HOLTER ECG AND RESPIRATORY CURVE MONITORING IN NEWBORNS WITH CONGENITAL HEART DISEASE: PILOT CASE–CONTROL STUDY

2021 ◽  
Vol 100 (1) ◽  
pp. 8-16
Author(s):  
N.A. Rybalko ◽  
◽  
N.N. Korableva ◽  
N.P. Kotlukova ◽  
L.M. Makarov ◽  
...  
Keyword(s):  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Neonatal Period ◽  
Heart Defects ◽  
Heart Rhythm ◽  
Functional Class ◽  
Arterial Hypoxemia ◽  
Heart Rhythm Disorders

Objective of the research: analysis of 24-hour ECG indicators with the search for heart rhythm disorders in children with congenital heart defects (CHD) during preparation for surgical correction of heart disease; determination of the number of apnea and periodic breathing (PB) episodes in children with CHD based on the daily pneumogram analysis. Materials and methods: 24-hour ECG monitoring with pneumogram (respiratory curve) recording was performed in 37 newborns in the late neonatal period, on the 13th [10; 16] (Me [95% CI]) day of life. Inclusion criteria: uncorrected congenital heart disease complicated by heart failure (HF) of functional class II – III according to R.D. Ross, and/or arterial hypoxemia. The group included patients whose heart disease hemodynamics did not require urgent or emergency cardiac surgery. The study was performed during the planned preparation for surgical treatment in somatic department. In CHD structure combined heart defects prevailed. Two children with tetralogy of Fallot had only arterial hypoxemia. The comparison group included 73 healthy full-term newborns examined in the early neonatal period – on the 2nd [2; 3] (Me [95% CI]) day of life before discharge. Researchers analyzed the heart rate (HR) during sleep and wakefulness, circadian index, heart rate variability (HRV), the frequency of heart rhythm disorders, the number and duration of apnea and PD episodes. Results and discussion: there was a significantly lower number of PD and sleep apnea episodes in newborns with hemodynamically significant CHD; parameters of HRV and heart rate in children with CHD are characterized by a high level of activity of nervous system sympathetic part due to a severe degree of HF and/or arterial hypoxemia; cardiac arrhythmias in newborns with CHD were represented by a rare single extrasystole.

scholarly journals LEVELS OF ESSENTIAL AND CONDITIONALLY ESSENTIAL NUTRIENTS IN THE INTRAOPERATIVE BIOPSY SPECIMENS OF CHILDREN WITH CONGENITAL HEART DISEASE AND HEART RHYTHM DISORDERS

2018 ◽  
Vol 7 (2) ◽  
pp. 112-120 ◽  
Author(s):  
A. V. Dubovaya ◽  
G. E. Sukhareva
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Strong Correlation ◽  
Congenital Heart ◽  
Heart Rhythm ◽  
Mineral Nutrients ◽  
Emission Spectrometry ◽  
Essential Nutrients ◽  
Biopsy Specimens ◽  
Heart Rhythm Disorders

Background. Despite recent numerous studies, etiopathogenesis, treatment and rehabilitation of children with heart rhythm disorders haven’t been studied well. We paid attention to the significant impact of mineral nutrients on cardiac activity, while addressing to the viable solutions. Aim. To measure the levels of essential and conditionally essential mineral nutrients and to determine any relationships between their concentrations in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease and heart rhythm disorders. Methods 55 children (34 boys and 21 girls) aged 6 to 17 years with different heart rhythm disorders and congenital heart disease were included in the study. Levels of 15 essential mineral nutrients (calcium, potassium, magnesium, sodium, phosphorus, sulfur, chromium, copper, iron, iodine, cobalt, manganese, molybdenum, selenium, zinc) and 3 conditionally essential nutrients (boron, silicon, vanadium) were measured in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease using inductively coupled plasma atomic emission spectrometry and electrothermal atomization atomic absorption spectrometry. The results of the study were processed using variational and alternative statistic methods with the commercially available software “MedStat”. Results The lack of essential nutrients (K, Mn, Se, Cr, P, Co, S, Cu, Na, Mo) and conditionally essential mineral, Si, in the intraoperative biopsy specimens of the heart and great arteries has been found. The direct strong correlation between the levels of essential (K, Mn, Se, Cr, Co) and conditionally essential (Si) minerals in hair and heart tissues of children with congenital heart disease and heart rhythm disorders has been determined. Conclusion The deficit of essential (potassium, manganese, selenium, chromium, phosphorus, cobalt, sulfur, copper, sodium, molybdenum) and conditionally essential (silicon) mineral nutrients, and the direct strong correlation between their levels in hair and heart tissues of children with congenital heart disease and heart rhythm disorders allows using hair as a biosubstrate, which is highly informative for the measurement of nutrients in the human body. 

scholarly journals Perinatal cardiology: the present and the future. Part I: congenital heart disease

2019 ◽  
Vol 64 (3) ◽  
pp. 5-10 ◽  
Author(s):  
E. L. Bokerija
Keyword(s):  
Congenital Heart Disease ◽  
Congenital Heart ◽  
Congenital Abnormalities ◽  
Heart Defects ◽  
Heart Rhythm ◽  
Care Level ◽  
Pregnancy And Childbirth ◽  
Existing Problems ◽  
Stage Of Development ◽  
Heart Rhythm Disorders

The article discussesthe currentstate of the care level for fetuses, newborns and children with congenital abnormalities of the cardiovascular system. There are considered the features of prenatal diagnostics of heart defects and aspects of the management of pregnancy and childbirth of women with the specified pathology in the fetus. The authors made the analysis of the existing problems in the diagnosis and treatment of congenital heart defects and heart rhythm disorders in children. The article substantiates the introduction of the perinatal cardiology concept and formulates the main issues to be solved at this stage of development.

scholarly journals Impact of hepatopathy in pediatric patients after surgery for complex congenital heart disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248776
Author(s):  
Torben Kehl ◽  
Daniel Biermann ◽  
Andrea Briem-Richter ◽  
Gerhard Schoen ◽  
Jakob Olfe ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Organ Dysfunction ◽  
Congenital Heart ◽  
Heart Rhythm ◽  
Complex Congenital Heart Disease ◽  
Control Group ◽  
Heart Rhythm Disorders ◽  
The Impact

Patients undergoing complex pediatric cardiac surgery in early infancy are at risk of postoperative secondary end-organ dysfunction. The aim of this study was to determine specific risk factors promoting the development of peri- and postoperative hepatopathy after surgery for congenital heart disease. In this retrospective study, we identified 20 consecutive patients operated between 2011 and 2019 from our institutional cohort who developed significant postsurgical hepatic dysfunction. These patients were compared to a control group of 30 patients with comparable initial cardiac conditions and STS-EACTS risk score. Patients who developed hepatopathy in the intensive care unit have chronic cholestasis and decreased liver synthesis. The impact of postoperative hepatopathy on morbidity was marked. In six patients (30%), liver transplantation was executed as ultima ratio, and two (10%) were listed for liver transplantation. The overall mortality related to postoperative hepatopathy is high: We found nine patients (45%) having severe hepatopathy and mostly multiple organ dysfunction who died in the postoperative course. According to risk analysis, postoperative right and left heart dysfunction in combination with a postoperative anatomical residuum needing a re-operation or re-intervention in the postoperative period is associated with a high risk for the development of cardiac hepatopathy. Furthermore, postoperative complications (pleural effusion, heart rhythm disorders, etc.), postoperative infections, and the need for parenteral nutrition also raise the risk for cardiac hepatopathy. Further investigations are needed to reduce hepatic complications and improve the general prognosis of such complex patients.

scholarly journals Arrhythmias in Patients with Congenital Heart Disease: a Modern View of the Problem

2019 ◽  
pp. 52-56
Author(s):  
O. S. Stychynskyi ◽  
P. O. Almiz ◽  
A. V. Topchii ◽  
M. M. Petkanych ◽  
V. V. Lazoryshynets
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Death ◽  
Congenital Heart ◽  
Heart Defects ◽  
Heart Rhythm ◽  
Surgical Correction ◽  
Current Trends ◽  
Cardioverter Defibrillators

Thanks to the successes of modern cardiac surgery, more and more patients with congenital heart disease (CHD) reach adulthood, with approximately one in four having various heart rhythm disturbances. Their causes are both the CHD themselves and the consequences of surgical or interventional intervention. Arrhythmias in this category of patients worsen the quality of life, lead to serious complications, and can cause sudden cardiac death. The paper summarizes and analyzes current trends and recommendations of the world’s leading specialized communities for the management of patients with congenital heart disease with cardiac arrhythmias. The article reflects approaches to the management and monitoring of this category of patients, including asymptomatic ones. The necessity of early detection of arrhythmia and the involvement of a team of specialists in specialized centers for the development of tactics and treatment after surgical correction is justified. Also discussed are the issues of indications for electrophysiological research and its feasibility, the possibility and effectiveness of catheter destruction, the need for continuous drug therapy, indications for implantation of artificial pacemakers and cardioverter-defibrillators. The paper also reflects the question of various mechanisms of the development of arrhythmia in patients after surgical correction of congenital heart defects, as well as highlighted the possible ways of preventing arrhythmogenesis in patients after surgical correction.

scholarly journals Personalized Genetic Diagnosis of Congenital Heart Defects in Newborns

2021 ◽  
Vol 11 (6) ◽  
pp. 562
Author(s):  
Olga María Diz ◽  
Rocio Toro ◽  
Sergi Cesar ◽  
Olga Gomez ◽  
Georgia Sarquella-Brugada ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart Defects ◽  
Congenital Malformations ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Genetic Diagnosis ◽  
Single Nucleotide Variants ◽  
Personalized Approach

Congenital heart disease is a group of pathologies characterized by structural malformations of the heart or great vessels. These alterations occur during the embryonic period and are the most frequently observed severe congenital malformations, the main cause of neonatal mortality due to malformation, and the second most frequent congenital malformations overall after malformations of the central nervous system. The severity of different types of congenital heart disease varies depending on the combination of associated anatomical defects. The causes of these malformations are usually considered multifactorial, but genetic variants play a key role. Currently, use of high-throughput genetic technologies allows identification of pathogenic aneuploidies, deletions/duplications of large segments, as well as rare single nucleotide variants. The high incidence of congenital heart disease as well as the associated complications makes it necessary to establish a diagnosis as early as possible to adopt the most appropriate measures in a personalized approach. In this review, we provide an exhaustive update of the genetic bases of the most frequent congenital heart diseases as well as other syndromes associated with congenital heart defects, and how genetic data can be translated to clinical practice in a personalized approach.

scholarly journals Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3266
Author(s):  
Laura Willinger ◽  
Leon Brudy ◽  
Renate Oberhoffer-Fritz ◽  
Peter Ewert ◽  
Jan Müller
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Congenital Heart ◽  
Z Score ◽  
Objectively Measured

Background: The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. Methods: In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the “Garmin vivofit jr.” for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. Results: MVPA was not associated with PWV (ß = −0.025, p = 0.446) and cSBP (ß = −0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). Conclusion: In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.

scholarly journals Down syndrome and congenital heart disease: perioperative planning and management

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dennis R. Delany ◽  
Stephanie S. Gaydos ◽  
Deborah A. Romeo ◽  
Heather T. Henderson ◽  
Kristi L. Fogg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Ventricle ◽  
Heart Defects ◽  
Careful Consideration ◽  
Children With Down Syndrome ◽  
Perioperative Planning

AbstractApproximately 50% of newborns with Down syndrome have congenital heart disease. Non-cardiac comorbidities may also be present. Many of the principles and strategies of perioperative evaluation and management for patients with congenital heart disease apply to those with Down syndrome. Nevertheless, careful planning for cardiac surgery is required, evaluating for both cardiac and noncardiac disease, with careful consideration of the risk for pulmonary hypertension. In this manuscript, for children with Down syndrome and hemodynamically significant congenital heart disease, we will summarize the epidemiology of heart defects that warrant intervention. We will review perioperative planning for this unique population, including anesthetic considerations, common postoperative issues, nutritional strategies, and discharge planning. Special considerations for single ventricle palliation and heart transplantation evaluation will also be discussed. Overall, the risk of mortality with cardiac surgery in pediatric patients with Down syndrome is no more than the general population, except for those with functional single ventricle heart defects. Underlying comorbidities may contribute to postoperative complications and increased length of stay. A strong understanding of cardiac and non-cardiac considerations in children with Down syndrome will help clinicians optimize perioperative care and long-term outcomes.

scholarly journals Prevalence and profile of congenital heart disease and pulmonary hypertension in Down syndrome in a pediatric cardiology service

2014 ◽  
Vol 32 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Felipe Alves Mourato ◽  
Lúcia Roberta R. Villachan ◽  
Sandra da Silva Mattos
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Descriptive Analysis ◽  
Atrioventricular Septal Defect

OBJECTIVE:To determine the frequence and profile of congenital heart defects in Down syndrome patients referred to a pediatric cardiologic center, considering the age of referral, gender, type of heart disease diagnosed by transthoracic echocardiography and its association with pulmonary hypertension at the initial diagnosis.METHODS:Cross-sectional study with retrospective data collection of 138 patients with Down syndrome from a total of 17,873 records. Descriptive analysis of the data was performed, using Epi-Info version 7.RESULTS: Among the 138 patients with Down syndrome, females prevailed (56.1%) and 112 (81.2%) were diagnosed with congenital heart disease. The most common lesion was ostium secundum atrial septal defect, present in 51.8%, followed by atrioventricular septal defect, in 46.4%. Ventricular septal defects were present in 27.7%, while tetralogy of Fallot represented 6.3% of the cases. Other cardiac malformations corresponded to 12.5%. Pulmonary hypertension was associated with 37.5% of the heart diseases. Only 35.5% of the patients were referred before six months of age.CONCLUSIONS: The low percentage of referral until six months of age highlights the need for a better tracking of patients with Down syndrome in the context of congenital heart disease, due to the high frequency and progression of pulmonary hypertension.

scholarly journals Discontinuity of Cardiac Follow‐Up in Young People With Congenital Heart Disease Transitioning to Adulthood: A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Philip Moons ◽  
Sandra Skogby ◽  
Ewa‐Lena Bratt ◽  
Liesl Zühlke ◽  
Ariane Marelli ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Transition Programs ◽  
The United States

Background The majority of people born with congenital heart disease require lifelong cardiac follow‐up. However, discontinuity of care is a recognized problem and appears to increase around the transition to adulthood. We performed a systematic review and meta‐analysis to estimate the proportion of adolescents and emerging adults with congenital heart disease discontinuing cardiac follow‐up. In pooled data, we investigated regional differences, disparities by disease complexity, and the impact of transition programs on the discontinuity of care. Methods and Results Searches were performed in PubMed, Embase, Cinahl, and Web of Science. We identified 17 studies, which enrolled 6847 patients. A random effects meta‐analysis of single proportions was performed according to the DerSimonian‐Laird method. Moderator effects were computed to explore sources for heterogeneity. Discontinuity proportions ranged from 3.6% to 62.7%, with a pooled estimated proportion of 26.1% (95% CI, 19.2%–34.6%). A trend toward more discontinuity was observed in simple heart defects (33.7%; 95% CI, 15.6%–58.3%), compared with moderate (25.7%; 95% CI, 15.2%–40.1%) or complex congenital heart disease (22.3%; 95% CI, 16.5%–29.4%) ( P =0.2372). Studies from the United States (34.0%; 95% CI, 24.3%–45.4%), Canada (25.7%; 95% CI, 17.0%–36.7%), and Europe (6.5%; 95% CI, 5.3%–7.9%) differed significantly ( P =0.0004). Transition programs were shown to have the potential to reduce discontinuity of care (12.7%; 95% CI, 2.8%–42.3%) compared with usual care (36.2%; 95% CI, 22.8%–52.2%) ( P =0.1119). Conclusions This meta‐analysis showed that there is a high proportion of discontinuity of care in young people with congenital heart disease. The highest discontinuity proportions were observed in studies from the United States and in patients with simple heart defects. It is suggested that transition programs have a protective effect. Registration URL: www.crd.york.ac.uk/prospero . Unique identifier: CRD42020182413.

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