Congenital heart disease and the cost of mortality

Multiscale cardiac imaging spanning the whole heart and its internal cellular architecture in a small animal model

Cardiac pumping depends on the morphological structure of the heart, but also on its subcellular (ultrastructural) architecture, which enables cardiac contraction. In cases of congenital heart defects, localized ultrastructural disruptions that increase the risk of heart failure are only starting to be discovered. This is in part due to a lack of technologies that can image the three-dimensional (3D) heart structure, to assess malformations; and its ultrastructure, to assess organelle disruptions. We present here a multiscale, correlative imaging procedure that achieves high-resolution images of the whole heart, using 3D micro-computed tomography (micro-CT); and its ultrastructure, using 3D scanning electron microscopy (SEM). In a small animal model (chicken embryo), we achieved uniform fixation and staining of the whole heart, without losing ultrastructural preservation on the same sample, enabling correlative multiscale imaging. Our approach enables multiscale studies in models of congenital heart disease and beyond.

Cyanotic congenital heart diseases among Nigerian children

BACKGROUND

There are only few reports on cyanotic congenital heart diseases (CCHD) among Nigerian and African Children. The current report aim to provide the most recent hospital based data on the distribution of CCHD in children less than 14 years of age, the demographic characteristics and risk factors identified.

METHODS

Prospective and cross-sectional involving consecutive cases of CCHD diagnosed with echocardiography at the Lagos State University Teaching Hospital between January 2007 and June 2016. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Level of significance set at P<0.05.

RESULTS

There were 352 subjects with CCHD with a male to female ratio of 1.34:1. The children were age 2 days to 14 years with a mean ± SD of 38.62±44.74 months and median of 21 months. The most common type of CCHD (both isolated and multiple CCHD) was tetralogy of Fallot (TOF) followed double outlet right ventricle (DORV) and transposition of the great arteries (TGA). The most common mode of presentation was cyanosis.

CONCLUSIONS

TOF was found in almost half of the subjects. Cases of DORV which have been rarely reported were more than those with TGA. Most were diagnosed late. Cyanosis was the most common mode of presentation. Clinical features are protean; thus a high index of suspicion is required to make an early diagnosis.