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New Insights in Pediatric Cardiology

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (4 April 2023) | Viewed by 32059

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Special Issue Editor

Prof. Dr. Bożena Werner

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Guest Editor

Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
Interests: pediatric cardiology; cardiac imaging modalities; hypertension in children; prevention of heart disease in childhood

Special Issue Information

Dear Colleagues,

In recent years, huge progress has been made in the diagnosis and management of heart disease in children.

Currently, modern pediatric cardiology combines the full scope of diagnostic methods, including genetic testing, laboratory testing, echocardiographic imaging using novel techniques and the innovative imaging of computed tomography and cardiac magnetic resonance; pharmacological, interventional and cardiosurgical treatment of congenital heart defects; pharmacological and invasive treatment of arrhythmias and heart failure.

The diagnostic process starts as early as fetal life and the detection of prenatally diagnosed congenital heart disease has significantly increased. Occasionally, invasive treatment procedures are performed in utero.

Several cardiac imaging modalities are now widely available and are considered a part of standard procedures. Echocardiography provides an accurate information regarding cardiac anatomy and function, and speckle tracking captures tissue deformation at the very early, subclinical stage. Computed tomography is especially valuable in the visualization of the exact morphological details of heart defects and cardiac magnetic resonance allows for the characterization of tissue properties. The integration of image data from different modalities to create 3-D printed models enhances the understanding of cardiovascular pathologies and helps to plan surgical treatment in complex congenital cardiac defects.

Pioneer molecular studies allow for the explanation of the genetic basis of many cardiac diseases, including life-threatening arrhythmia syndromes and heritable cardiomyopathies. The use of cardiac biomarkers enables the evaluation of cardiac status in children with both asymptomatic and symptomatic ventricular dysfunction.

A milestone in the treatment of heart defects was the introduction of percutaneous interventional cardiology procedures which complement or even replace cardiac surgery. The non-operative treatment of congenital heart defects has made enormous progress in the last decade.

A turning point in the treatment of cardiac arrhythmias was the introduction of electrophysiological mapping techniques and radiofrequency catheter ablation procedures, which can eliminate rhythm disturbances.

The recent availability of pediatric ventricular assist devices and ECMO has greatly improved the ability to rescue children in life-threatening conditions.

These advancements play a significant role in the increased survival of children with cardiac diseases to adulthood.

Therefore, research focused on the new achievements in pediatric cardiology is welcome, including original research papers, reviews, short communications, and comprehensive case reports.

Prof. Dr. Bożena Werner
Guest Editor

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 papers will be 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, short communications as well as comprehensive case reports 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.

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Keywords

Genetic testing
Cardiac biomarkers
Heart rate variability
Cardiac imaging
Congenital heart defects
Arrhythmia
Heart failure
Cardiac tumors
Interventional cardiology
Telemedicine

Published Papers (6 papers)

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Research

Jump to: Review

12 pages, 360 KiB

Open AccessArticle

by Agnieszka Trawicka, Aleksandra Lewandowska-Walter, Mikołaj Majkowicz, Robert Sabiniewicz and Lidia Woźniak-Mielczarek

Int. J. Environ. Res. Public Health 2022, 19(11), 6827; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19116827 - 02 Jun 2022

Cited by 2 | Viewed by 1886

Abstract

Background: Despite extensive knowledge about the quality of life of people suffering from rare diseases, data on patients with Marfan syndrome (MFS) are scarce and inconsistent. Hence, the problem of assessing the quality of life (QOL) and its relationship with the assessment of which ailments are the most burdensome for these patients is still open. Aim: Comparison of the quality of life of patients with MFS and determination as to which of the reported complaints in patients with MFS are related to the QOL of patients. Methods: The study included 35 patients with MFS and 35 healthy controls, matched for gender and age. In the study, the questionnaire of quality of life assessment SF-36 was used to assess the level of health-related quality of life, as well as an interview of the most severe symptoms reported by patients with MFS. Results: The level of the physical dimension of the QOL (p < 0.001) and limiting of roles due to physical health (p = 0.002), as well as the level of general index of the QOL (p < 0.001), were statistically significantly lower in MFS patients when compared to controls. People from both studied groups do not vary in the scope of pain, vitality, social functioning, limiting the roles due to emotional problems, and state of mind but also in the mental dimension of the health-related quality of life (HRQL). Additionally, there has been a correlation between HRQL and the subjective assessment of the effects of orthopedic, ophthalmic, and cardiological problems in life, as well as lower exercise tolerance in the evaluation of people with MFS and QOL in most areas. Conclusions: Patients with MFS present a reduced QOL in the areas of physical functioning, limiting roles due to physical health, general feeling of general health, the physical dimension of the HRQL, and the general index of the QOL; in these areas, they require careful evaluation, as well as medical and psychosocial assistance. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

13 pages, 663 KiB

Open AccessArticle

The Impact of Physical Activity Restrictions on Health-Related Fitness in Children with Congenital Heart Disease

by Joel Blanchard, Brian W. McCrindle and Patricia E. Longmuir

Int. J. Environ. Res. Public Health 2022, 19(8), 4426; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084426 - 07 Apr 2022

Cited by 2 | Viewed by 1996

Abstract

Children with congenital heart disease (CHD) are often restricted from some types of physical activity (PA) despite the lack of evidence regarding the need to restrict recreational PA, apart from those with rhythm disorders. This study retrospectively investigated the associations between parent-reported activity restrictions (on-going need to restrict exertion, body contact or competition) and measures of health-related fitness among 236 children (8.2 ± 2.1 years, range 4–12 years) treated for single ventricle (n = 104), tetralogy of Fallot (n = 48), transposition of the great arteries (n = 47) or atrial septal defect (n = 37). Body mass index (BMI), moderate-to-vigorous physical activity (MVPA; 7 day accelerometry), strength, flexibility, and movement skill assessment results were collected from the baseline assessment research records for two studies completed in Ontario, Canada. A subset of 62 children also had physician-reported activity restrictions. Regression models empirically tested the goodness of fit between the dependent and independent variables. Participants with body contact restrictions from both parents and physicians had significantly higher BMI z-scores (0.23 ± 1.19 vs. −0.32 ± 0.85; t = 2.55; p = 0.04 and 0.66 ± 1.33 vs. −0.02 ± 0.98; t = 2.25; p = 0.02 for CDC and WHO scores, respectively). Otherwise, BMI z-score was not associated with patient variables (p > 0.36; sex, cardiac diagnosis, age, or activity restriction). Children with any type of parent-reported restriction (0.98 ± 2.06 vs. −0.08 ± 1.99; t = 3.77; p = 0.0002) were less flexible. Movement skill (TGMD-2) scores were 50% lower (25.1 ± 31.2 vs. 52.6 ± 28.6; F = 6.93; p = 0.009) among children with parent-reported competitive sport restrictions. Weekly MVPA (p > 0.18) and strength (p > 0.05) were not associated with activity restriction. Children whose parents reported PA restrictions were less flexible, and had decreased movement skill and increased BMI z-scores if the restrictions impacted competitive sport or body contact, respectively. Future research is recommended to confirm these results among larger samples of children who have both parent- and physician-specified PA restrictions. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

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13 pages, 1339 KiB

Open AccessArticle

How to Distinguish Marfan Syndrome from Marfanoid Habitus in a Physical Examination—Comparison of External Features in Patients with Marfan Syndrome and Marfanoid Habitus

by Lidia Wozniak-Mielczarek, Michalina Osowicka, Alicja Radtke-Lysek, Magda Drezek-Nojowicz, Natasza Gilis-Malinowska, Anna Sabiniewicz, Maksymilian Mielczarek and Robert Sabiniewicz

Int. J. Environ. Res. Public Health 2022, 19(2), 772; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020772 - 11 Jan 2022

Cited by 8 | Viewed by 17080

Abstract

Marfan Syndrome (MFS) is a systemic disorder caused by mutations in fibrillin-1. The most common cause of mortality in MFS is dissection and rupture of the aorta. Due to a highly variable and age-dependent clinical spectrum, the diagnosis of MFS still remains sophisticated. The aim of the study was to determine if there exist phenotypic features that can play the role of “red flags” in cases of MFS suspicion. The study population included 306 patients (199 children and 107 adults) who were referred to the Department of Pediatric Cardiology due to suspicion of MFS. All patients underwent complete clinical evaluation in order to confirm the diagnosis of MFS according to the modified Ghent criteria. MFS was diagnosed in 109 patients and marfanoid habitus in 168 patients. The study excluded 29 patients with other hereditary thoracic aneurysm syndromes. Comparative analysis between patients with Marfan syndrome and marfanoid habitus was performed. Symptoms with high prevalence and high positive likelihood ratio were identified (pectus carinatum, reduced elbow extension, hindfoot deformity, gothic palate, downslanting palpebral fissures, lens subluxation, myopia ≥ 3 dioptres remarkably high stature). The differentiation between patients with MFS and marfanoid body habitus is not possible by only assessing external body features; however, “red flags” could be helpful in the screening phase. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

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7 pages, 301 KiB

Open AccessArticle

Anthropometric Determinants of Respiratory Sinus Arrhythmia in Children

by Paulina Lubocka, Robert Sabiniewicz, Klaudia Suligowska and Tomasz Zdrojewski

Int. J. Environ. Res. Public Health 2022, 19(1), 566; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010566 - 05 Jan 2022

Cited by 1 | Viewed by 1479

Abstract

Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = −0.52 for pvRSA and r = −0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

11 pages, 1146 KiB

Open AccessArticle

Evaluation of Galectin-3 Plasma Concentration in Adolescents with Ventricular Arrhythmia

by Radosław Pietrzak, Tomasz M. Książczyk, Elżbieta Górska, Łukasz A. Małek and Bożena Werner

Int. J. Environ. Res. Public Health 2021, 18(5), 2410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052410 - 02 Mar 2021

Cited by 2 | Viewed by 1688

Abstract

Galectin-3 (G3) is a biomarker known as an inflammatory state exponent. The aim of this paper was to analyze the G3 in adolescents with ventricular arrhythmia (VES) in order to evaluate its impact on myocardial tissue preservation. The study group (SG) consisted of 25 VES adolescents. The control group (CG) was 21 healthy children. G3 was assessed in the SG and CG. In the SG electrocardiography, Holter monitoring, echocardiography and CMR were performed. The G3 in SG was 13.45 ± 11.4 ng/mL and in CG 7.2 ± 2.0 ng/mL, p < 0.001. Moderate positive correlation between the G3 and z-score of the left ventricular diameter (r = 0.47, p = 0.041) and moderate negative correlation between the G3 and the left ventricular ejection fraction in cardiac magnetic resonance (CMR EF) (−0.49, p = 0.032) were found. According to the multiple linear regression analysis, CMR EF and VES were independent predictors for G3 elevation. Conclusion: Galectin-3 plasma concentration is elevated and correlates with the chosen left ventricular dysfunction parameters in adolescents suffering from ventricular arrhythmia. Further investigation is necessary to establish if elevated G3 is a useful biomarker for screening young individuals with ventricular arrhythmia who are at risk of structural cardiovascular pathology. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

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Review

Jump to: Research

38 pages, 7114 KiB

Open AccessReview

The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals—Cross-Sectional Multispecialty Review

by Jarosław Meyer-Szary, Marlon Souza Luis, Szymon Mikulski, Agastya Patel, Finn Schulz, Dmitry Tretiakow, Justyna Fercho, Kinga Jaguszewska, Mikołaj Frankiewicz, Ewa Pawłowska, Radosław Targoński, Łukasz Szarpak, Katarzyna Dądela, Robert Sabiniewicz and Joanna Kwiatkowska

Int. J. Environ. Res. Public Health 2022, 19(6), 3331; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063331 - 11 Mar 2022

Cited by 51 | Viewed by 6443

Abstract

Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative. Full article

(This article belongs to the Special Issue New Insights in Pediatric Cardiology)

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