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Children
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Frontiers in Pediatric Cardiac Imaging
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Frontiers in Pediatric Cardiac Imaging

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Cardiology".

Deadline for manuscript submissions: closed (10 July 2022) | Viewed by 8784

Special Issue Editors

Dr. Joshua D. Robinson

E-Mail Website
Guest Editor
1. Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
2. Pediatrics & Radiology, Northwestern University Feinberg School of Medicine, Evanston, IL 60208, USA
Interests: cardiovascular imaging; congenital heart disease; pediatric cardiology; radiology; CAT scan; medical imaging; telemedicine
Dr. Joyce T. Johnson

E-Mail Website
Guest Editor
Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701, USA
Interests: cardiovascular imaging; congenital heart disease; fetal cardiology; pediatric cardiology; outcomes and cost

Special Issue Information

Dear Colleagues,

Congenital heart disease (CHD) is common and costly and carries a high risk of a need for reintervention over time. With increasing survival, the care of patients with CHD requires frequent, lifelong surveillance, and better outcome predictors are needed. Multimodality imaging is critical for gaining new insights into the mechanisms of disease progression, reducing the need for costly invasive procedures and improving patient outcomes.

Recent technological advances in cardiac imaging have revolutionized the care of patients with congenital and acquired pediatric heart disease and are driven by the many demands of imaging patients across the age spectrum. From advances in echocardiography to novel techniques in cardiac MRI and CTA, the impacts are far reaching and extend across care settings and stages of disease, from fetal life to adulthood.

In this Special Issue, we aim to highlight and review the most comprehensive and cutting-edge imaging techniques and innovations that are advancing care for patients with CHD. Some suggested keywords and topics are listed below but are, by no means, exhaustive; all submissions related to advanced cardiac imaging are encouraged.

Dr. Joshua D. Robinson
Dr. Joyce T. Johnson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • congenital heart disease
  • echocardiography
  • magnetic resonance imaging
  • computed tomography
  • technological innovation

Published Papers (5 papers)

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Research

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13 pages, 3324 KiB  
Article
Cardiac Magnetic Resonance Strain in Beta Thalassemia Major Correlates with Cardiac Iron Overload
by Deidra Ansah, Nazia Husain, Alexander Ruh, Haben Berhane, Anthony Smith, Alexis Thompson, Andrew De Freitas, Cynthia K. Rigsby and Joshua D. Robinson
Children 2023, 10(2), 271; https://0-doi-org.brum.beds.ac.uk/10.3390/children10020271 - 31 Jan 2023
Cited by 1 | Viewed by 1286
Abstract
Background: Beta thalassemia major (Beta-TM) is an inherited condition which presents at around two years of life. Patients with Beta-;TM may develop cardiac iron toxicity secondary to transfusion dependence. Cardiovascular magnetic resonance (CMR) T2*, a technique designed to quantify myocardial iron deposition, is [...] Read more.
Background: Beta thalassemia major (Beta-TM) is an inherited condition which presents at around two years of life. Patients with Beta-;TM may develop cardiac iron toxicity secondary to transfusion dependence. Cardiovascular magnetic resonance (CMR) T2*, a technique designed to quantify myocardial iron deposition, is a driving component of disease management. A decreased T2* value represents increasing cardiac iron overload. The clinical manifestation is a decline in ejection fraction (EF). However, there may be early subclinical changes in cardiac function that are not detected by changes in EF. CMR-derived strain assesses myocardial dysfunction prior to decline in EF. Our primary aim was to assess the correlation between CMR strain and T2* in the Beta-TM population. Methods: Circumferential and longitudinal strain was analyzed. Pearson’s correlation was calculated for T2* values and strain in the Beta-TM population. Results: We identified 49 patients and 18 controls. Patients with severe disease (low T2*) were found to have decreased global circumferential strain (GCS) in comparison to other T2* groups. A correlation was identified between GCS and T2* (r = 0.5; p < 0.01). Conclusion: CMR-derived strain can be a clinically useful tool to predict early myocardial dysfunction in Beta-TM. Full article
(This article belongs to the Special Issue Frontiers in Pediatric Cardiac Imaging)
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11 pages, 1867 KiB  
Article
Left Atrial Dysfunction in Children with Repaired Pulmonary Artery Atresia with Ventricular Septal Defect: A Cardiovascular Magnetic Resonance Imaging Study
by Yanyan Ma, Liwei Hu, Qian Wang, Aimin Sun, Rongzhen Ouyang, Jinglei Wang, Hao Zhang, Haibo Zhang, Chen Guo and Yumin Zhong
Children 2022, 9(10), 1536; https://0-doi-org.brum.beds.ac.uk/10.3390/children9101536 - 08 Oct 2022
Cited by 2 | Viewed by 1203
Abstract
(1) Background: The left atrium (LA) is much more than a reservoir for left ventricular filling. The aim of this study was to assess the LA volume and function in patients with repaired pulmonary artery atresia with ventricular septal defect (rPA/VSD) using CMR. [...] Read more.
(1) Background: The left atrium (LA) is much more than a reservoir for left ventricular filling. The aim of this study was to assess the LA volume and function in patients with repaired pulmonary artery atresia with ventricular septal defect (rPA/VSD) using CMR. (2) Methods: 31 pediatric patients with rPA/VSD and 30 healthy controls were prospectively recruited. Left atrial ejection fraction (EF), strain and strain rate of three phases (reservoir, conduit, and pump) and left atrial volume were measured with cardiac function analysis software. (3) Results: Patients with rPA/VSD had decreased maximal volume index (p = 0.008). Compared to controls, LA reservoir strain and strain rate, conduit strain and strain rate, booster pump strain rate, total EF and passive EF were significantly lower (p = 0.001, p < 0.001, p = 0.001, p = 0.02, p = 0.03, p < 0.001, p < 0.001); the patients with preserved but lower RVEF(<50%) had lower reservoir strain, reservoir strain rate and pump strain rate (p = 0.01, p = 0.02, p = 0.04, respectively) than the patients with higher RVEF (≥50%). (4) Conclusions: In patients with rPA/VSD, LA function was altered when biventricular EF was preserved, which may provide an early indication of left ventricular diastolic dysfunction. CMR can detect LA dysfunction at an early stage, even before LA enlargement. Full article
(This article belongs to the Special Issue Frontiers in Pediatric Cardiac Imaging)
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9 pages, 712 KiB  
Article
Clinical Question Influence on Radiation Dose of Cardiac CT Scan in Children
by Theodor Adla, Martin Kočí, Vojtěch Suchánek, Zuzana Šalagovičová, Michal Polovinčák, Lukáš Mikšík, Jan Janoušek and Miloslav Roček
Children 2022, 9(8), 1172; https://0-doi-org.brum.beds.ac.uk/10.3390/children9081172 - 05 Aug 2022
Viewed by 1122
Abstract
Background: To assess the impact of different clinical questions on radiation doses acquired during cardiac computed tomography in children. Methods: A total of 116 children who underwent cardiac CT on a third-generation dual-source CT scanner were included. The clinical questions were divided into [...] Read more.
Background: To assess the impact of different clinical questions on radiation doses acquired during cardiac computed tomography in children. Methods: A total of 116 children who underwent cardiac CT on a third-generation dual-source CT scanner were included. The clinical questions were divided into three main categories: the extent of scanning in the z-axis, coronary artery assessment and cardiac function assessment. Radiation dose values represented as a dose-length product (DLP) in mGy*cm were recorded from the CT scanner protocols. Results: There were significantly higher doses in cases with cardiac function assessment (median DLP 348 versus 59 mGy*cm, p < 0.01) and in cases with coronary artery assessment (median DLP 133 versus 71 mGy*cm, p < 0.01). Conclusion: The most important factor was the assessment of cardiac function, where the median radiation dose was 4.3× higher in patients with a request for cardiac function assessment. We strongly recommend that clinical requests for cardiac CT should be carefully considered in the paediatric population. Full article
(This article belongs to the Special Issue Frontiers in Pediatric Cardiac Imaging)
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Review

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15 pages, 4198 KiB  
Review
Utility of Fetal Echocardiography with Acute Maternal Hyperoxygenation Testing in Assessment of Complex Congenital Heart Defects
by Sheetal R. Patel, Nitin Madan, Pei-Ni Jone and Mary T. Donofrio
Children 2023, 10(2), 281; https://0-doi-org.brum.beds.ac.uk/10.3390/children10020281 - 31 Jan 2023
Cited by 2 | Viewed by 2400
Abstract
Fetal echocardiography is an excellent tool for accurately assessing the anatomy and physiology of most congenital heart defects (CHDs). Knowledge gathered from a thorough initial fetal echocardiogram and serial assessment assists with appropriate perinatal care planning, resulting in improved postnatal outcomes. However, fetal [...] Read more.
Fetal echocardiography is an excellent tool for accurately assessing the anatomy and physiology of most congenital heart defects (CHDs). Knowledge gathered from a thorough initial fetal echocardiogram and serial assessment assists with appropriate perinatal care planning, resulting in improved postnatal outcomes. However, fetal echocardiography alone provides limited information about the status of the pulmonary vasculature, which can be abnormal in certain complex CHDs with obstructed pulmonary venous flow (hypoplastic left heart syndrome with restrictive atrial septum) or excessive pulmonary artery flow (d-transposition of the great arteries, usually with a restrictive ductus arteriosus). Fetuses with these CHDs are at high risk of developing severe hemodynamic instability with the immediate transition from prenatal to postnatal circulatory physiology at the time of birth. Adjunctive use of acute maternal hyperoxygenation (MH) testing in such cases can help determine pulmonary vascular reactivity in prenatal life and better predict the likelihood of postnatal compromise and the need for emergent intervention. This comprehensive review discusses the findings of studies describing acute MH testing in a diverse spectrum of CHDs and congenital diagnoses with pulmonary hypoplasia. We review historical perspectives, safety profile, commonly used clinical protocols, limitations, and future directions of acute MH testing. We also provide practical tips on setting up MH testing in a fetal echocardiography laboratory. Full article
(This article belongs to the Special Issue Frontiers in Pediatric Cardiac Imaging)
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19 pages, 3427 KiB  
Review
Ferumoxytol-Enhanced Cardiac Magnetic Resonance Angiography and 4D Flow: Safety and Utility in Pediatric and Adult Congenital Heart Disease
by Pierangelo Renella, Jennifer Li, Ashley E. Prosper, J. Paul Finn and Kim-Lien Nguyen
Children 2022, 9(12), 1810; https://0-doi-org.brum.beds.ac.uk/10.3390/children9121810 - 24 Nov 2022
Cited by 2 | Viewed by 1967
Abstract
Cardiac magnetic resonance imaging and angiography have a crucial role in the diagnostic evaluation and follow up of pediatric and adult patients with congenital heart disease. Although much of the information required of advanced imaging studies can be provided by standard gadolinium-enhanced magnetic [...] Read more.
Cardiac magnetic resonance imaging and angiography have a crucial role in the diagnostic evaluation and follow up of pediatric and adult patients with congenital heart disease. Although much of the information required of advanced imaging studies can be provided by standard gadolinium-enhanced magnetic resonance imaging, the limitations of precise bolus timing, long scan duration, complex imaging protocols, and the need to image small structures limit more widespread use of this modality. Recent experience with off-label diagnostic use of ferumoxytol has helped to mitigate some of these barriers. Approved by the U.S. FDA for intravenous treatment of anemia, ferumoxytol is an ultrasmall superparamagnetic iron oxide nanoparticle that has a long blood pool residence time and high relaxivity. Once metabolized by macrophages, the iron core is incorporated into the reticuloendothelial system. In this work, we aim to summarize the evolution of ferumoxytol-enhanced cardiovascular magnetic resonance imaging and angiography and highlight its many applications for congenital heart disease. Full article
(This article belongs to the Special Issue Frontiers in Pediatric Cardiac Imaging)
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