablation target site and the number of RF applications as a function of higher cTnI and cTnT levels, with the maximum increase due to ventricular ablation and higher numbers of RF applications. No significant difference in cTnT levels after RFA or cryoablation were observed for AV nodal reentrant tachycardia procedures and no significant differences were observed after nonirrigated tip or irrigated tip RFA in atrial wall or ventricular wall ablation. Elevations in both troponin T and troponin I levels were commonly observed after ablation, especially in ventricular wall ablation as well as with increasing numbers of radiofrequency applications. However, unlike in patients with acute coronary syndrome, these elevated levels had no specific significance. Reference values for each ablation target site were proposed in order to potentially detect additional subclinical injuries to the coronary arteries.
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Affiliation(s)
- Joachim C Will
- Department of Pediatric Cardiology, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Simpson JM, Rawlins D, Mathur S, Chubb H, Sinha MD. Systolic and Diastolic Ventricular Function Assessed by Tissue Doppler Imaging in Children with Chronic Kidney Disease. Echocardiography 2012; 30:331-7. [DOI: 10.1111/echo.12015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- John M. Simpson
- Department of Congenital Heart Disease; Evelina Children's Hospital, Guys & St Thomas' NHS Foundation Trust; London; UK
| | - Debbie Rawlins
- Department of Congenital Heart Disease; Evelina Children's Hospital, Guys & St Thomas' NHS Foundation Trust; London; UK
| | - Sujeev Mathur
- Department of Congenital Heart Disease; Evelina Children's Hospital, Guys & St Thomas' NHS Foundation Trust; London; UK
| | - Henry Chubb
- Department of Congenital Heart Disease; Evelina Children's Hospital, Guys & St Thomas' NHS Foundation Trust; London; UK
| | - Manish D. Sinha
- Department of Paediatric Nephrology; Evelina Children's Hospital, Guys & St Thomas' NHS Foundation Trust; London; UK
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Abstract
Z-scores are a means of expressing the deviation of a given measurement from the size or age specific population mean. By taking account of growth or age, Z-scores are an excellent means of charting serial measurements in paediatric cardiological practice. They can be applied to echocardiographic measurements, blood pressure and patient growth, and thus may assist in clinical decision-making.
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Affiliation(s)
- Henry Chubb
- Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's and St Thomas' NHS Trust, London, UK
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Ronvelia D, Greenwood J, Platt J, Hakim S, Zaragoza MV. Intrafamilial variability for novel TAZ gene mutation: Barth syndrome with dilated cardiomyopathy and heart failure in an infant and left ventricular noncompaction in his great-uncle. Mol Genet Metab 2012; 107:428-32. [PMID: 23031367 PMCID: PMC3483384 DOI: 10.1016/j.ymgme.2012.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/11/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The tafazzin gene (TAZ) is located at Xq28 and encodes a protein involved in the transacylation of cardiolipin, an essential mitochondrial phospholipid. Mutations in TAZ are associated with Barth syndrome (BTHS), the X-linked recessive condition with dilated cardiomyopathy, skeletal myopathy, growth retardation, neutropenia and organic aciduria. TAZ mutations also contribute to left ventricular noncompaction (LVNC), a cardiomyopathy characterized by loose, trabeculated myocardium. CASE REPORT We report a family with a novel TAZ mutation and the clinical spectrum from severe BTHS in an infant to skeletal myopathy with LVNC in an adult, the oldest individual with BTHS reported. The proband is a 51-year-old male with muscle weakness since early childhood. He remained stable until the age of 43. His initial evaluations found LVNC and borderline neutropenia with no elevation of urine 3-methylglutaconic acid. The proband's great nephew is a 3-year-old who presented at birth with poor feeding, hypotonia, lactic acidosis and hypoglycemia. At three months he was admitted with failure to thrive, lethargy and respiratory distress due to heart failure. Cardiac studies revealed dilated cardiomyopathy with a spongiform trabeculated pattern of the left ventricle. Laboratory studies showed cyclic neutropenia and elevated urine 3-methylglutaconic and 3-methylglutaric acids. At age 11months the patient had a heart transplant. We conducted sequence analysis of the TAZ gene for two affected individuals, the proband first and then his great-nephew. A novel, hemizygous nonsense mutation in TAZ exon 7 (c.583G>T, p.Gly195X) was detected. CONCLUSION At his current age of 51years-old, the proband is the oldest surviving individual reported with a confirmed molecular diagnosis and features of Barth syndrome. Further studies will be conducted to identify the genetic modifying factor(s) associated with the wide phenotypic range seen in this family.
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Affiliation(s)
- Diti Ronvelia
- UC Irvine Cardiogenomics Program, Dept of Pediatrics, Division of Genetics & Metabolism and Dept of Biological Sciences, University of California, Irvine, School of Medicine, Irvine, CA
| | - Jaclyn Greenwood
- UC Irvine Cardiogenomics Program, Dept of Pediatrics, Division of Genetics & Metabolism and Dept of Biological Sciences, University of California, Irvine, School of Medicine, Irvine, CA
| | - Julia Platt
- UC Irvine Cardiogenomics Program, Dept of Pediatrics, Division of Genetics & Metabolism and Dept of Biological Sciences, University of California, Irvine, School of Medicine, Irvine, CA
| | - Simin Hakim
- UC Irvine Cardiogenomics Program, Dept of Pediatrics, Division of Genetics & Metabolism and Dept of Biological Sciences, University of California, Irvine, School of Medicine, Irvine, CA
| | - Michael V. Zaragoza
- UC Irvine Cardiogenomics Program, Dept of Pediatrics, Division of Genetics & Metabolism and Dept of Biological Sciences, University of California, Irvine, School of Medicine, Irvine, CA
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Banerjee I, Avatapalle B, Petkar A, Skae M, Padidela R, Ehtisham S, Patel L, Rigby L, Flanagan S, Ellard S, Jones C, Ciotti G, Malaiya N, Clayton PE. The association of cardiac ventricular hypertrophy with congenital hyperinsulinism. Eur J Endocrinol 2012; 167:619-24. [PMID: 22894813 DOI: 10.1530/eje-12-0632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Ventricular hypertrophy (VH) has been observed in children with congenital hyperinsulinism (CHI), a condition of hypoglycaemia characterised by dysregulated insulin secretion, but the prevalence is not known. PATIENTS AND METHODS Cardiac assessment was performed in children (n=49) with CHI at diagnosis and follow-up. Two dimensional and Doppler echocardiography studies were used to assess cardiac structures, while M-mode study was used to measure left ventricular (LV) dimensions, subsequently converted to Z scores. Where possible, LV hypertrophy was confirmed by LV mass index (g/m(2.7)) >95th centile. RESULTS Cardiac structural lesions were found in 14 (28%) children. At initial echocardiography, VH was present in 31 (65%) children with median (range) LV posterior wall dimension in diastole Z scores of +1.6 (-2.4 to +5.8) and interventricular septal wall dimension in end diastole Z scores of +1.9 (-1.7 to +17.2). At follow-up echocardiography, performed after an interval of 178 (45-390) days, VH persisted in 16 (33%) children. In regression analysis, the presence of VH (odds ratio (95% confidence intervals) 1.1 (1.0-1.2), P=0.04) at initial echocardiography was correlated with maximum glucose requirement at diagnosis, indicating that severity of CHI at presentation may play a role in the pathogenesis of VH. CONCLUSIONS A significant proportion of children with CHI have cardiac structural lesions. A majority also have VH, which may be associated with the severity of CHI at diagnosis. VH may persist in some children, which requires careful long-term cardiac review.
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Affiliation(s)
- Indraneel Banerjee
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, UK.
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Mavinkurve-Groothuis AMC, Marcus KA, Pourier M, Loonen J, Feuth T, Hoogerbrugge PM, de Korte CL, Kapusta L. Myocardial 2D strain echocardiography and cardiac biomarkers in children during and shortly after anthracycline therapy for acute lymphoblastic leukaemia (ALL): a prospective study. Eur Heart J Cardiovasc Imaging 2012; 14:562-9. [DOI: 10.1093/ehjci/jes217] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fan Y, Zhang AM, Weng YG, Huebler M, Miera O, Franz N, Qian GS, Hetzer R. Factors associated with the need of biventricular mechanical circulatory support in children with advanced heart failure. Eur J Cardiothorac Surg 2012; 43:1028-35. [DOI: 10.1093/ejcts/ezs481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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216
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Laurent G, Saal S, Amarouch MY, Béziau DM, Marsman RF, Faivre L, Barc J, Dina C, Bertaux G, Barthez O, Thauvin-Robinet C, Charron P, Fressart V, Maltret A, Villain E, Baron E, Mérot J, Turpault R, Coudière Y, Charpentier F, Schott JJ, Loussouarn G, Wilde AA, Wolf JE, Baró I, Kyndt F, Probst V. Multifocal Ectopic Purkinje-Related Premature Contractions. J Am Coll Cardiol 2012; 60:144-56. [DOI: 10.1016/j.jacc.2012.02.052] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/19/2012] [Accepted: 02/14/2012] [Indexed: 11/29/2022]
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217
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Herzog A, Hartung R, Reuser AJJ, Hermanns P, Runz H, Karabul N, Gökce S, Pohlenz J, Kampmann C, Lampe C, Beck M, Mengel E. A cross-sectional single-centre study on the spectrum of Pompe disease, German patients: molecular analysis of the GAA gene, manifestation and genotype-phenotype correlations. Orphanet J Rare Dis 2012; 7:35. [PMID: 22676651 PMCID: PMC3479421 DOI: 10.1186/1750-1172-7-35] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 06/07/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pompe disease (Glycogen storage disease type II, GSD II, acid alpha-glucosidase deficiency, acid maltase deficiency, OMIM # 232300) is an autosomal-recessive lysosomal storage disorder due to a deficiency of acid alpha-glucosidase (GAA, acid maltase, EC 3.2.1.20, Swiss-Prot P10253). Clinical manifestations are dominated by progressive weakness of skeletal muscle throughout the clinical spectrum. In addition, the classic infantile form is characterised by hypertrophic cardiomyopathy. METHODS In a cross-sectional single-centre study we clinically assessed 3 patients with classic infantile Pompe disease and 39 patients with non-classic presentations, measured their acid alpha-glucosidase activities and analysed their GAA genes. RESULTS Classic infantile patients had nearly absent residual enzyme activities and a typical clinical course with hypertrophic cardiomyopathy until the beginning of therapy. The disease manifestations in non-classic patients were heterogeneous. There was a broad variability in the decline of locomotive and respiratory function. The age of onset ranged from birth to late adulthood and correlated with enzyme activities. Molecular analysis revealed as many as 33 different mutations, 14 of which are novel. All classic infantile patients had two severe mutations. The most common mutation in the non-classic group was c.-32-13T>G. It was associated with a milder course in this subgroup. CONCLUSIONS Disease manifestation strongly correlates with the nature of the GAA mutations, while the variable progression in non-classic Pompe disease is likely to be explained by yet unknown modifying factors. This study provides the first comprehensive dataset on the clinical course and the mutational spectrum of Pompe disease in Germany.
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Affiliation(s)
- Andreas Herzog
- Center for Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
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218
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Pauliks LB, Brian Clark J, Rogerson A, DiPietro A, Myers JL, Cyran SE. Exercise stress echocardiography after childhood Ross surgery: functional outcome in 26 patients from a single institution. Pediatr Cardiol 2012; 33:797-801. [PMID: 22349730 DOI: 10.1007/s00246-012-0218-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 12/09/2011] [Indexed: 11/24/2022]
Abstract
Adult studies suggest a better functional outcome after aortic valve replacement with a pulmonary autograft compared with mechanical or homograft valves. Little is known about functional results after Ross surgery in growing children. This study reports formal exercise stress echocardiographic data from 26 pediatric Ross patients. A retrospective cohort study analyzed stress echocardiographic data of patients who underwent Ross surgery as a child (<17 years old). All patients were operated by a single surgeon and underwent a Bruce protocol stress echocardiogram on the treadmill. Twenty-six patients (4 girls) were 9.3 ± 5.0 years at surgery and 14.9 ± 3.5 years (range 6.6-19.7 years) at follow-up. Mean follow-up was 5.4 ± 3.7 years (median 4.2). All were asymptomatic. The exercise time was normal in 87% of cases at 12.8 ± 2.5 min. On stress echocardiography, the mean right-ventricular outflow tract (RVOT) gradient increased from 38 ± 22 mmHg at rest to 82 ± 33 mmHg after exercise, but this did not correlate with exercise times. Stress echocardiography is useful in evaluating patients after childhood Ross surgery for aortic valve disease. In this pediatric cohort, most patients achieved normal exercise capacity. The presence of mild or moderate RVOT obstruction had no significant impact on exercise capacity.
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Affiliation(s)
- Linda B Pauliks
- Department of Pediatric Cardiology, Penn State Hershey Children's Hospital, Hershey, PA 17033, USA.
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219
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Sherief LM, Kamal AG, Khalek EA, Kamal NM, Soliman AAA, Esh AM. Biomarkers and early detection of late onset anthracycline-induced cardiotoxicity in children. Hematology 2012; 17:151-156. [DOI: 10.1179/102453312x13376952196412] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Affiliation(s)
- Laila M. Sherief
- Department of PediatricsFaculty of Medicine, Zagazig University, Egypt
| | - Ahmad G. Kamal
- Department of PediatricsFaculty of Medicine, Zagazig University, Egypt
| | - E. A. Khalek
- Department of PediatricsFaculty of Medicine, Zagazig University, Egypt
| | | | | | - Asmaa M. Esh
- Department of Clinical PathologyFaculty of Medicine, Zagazig University, Egypt
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220
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Baño-Rodrigo A, Salcedo-Posadas A, Villa-Asensi JR, Tamariz-Martel A, Lopez-Neyra A, Blanco-Iglesias E. Right ventricular dysfunction in adolescents with mild cystic fibrosis. J Cyst Fibros 2012; 11:274-80. [PMID: 22483972 DOI: 10.1016/j.jcf.2012.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 02/20/2012] [Accepted: 03/04/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND In cystic fibrosis (CF) patients the right ventricle (RV) suffers a progressive deterioration, but it is not clear when these changes begin. The aim of this study was to analyze the RV function in CF patients with mild respiratory disease. METHODS Color-Doppler-Echocardiographic studies were prospectively performed in CF adolescent patients and an age-matched control group. Findings were correlated with pulmonary function tests (PFT), genotype, chronic bacterial colonization, pancreatic status and clinical scores. Only patients with mild CF were selected. RESULTS Thirty seven CF patients and 40 healthy controls were recruited. In CF patients all echocardiographic parameters were abnormal compared to controls. Doppler analysis showed slightly elevated pulmonary artery pressure values, and abnormal relaxation and systolic function for all indexes. No correlation was found with any of the features studied. CONCLUSIONS In CF patients, abnormalities in the structure and function of the RV may be present at early stages of the disease. These abnormalities are subclinical and do not correlate with clinical scores, PFT, genotype, chronic bacterial colonization or pancreatic insufficiency.
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Affiliation(s)
- Antonio Baño-Rodrigo
- Department of Cardiology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
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221
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Outcome of biventricular repair in infants with multiple left heart obstructive lesions. Pediatr Cardiol 2012; 33:506-12. [PMID: 22159427 DOI: 10.1007/s00246-011-0142-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 11/03/2011] [Indexed: 10/14/2022]
Abstract
The decision to perform biventricular repair for infants with multiple obstructive or hypoplastic left heart lesions (LHL) and borderline left ventricle (LV) may be controversial. This study sought to assess the mortality and morbidity of patients with LHL after biventricular repair and to determine the growth of the left-sided cardiac structures. Retrospective analysis of 39 consecutive infants with LHL who underwent biventricular repair was performed. The median age at surgery was 7 days (range 1-225 days), and the median follow-up period was 34 months (range 1-177 months). Between diagnosis and the end of the follow-up period, the size of the aortic annulus (z-score -4.1 ± 2.8 vs. -0.1 ± 2.7) and the LV (LV end-diastolic diameter z-score -1.7 ± 2.8 vs. 0.21 ± 1.7) normalized. During the follow-up period, 23 patients required 39 reinterventions (62%) consisting of redo surgery for 21 patients (57%) and catheter-guided reinterventions for 8 patients (22%). At the end of the follow-up period, 25 of 34 patients were doing subjectively well; 10 children (29%) received cardiac medication; 12 (35%) presented with failure to thrive (weight ≤ P3) and 5 (15%) with pulmonary hypertension. The overall mortality rate was 13%. Biventricular repair for patients with multiple LHL results in sufficient growth of the left-sided cardiac structures. Nevertheless, residual or newly developing obstructive lesions and pulmonary hypertension are frequent, causing significant morbidity that requires reintervention.
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222
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Abstract
OBJECTIVE To assess the reference values of M-mode echocardiographic measurements in healthy newborns according to body weight. METHODS From January, 2008 to June, 2008, a total of 250 - 130 female and 120 male - term healthy newborns were included in the study. M-mode echocardiographic measurements were recorded by a paediatric cardiologist in accordance with the American Society of Echocardiography recommendations. Right ventricular anterior wall end-diastolic thickness, right ventricular end-diastolic diameter, interventricular septum end-diastolic thickness, left ventricular end-diastolic diameter, left ventricular posterior wall end-diastolic thickness, interventricular septum end-systolic thickness, left ventricular end-systolic diameter, left ventricular posterior wall end-systolic thickness, aortic root dimension, left atrium dimension, left ventricular ejection, and shortening fraction were measured. RESULTS The values of echocardiographic measurements revealed a good correlation with body weight. When body weight increased, the measured values also increased in parallel. The measured values were not influenced by gender. Ejection and shortening fraction parameters did not change with body weight and gender. CONCLUSION In this study, normative values related to body weight for cardiac chambers and wall thickness were determined in healthy newborns. These reference values can be used to evaluate whether newborns have normal or abnormal echocardiographic measurement.
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223
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Cantinotti M, Scalese M, Molinaro S, Murzi B, Passino C. Limitations of Current Echocardiographic Nomograms for Left Ventricular, Valvular, and Arterial Dimensions in Children: A Critical Review. J Am Soc Echocardiogr 2012; 25:142-52. [DOI: 10.1016/j.echo.2011.10.016] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Indexed: 10/15/2022]
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224
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Mertens L, Seri I, Marek J, Arlettaz R, Barker P, McNamara P, Moon-Grady AJ, Coon PD, Noori S, Simpson J, Lai WW. Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: practice guidelines and recommendations for training. Writing Group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC). J Am Soc Echocardiogr 2012; 24:1057-78. [PMID: 21933743 DOI: 10.1016/j.echo.2011.07.014] [Citation(s) in RCA: 236] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Luc Mertens
- The Labatt Family Heart Center, The Hospital for Sick Children, Toronto, Ontario, Canada
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225
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Does reversed apical or basal left ventricular rotation in children with dilated cardiomyopathy recover following medical therapy? A two-dimensional speckle tracking study. Int J Cardiol 2011; 153:330-3. [DOI: 10.1016/j.ijcard.2011.09.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 09/17/2011] [Indexed: 11/21/2022]
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226
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Mertens L, Seri I, Marek J, Arlettaz R, Barker P, McNamara P, Moon-Grady AJ, Coon PD, Noori S, Simpson J, Lai WW. Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: Practice Guidelines and Recommendations for Training: Writing group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC). EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2011; 12:715-36. [PMID: 21998460 DOI: 10.1093/ejechocard/jer181] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Luc Mertens
- The Labatt Family Heart Center, The Hospital for Sick Children, Toronto, Ontario, Canada
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227
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Lopez L, Lai WW. Chamber and Vessel Quantification in Pediatric Echocardiography: What Do the Guidelines Teach Us? CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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228
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Tiosano D, Schwartz Y, Braver Y, Hadash A, Gepstein V, Weisman Y, Lorber A. The renin-angiotensin system, blood pressure, and heart structure in patients with hereditary vitamin D-resistance rickets (HVDRR). J Bone Miner Res 2011; 26:2252-60. [PMID: 21590741 DOI: 10.1002/jbmr.431] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Vitamin D deficiency has been linked to hypertension and an increased prevalence of cardiovascular risk factors and disease. Studies in vitamin D receptor knockout (VDR KO) mice revealed an overstimulated renin-angiotensin system (RAS) and consequent high blood pressure and cardiac hypertrophy. VDR KO mice correspond phenotypically and metabolically to humans with hereditary 1,25-dihydroxyvitamin D-resistant rickets (HVDRR). There are no data on the cardiovascular system in human HVDRR. To better understand the effects of vitamin D on the human cardiovascular system, the RAS, blood pressure levels, and cardiac structures were examined in HVDRR patients. Seventeen patients (9 males, 8 females, aged 6 to 36 years) with hereditary HVDRR were enrolled. The control group included age- and gender-matched healthy subjects. Serum calcium, phosphorous, creatinine, 25-hydroxyvitamin D [25(OH)D],1,25-dihydroxyvitamin D(3) [1,25(OH)(2) D(3) ], parathyroid hormone (PTH), plasma rennin activity (PRA), aldosterone, angiotensin II (AT-II), and angiotensin-converting enzyme (ACE) levels were determined. Ambulatory 24-hour blood pressure measurements and echocardiographic examinations were performed. Serum calcium, phosphorus, and alkaline phosphatase values were normal. Serum 1,25(OH)(2) D(3) and PTH but not PRA and ACE levels were elevated in the HVDRR patients. AT-II levels were higher than normal in the HVDRR patients but not significantly different from those of the controls. Aldosterone levels were normal in all HVDRR patients. No HVDRR patient had hypertension or echocardiographic pathology. These findings reveal that 6- to 36-year-old humans with HVDRR have normal renin and ACE activity, mild but nonsignificant elevation of AT-II, normal aldosterone levels, and no hypertension or gross heart abnormalities.
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Affiliation(s)
- Dov Tiosano
- Division of Pediatric Endocrinology, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
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229
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Bekdache GN, Hamdan MA, Begam MA, Chedid F, Tamim MM, Mirghani H. Prenatal diagnosis of extrahepatic umbilicoportosystemic shunt: impact on postnatal management. J OBSTET GYNAECOL 2011; 31:542-3. [DOI: 10.3109/01443615.2011.580395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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230
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Avelar T, Pauliks LB, Freiberg AS. Clinical impact of the baseline echocardiogram in children with high-risk acute lymphoblastic leukemia. Pediatr Blood Cancer 2011; 57:227-30. [PMID: 21360659 DOI: 10.1002/pbc.23066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 01/10/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND It is common practice to hold anthracycline induction chemotherapy in children with high-risk acute lymphoblastic leukemia (HR-ALL) until an echocardiogram is performed and interpreted. It is unclear whether withholding therapy in HR-ALL children is justified by echocardiogram findings. We reviewed the initial echocardiograms in a cohort of children with HR-ALL to determine the incidence of contraindications for anthracycline treatment. PROCEDURE We identified 50 consecutive children (<21 years old) with HR-ALL presenting at our institution over a 10-year period. One didn't have an initial echocardiogram, 39 had pre-therapy studies, and 10 were studied within 6 days of beginning chemotherapy. These 49 studies were reviewed to determine the incidence and clinical significance of abnormalities. RESULTS All 49 patients had normal cardiac function. Initial echocardiogram findings had no impact on induction chemotherapy administration in any patient. However, only 22(45%) of the studies were completely normal. Echocardiographic abnormalities included pericardial effusion (17/49), trivial or mild mitral or aortic insufficiency (13/49), left ventricular enlargement (3/49), and structural heart disease (4/49). Twelve percent of the children had a patent foramen ovale. None of the cardiac findings required therapeutic intervention other than repositioning of indwelling lines (6/49) due to intracardiac positioning. CONCLUSIONS In our experience, findings on echocardiograms in childhood HR-ALL did not impact anthracycline administration. This study suggests that induction chemotherapy should not be delayed for an echocardiogram. However, whenever possible, a pre-therapy echocardiogram is still recommended for determining baseline function and to identify associated problems like pericardial effusions which were common in this study.
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Affiliation(s)
- Taurino Avelar
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
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231
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Hussain T, Greil GF, Bilska K, Miller OI. Toward defining pulmonary sequestration in infancy using two-dimensional echocardiography and novel high temporal resolution "keyhole" three-dimensional magnetic resonance angiography. CONGENIT HEART DIS 2011; 6:488-91. [PMID: 21801313 DOI: 10.1111/j.1747-0803.2011.00551.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article describes a rare case of pulmonary sequestration presenting in infancy with mixed systemic and pulmonary venous drainage. This case illustrates the clinical application of the high temporal resolution three-dimensional "keyhole" magnetic resonance angiography technique in the neonatal age group to achieve a diagnosis noninvasively. Further insight into the classification of pulmonary sequestration is also given.
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Affiliation(s)
- Tarique Hussain
- Department of Paediatric Cardiology, Evelina Children's Hospital, London, UK.
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232
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Lagedrost SJ, Sutton MSJ, Cohen MS, Satou GM, Kaufman BD, Perlman SL, Rummey C, Meier T, Lynch DR. Idebenone in Friedreich ataxia cardiomyopathy-results from a 6-month phase III study (IONIA). Am Heart J 2011; 161:639-645.e1. [PMID: 21392622 DOI: 10.1016/j.ahj.2010.10.038] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 10/29/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Friedreich ataxia (FRDA) is commonly associated with hypertrophic cardiomyopathy, but little is known about its frequency, severity, or treatment. In this 6-month randomized, double-blind, controlled study, we sought to determine whether idebenone improves cardiac measures in FRDA. METHODS Seventy pediatric subjects were treated either with idebenone (450/900 mg/d or 1,350/2,250 mg/d) or with placebo. Electrocardiograms (ECGs) were assessed at each visit, and echocardiograms, at baseline and week 24. RESULTS We found ECG abnormalities in 90% of the subjects. On echocardiogram, 81.4% of the total cohort had left ventricular (LV) hypertrophy, as measured by increased LV mass index-Dubois, and the mean ejection fraction (EF) was 56.9%. In linear regression models, longer PR intervals at baseline were marginally associated with longer GAA repeat length (P = .011). Similarly, GAA repeat length did not clearly predict baseline EF (P = .086) and LV mass by M-mode (P = .045). Left ventricular mass index, posterior wall thickness, EF, and ECG parameters were not significantly improved by treatment with idebenone. Some changes in echocardiographic parameters during the treatment phase correlated with baseline status but not with treatment group. CONCLUSIONS Idebenone did not decrease LV hypertrophy or improve cardiac function in subjects with FRDA. The present study does not provide evidence of benefit in this cohort over a 6-month treatment period.
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Affiliation(s)
- Sarah J Lagedrost
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA
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233
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Ichikawa R, Sumitomo N, Komori A, Abe Y, Nakamura T, Fukuhara J, Matsumura M, Miyashita M, Kanamaru H, Ayusawa M, Mugishima H. The follow-up evaluation of electrocardiogram and arrhythmias in children with fulminant myocarditis. Circ J 2011; 75:932-8. [PMID: 21343655 DOI: 10.1253/circj.cj-10-0918] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fulminant myocarditis involves various serious arrhythmias that sometimes have lethal consequences. The purpose of the present study was to investigate the electrocardiogram findings, arrhythmogenicity and abnormalities of the cardiac conduction system in children with fulminant myocarditis. METHODS AND RESULTS Between 1999 and 2008, 7 consecutive patients (mean age: 7 years) who suffered from fulminant myocarditis were included in the study. A 12-lead electrocardiogram, Holter monitoring and signal-averaged electrocardiograms were performed and compared between the acute, convalescent, and recovery phases in the 4 surviving patients. Also, electrophysiologic assessment was carried out during the convalescent phase. Five out of 7 patients developed complete atrioventricular block, 3 developed ventricular tachycardia, 2 had cardiac arrest, 2 developed sinus tachycardia, 1 developed ventricular fibrillation, 1 had advanced atrioventricular block, and 1 developed sick sinus syndrome. Among the surviving patients, all arrhythmias resolved during the convalescent and remote phases. No atrial or ventricular arrhythmias were induced in any patients during the programmed stimulation study. In the convalescent phase, no arrhythmias could be induced and there were no signs of any conduction abnormalities on electrophysiological assessment. CONCLUSIONS Close follow-up should be performed to observe for the occurrence of any new arrhythmias and/or a decrease in cardiac function in children with fulminant myocarditis.
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Affiliation(s)
- Rie Ichikawa
- Department of Pediatrics and Child Health, Nihon University, School of Medicine, Tokyo, Japan
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234
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Awori MN, Finucane K, Gentles TL. Optimal Normative Pediatric Cardiac Structure Dimensions for Clinical Use. World J Pediatr Congenit Heart Surg 2010; 2:85-9. [DOI: 10.1177/2150135110386500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiac structure size influences surgical decision making in pediatric cardiac surgery. Lack of universally adopted normative cardiac structure dimensions may confound decision making. A review of the relevant literature contained in 2 large databases was performed with a view to determine the optimal normative cardiac structure dimensions for clinical use. The current article initially discusses technical issues related to cardiac structure measurement and measurement normalization. It then describes the literature search strategy and examines the quality of published data in subjects below 19 years of age. The optimal normative dimension data set is then recommended.
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Affiliation(s)
- Mark N. Awori
- Pediatric and Congenital Cardiac Service, Starship Children’s Hospital, Auckland, New Zealand
| | - Kirsten Finucane
- Pediatric and Congenital Cardiac Service, Starship Children’s Hospital, Auckland, New Zealand
| | - Thomas L. Gentles
- Pediatric and Congenital Cardiac Service, Starship Children’s Hospital, Auckland, New Zealand
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235
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Cuccaro P, Rapacciuolo A, Vitiello R, di Pietro E, Montaldo P, Esposito F, Maresca G, Correra A. Infantile facial haemangioma and subclinical left ventricular dysfunction: the importance of z score in the diagnostic and therapeutic process. J Cardiovasc Med (Hagerstown) 2010; 11:692-4. [DOI: 10.2459/jcm.0b013e328332e861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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236
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Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23:465-95; quiz 576-7. [PMID: 20451803 DOI: 10.1016/j.echo.2010.03.019] [Citation(s) in RCA: 1081] [Impact Index Per Article: 77.2] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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237
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Colombatti R, Maschietto N, Varotto E, Grison A, Grazzina N, Meneghello L, Teso S, Carli M, Milanesi O, Sainati L. Pulmonary hypertension in sickle cell disease children under 10 years of age. Br J Haematol 2010; 150:601-9. [DOI: 10.1111/j.1365-2141.2010.08269.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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238
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Nasseri BA, Alexi-Meskishvili V, Nordmeyer S, Weng YG, Böttcher W, Hübler M, Stamm C, Berger F, Hetzer R. Predictors for the Use of Left Ventricular Assist Devices in Infants With Anomalous Left Coronary Artery From the Pulmonary Artery. Ann Thorac Surg 2010; 90:580-7. [DOI: 10.1016/j.athoracsur.2010.03.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 03/16/2010] [Accepted: 03/18/2010] [Indexed: 10/19/2022]
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239
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Kim HJ, Yoo GH, Kil HR. Clinical outcome of acute myocarditis in children according to treatment modalities. KOREAN JOURNAL OF PEDIATRICS 2010; 53:745-52. [PMID: 21189950 PMCID: PMC3004486 DOI: 10.3345/kjp.2010.53.7.745] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 02/17/2010] [Accepted: 03/17/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE There is currently little evidence to support intravenous immune globulin (IVIG) therapy for pediatric myocarditis. The purpose of our retrospective study was to assess the effects of IVIG therapy in patients with presumed myocarditis on survival and recovery of ventricular function and to determine the factors associated with its poor outcome. METHODS We reviewed all consecutive cases of patients with myocarditis with left ventricular dysfunction verified by echocardiogram who had visited 3 university hospitals between January 2000 and September 2009. These patients were divided into 2 groups. Group 1 consisted of 23 patients (69.6%) who received IVIG alone or IVIG in combination with steroids, and group 2 consisted of 10 patients (30.3%) who received neither IVIG nor other immunosuppressive agents. Clinical manifestations, laboratory results, echocardiographic findings, and outcomes were compared between these 2 groups. RESULTS One year after the initial presentation, the difference in the probability of survival did not show statistical significance in IVIG-treated patients (P=0.607). Of the echocardiographic parameters on admission, a shortening fraction of less than 15% was associated with unremitting cardiac failure. Furthermore, anemic patients were more likely to have elevated N-terminal fragment levels of the B-type natriuretic peptide (NT-proBNP) in the progressed group (P=0.036). CONCLUSION There was no difference between the IVIG-treated patients and the control patients in the degree of recovery of left ventricular function and survival. Prospective, randomized, clinical studies are needed to elucidate the effects of IVIG treatment during the acute stage of myocarditis on ultimate outcomes.
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Affiliation(s)
- Hyun Jung Kim
- Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea
| | - Gyeong-Hee Yoo
- Department of Pediatrics, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Hong Ryang Kil
- Department of Pediatrics, Chungnam University School of Medicine, Daejeon, Korea
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Abstract
PRINCIPLE Mucopolysaccharidosis is an inborn error of metabolism causing glucosaminoglycans tissue storage. Cardiovascular involvement is variable but contributes significantly towards the morbidity and mortality of the patients. OBJECTIVE To characterise the echocardiographic abnormalities in children and adolescents with different types of mucopolysaccharidosis. METHOD Echocardiograms and medical records of 28 patients aged 2-14 years, seen from 2003 to 2005, were revised. At that time, the enzymatic replacement therapy was still not available in our institution. RESULTS Echocardiographic alterations were detected in 26 patients (93%), whereas 16 (57%) had abnormal auscultation, and only 6 (21%) presented with cardiovascular complaint. Mitral valve thickening with dysfunction (regurgitation, stenosis, or double lesion) was diagnosed in 60.8%, left ventricular hypertrophy in 43% and aortic valve thickening with regurgitation in 35.8% of the patients. There was no systolic dysfunction and mild left diastolic dysfunction was shown in 21.5% of the patients. Pulmonary hypertension was present in 36% of the patients, causing the only two deaths recorded. There was a strong association between the accumulation of dermatan sulphate and the presence of mitral valve dysfunction (p = 0.0003), aortic valve dysfunction (p = 0.006), and pulmonary hypertension (p = 0.006). Among individuals with two or more examinations, 82% had a worsening evolution. CONCLUSIONS Echocardiographic alterations in children with Mucopolysaccharidosis are frequent and have a progressive character. Left valve lesions, ventricular hypertrophy, and pulmonary hypertension were the most common findings and there was an association between the accumulation of dermatan sulphate and cardiovascular involvement. Unlike in adults, pulmonary hypertension was the main cause of death, not left ventricle systolic dysfunction.
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241
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Knirsch W, Tlach L, Stambach D, Bauersfeld U. Angiotensin-converting Enzyme Inhibitors in Pediatric Patients with Mitral Valve Regurgitation-Case-control Study and Review of the Literature. CONGENIT HEART DIS 2010; 5:278-84. [DOI: 10.1111/j.1747-0803.2010.00407.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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242
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Serum Levels of Natriuretic Peptides in Children before and after Treatment for an Atrial Septal Defect, a Patent Ductus Arteriosus, and a Coarctation of the Aorta-A Prospective Study. Int J Pediatr 2010; 2010:674575. [PMID: 20445736 PMCID: PMC2859410 DOI: 10.1155/2010/674575] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2009] [Revised: 12/13/2009] [Accepted: 02/08/2010] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives. We evaluated and compared the influence of treatment for atrial septal defect (ASD), patent ductus arteriosus (PDA), and coarctation of the aorta (CoA) on serum levels of N-terminal proatriopeptide and N-terminal probrain natriuretic peptide. Correlations between peptide levels and echocardiographic measurements were calculated. Patients and Methods. Peptide levels were measured and echocardiography performed before and 6-12 months after treatment in 21 children with ASD, 25 with PDA, 15 with CoA, and 76 control children. Results. ANPN levels were higher than in controls at baseline in all patient groups, and NT-proBNP in patients with ASD and PDA. Both peptide levels were elevated 6 months after treatment and decreased thereafter. Peptide levels were higher in patients with volume than pressure overload. They correlated with echocardiographic measurements. At the 6-month follow-up, dimensions of the originally overloaded ventricle had normalized only in patients with PDA. Conclusions. After intervention, peptide levels decrease but normalization takes over 6 months. The type of correlation between peptide levels and echocardiography varies according to the loading condition. Measurement of peptide levels can be used for monitoring the course of a patient's heart disease.
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243
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Gautier M, Detaint D, Fermanian C, Aegerter P, Delorme G, Arnoult F, Milleron O, Raoux F, Stheneur C, Boileau C, Vahanian A, Jondeau G. Nomograms for aortic root diameters in children using two-dimensional echocardiography. Am J Cardiol 2010; 105:888-94. [PMID: 20211339 DOI: 10.1016/j.amjcard.2009.11.040] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 11/06/2009] [Accepted: 11/06/2009] [Indexed: 11/25/2022]
Abstract
The evaluation of aortic root dilation is of major importance for the diagnosis and follow-up of patients with diverse diseases, including the Marfan syndrome. However, we noted that the available nomograms suggested a lower aortic root dilation rate in adults (75%) than in children (90%), when the opposite would have been expected. To establish new nomograms, we selected a population of 353 normal children. We took transthoracic echocardiographic measurements of the aortic root diameters at the level of the aortic annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta according to the American Society of Echocardiography recommendations. All diameters correlated well with the height, weight, body surface area, and age (r = 0.75 to 0.84, p <0.0001). Covariance analysis adjusting for body surface area showed slightly larger diameters at the level of the sinuses of Valsalva in male children than in female children (+1 mm, p = 0.0002). Equations and derived nomograms were developed, giving the upper limit of normal (allowing simple recognition of aortic dilation) and the Z score (allowing fine quantification of dilation and differentiation of normal growth from pathologic dilation) for all 4 aortic root diameters (ie, aortic annulus, sinuses of Valsalva, sinotubular junction, and proximal ascending aorta) according to body surface area and gender. We applied the nomograms to 282 children with confirmed Marfan syndrome, of whom 65.2% presented with dilation of the sinuses of Valsalva. In conclusion, we propose equations to calculate the upper limit of normal and Z-score for aortic root diameters measured by 2-dimensional echocardiography, which should be useful tools for the diagnosis and follow-up of aortic root aneurysms in children.
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244
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Clinical and functional characterisation of rheumatic mitral regurgitation in children and adolescents including the brain natriuretic peptide. Cardiol Young 2010; 20:66-72. [PMID: 20178681 DOI: 10.1017/s1047951109990941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rheumatic fever is a public health problem of universal distribution, predominantly affecting individuals in developing countries. In individuals less than 20 years of age, pure mitral regurgitation is the most commonly found condition in chronic rheumatic valve disease. In the present study, rheumatic mitral regurgitation was assessed in children and adolescents, addressing its clinical (duration of the disease, symptoms, use of benzathine penicillin, and number of outbreaks of the acute phase of rheumatic fever), electrocardiographic (left atrium abnormality and/or left ventricle hypertrophy) and echocardiographic characteristics (left atrium and ventricle measurements, ejection fraction and pulmonary artery pressure), as well as plasma dose of N-terminal portion of the brain natriuretic peptide through electrochemiluminescence immunoassay. Fifty-three patients were studied. The patients had moderate (41.5%) or severe (58.5%) rheumatic mitral regurgitation; had not undergone surgery; were not in the acute phase of the disease; and were being treated at a paediatric cardiology reference hospital in Northeastern Brazil. Mean patient age was 10.6 years (minimum of 3 and maximum of 19 years). With the exception of the ejection fraction, the echocardiographic variables had a significant correlation to the natriuretic peptide, demonstrating that this hormone reflects the haemodynamic consequences of mitral regurgitation. It was concluded that cardiac remodelling that occurs in rheumatic mitral regurgitation in children and adolescents leads to the production of the brain natriuretic peptide, which could be used as a complementary diagnostic tool in the follow-up of such patients.
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245
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Nussinovitch U, Katz U, Nussinovitch M, Blieden L, Nussinovitch N. Echocardiographic abnormalities in familial dysautonomia. Pediatr Cardiol 2009; 30:1068-74. [PMID: 19641840 DOI: 10.1007/s00246-009-9497-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Revised: 05/26/2009] [Accepted: 06/24/2009] [Indexed: 11/28/2022]
Abstract
Sudden death accounts for up to 43% of all deaths in patients with familial dysautonomia (FD). The classic features of FD, namely, autonomic dysfunction, high blood pressure, and blood pressure labiality, are all risk factors for cardiac remodeling and hypertrophy. Myocardial remodeling and hypertrophy are independent risk factors for arrhythmias, cardiovascular events, and sudden death. An extensive review of the medical literature found no documentation of structural heart defects or myocardial remodeling in patients with FD. Sixteen patients with FD underwent physical examination, in-clinic blood pressure measurements, and echocardiographic study. On the basis of the findings, the patients were categorized by left ventricular geometric pattern. Twenty-four-hour ambulatory blood pressure monitoring was recommended to all participants. The majority of FD patients were found to have very high blood pressure values both during in-clinic measurements and during ambulatory blood pressure monitoring. Echocardiographic abnormalities were found in 43.75% of the study group; 18.75% of the study group had concentric hypertrophy, among which severe hypertrophy was found in 2 patients. Unknown previously, cardiac remodeling or hypertrophy is common in FD. We recommend that routine cardiac echocardiography be performed in this population, and attempts to treat high blood pressure should begin earlier in life.
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Affiliation(s)
- Udi Nussinovitch
- Department of Internal Medicine B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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246
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Management of arterial hypertension occurring early after living donor liver transplantation in children: report of three cases and review of the literature. Pediatr Cardiol 2009; 30:1161-5. [PMID: 19680716 DOI: 10.1007/s00246-009-9498-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Accepted: 06/25/2009] [Indexed: 10/20/2022]
Abstract
Three pediatric patients with hypertension occurring early after liver transplantation are reviewed. The patients were all female, and underwent living donor liver transplantation at the age of 9 years, 1 month, and 7 months. The etiology of liver disease was cirrhosis due to biliary atresia in two patients and fulminant hepatitis in one patient. Antihypertensive therapy with calcium channel blocker alone was not effective. Blood pressure was eventually controlled after the administration of a beta-adrenergic blocker in addition to the calcium channel blocker to all patients. No end-organ damage was observed, except that two patients developed temporary left ventricular hypertrophy.
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247
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Sarikouch S, Peters B, Gutberlet M, Leismann B, Kelter-Kloepping A, Koerperich H, Kuehne T, Beerbaum P. Sex-specific pediatric percentiles for ventricular size and mass as reference values for cardiac MRI: assessment by steady-state free-precession and phase-contrast MRI flow. Circ Cardiovasc Imaging 2009; 3:65-76. [PMID: 19820203 DOI: 10.1161/circimaging.109.859074] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cardiac MRI is important in the treatment of children with congenital heart disease, but sufficient normative data are lacking. For ventricular volumes and mass, we sought to deliver reference centiles and to investigate sex effects. METHODS AND RESULTS We included 114 healthy children and adolescents, uniformly distributed spanning an age range of 4 to 20 years, as required by the Lambda-Mu-Sigma method to achieve a percentile distribution, thus avoiding arbitrary age categories. Subjects underwent axial volumetry (1.5-T scanner) using standardized 2D steady-state free-precession and flow protocols. Percentiles were computed for age 8 to 20 years (99 subjects) because breath-holds were more consistent in this group. When indexed for body surface area or height, the centile curves of ventricular volumetric parameters showed allometric increase until adolescence, when a plateau was reached, with values comparable to published adult reference data. In contrast, ventricular mass centiles increased without plateau. There was a significant sex difference, with centiles reflecting larger values in boys than in girls (P<0.05) when ventricular volumes were indexed to body surface area or height but not when indexed to weight (exception: mass). There was excellent agreement of axial and short-axis volumetry and of volumetric and flow-derived stroke volumes. CONCLUSIONS Percentiles for ventricular volumes and mass in healthy children have been established to serve as reference values in pediatric heart disease. Significant sex differences were noted when indexing volumes to body surface area or height. Unisex centiles related to weight may be considered for chamber volumes albeit not for mass.
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Affiliation(s)
- Samir Sarikouch
- Department of Heart, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany.
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Eerola A, Jokinen E, Pihkala JI. Serum levels of natriuretic peptides in children with various types of loading conditions. SCAND CARDIOVASC J 2009; 43:187-93. [DOI: 10.1080/14017430802455841] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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249
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Ragni L, Biagini E, Picchio FM, Prandstraller D, Leone O, Berardini A, Perolo A, Grigioni F, di Diodoro L, Gargiulo G, Arbustini E, Rapezzi C. Heart transplantation in infants with idiopathic hypertrophic cardiomyopathy. Pediatr Transplant 2009; 13:650-3. [PMID: 18992068 DOI: 10.1111/j.1399-3046.2008.01022.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Whereas it is well known that idiopathic HCM can present in newborns and infants, little information is available on HT in this very young age group. We report a series of 17 infants with idiopathic HCM, including two neonates with rapidly progressive severe HF for whom HT was necessary. When HF manifests in a newborn/infant with idiopathic HCM and extreme cavity size reduction, the possibility of a rapidly progressive clinical course should be anticipated and HT may become the only available therapeutic solution.
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Affiliation(s)
- Luca Ragni
- Pediatric Cardiology and Adult Congenital Cardiology Unit, University of Bologna, Bologna, Italy
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Eerola A, Jokinen E, Boldt T, Mattila IP, Pihkala JI. Left ventricular hypertrophy persists after successful treatment for coarctation of the aorta. SCAND CARDIOVASC J 2009; 41:370-7. [PMID: 17852783 DOI: 10.1080/14017430701397839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate cardiac size and function in patients with coarctation of the aorta (CoA) before and after treatment. DESIGN Ventricular size and function were examined by 2- and 3-dimensional echocardiography, and concentrations of natriuretic peptides measured in 15 paediatric patients before repair, and one, 6, and 12 months thereafter. Controls comprised 15 children. RESULTS Before repair, mitral inflow velocities and left ventricular (LV) size and wall thickness were higher in patients. Thicknesses of interventricular septum and LV posterior wall decreased after repair but increased to initial level one year thereafter. The LV end-diastolic diameter remained larger than in controls despite successful repair. The size of right ventricle increased and levels of natriuretic peptides decreased during follow-up. Levels of natriuretic peptides correlated with the smallest diameter of CoA segment and diastolic indices of LV function. CONCLUSION LV hypertrophy persists and LV size remains larger than in controls after successful repair even in normotensive patients with normal growth of CoA segment. This may be due to remodelling of ventricles and the aorta caused by CoA.
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Affiliation(s)
- Anneli Eerola
- Department of Paediatric, University of Kuopio, Kuopio, Finland.
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