Congenital Heart
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2021 ◽  
Yannan Liu ◽  
Dongjie Hu ◽  
Chunfang Dai ◽  
Dan Wang ◽  
Song Weihong

Abstract Background: Patients with Down’s syndrome (DS) often have an increased rate of infections, hypertension, objectivity and gastrointestinal disorders, which are the most common abnormalities and have a significant impact on their daily life. The gut microbiota plays an important role in maintaining gut homeostasis and improving immunity and has been linked to the development of obesity, hypertension, and colon cancer. However, there are few studies on the intestinal flora and the mother's reproductive tract flora of children with DS in childhood. Therefore, 16S sequencing technology was used to analyze and explore the intestinal flora of children with DS and CHD patients in DS and the microbial abundance and diversity composition in the mother's reproductive tract. Results: We found that the gut microbiota in children with DS was mainly composed of Escherichia, Bifidobacterium, Clostridium and Bacteroides, which have significant differences in the abundance and diversity of intestinal flora compared with healthy children, and the abundance of Enterococcus and Erysipelatoclostridium in the intestine of children with CHD was significantly higher than that of children without CHD, and the relative abundance of Lactobacillus in the reproductive tract of mothers with DS was significantly higher than that of mothers with healthy children, which may suggest potential ways of using microbiome composition for prognosis and diagnosis. Through functional analysis, it was found that Down’s syndrome patients significantly downregulated immune system and their cell growth and nucleotide metabolism were lower than those of healthy children.Conclusion: We performed 16S rRNA gene sequencing on fecal samples from 60 children and vaginal swab samples from 63 mothers to identify a number of potentially important taxonomic, functional and microbiomes associated with congenital heart disease and Down’s syndrome. Structural changes and its correlation with the mother’s vaginal flora. Our analysis shows that the ecosystem associated with childhood congenital heart disease affects the selection of bacterial communities in the native microbiota, and we focus on specific bacteria and their relevance to disease.

PLoS Genetics ◽  
2021 ◽  
Vol 17 (9) ◽  
pp. e1009809
Enrique Audain ◽  
Anna Wilsdon ◽  
Jeroen Breckpot ◽  
Jose M. G. Izarzugaza ◽  
Tomas W. Fitzgerald ◽  

2021 ◽  
Gökhan Alıcı ◽  
Ömer Genç

Abstract Background: To investigate the frequencies and patterns of cardiovascular diseases (CVD), including rheumatic and congenital heart diseases, assessed by echocardiographic examinations in the only referral tertiary care hospital in Mogadishu, the capital of Somalia.Methods: This retrospective, descriptive registry reviewed the pathological echocardiographic findings of 1140 patients aged 0-100 years who were admitted to the cardiology outpatient clinic in a tertiary training hospital in Mogadishu.Results: Hypertensive heart disease (HHD) 454 (39.8%) and degenerative valvular disease 395 (34.6%) were the most common comorbidities. Congenital heart diseases (CHD) were detected in 151 (13.2%) of the patients, with the most common ones including atrial septal defect (ASD) 37 (3.2%) and ventricular septal defect (VSD) 26 (2.3%).Rheumatic heart disease (RHD) was detected in 84 (7.4%) patients, among whom the most common age range was 16-30 years (40.5%), followed by 31-45 years (31%) and 0-15 years (15.5%). Conclusıon: In the present study, we found that HHD was the most common comorbidity , followed by degenerative valvular disease, Heart failure with reduced ejection fraction(HFrEF),and Ischemic heart disease(IHD).Moreover, the most common valvular disease was mitral insufficiency and the most common CHD was ASD.

2021 ◽  
Vol 34 (4) ◽  
pp. 420-429
Jenna L. Shackleford ◽  
Regena Spratling ◽  
Susan J. Kelley

The purpose of this paper is to present a conceptual-theoretical-empirical model addressing variables associated with self-management of care and adherence to treatment and its relationship to health-related quality of life for adolescents with congenital heart disease. There is limited research on adolescents with congenital heart disease regarding the relationship between autonomy, relatedness, competence, self-management of care and adherence to treatment, and health-related quality of life. The proposed Health-Related Quality of Life and Transition of Adolescents With Congenital Heart Disease to Self-Manage in Adulthood model, adapted from the Self-Determination Theory, will help to better understand these relationships.

2021 ◽  
pp. 1-7
Brian Lee ◽  
Enrique G. Villarreal ◽  
Emad B. Mossad ◽  
Jacqueline Rausa ◽  
Ronald A. Bronicki ◽  

Abstract Introduction: The effects of alpha-blockade on haemodynamics during and following congenital heart surgery are well documented, but data on patient outcomes, mortality, and hospital charges are limited. The purpose of this study was to characterise the use of alpha-blockade during congenital heart surgery admissions and to determine its association with common clinical outcomes. Materials and Methods: A cross-sectional study was conducted using the Pediatric Health Information System database. De-identified data for patients under 18 years of age with a cardiac diagnosis who underwent congenital heart surgery were obtained from 2004 to 2015. Patients were subdivided on the basis of receiving alpha-blockade with either phenoxybenzamine or phentolamine during admission or not. Continuous and categorical variables were analysed using Mann−Whitney U-tests and Fisher exact tests, respectively. Characteristics between subgroups were compared using univariate analysis. Regression analyses were conducted to determine the impact of alpha-blockade on ICU length of stay, hospital length of stay, billed charges, and mortality. Results: Of the 81,313 admissions, 4309 (5.3%) utilised alpha-blockade. Phentolamine was utilised in 4290 admissions. In univariate analysis, ICU length of stay, total length of stay, inpatient mortality, and billed charges were all significantly higher in the alpha-blockade admissions. However, regression analyses demonstrated that other factors were behind these increased. Alpha-blockade was significantly, independently associated with a 1.5 days reduction in ICU length of stay (p < 0.01) and a 3.5 days reduction in total length of stay (p < 0.01). Alpha-blockade was significantly, independently associated with a reduction in mortality (odds ratio 0.8, 95% confidence interval 0.7−0.9). Alpha-blockade was not independently associated with any significant change in billed charges. Conclusions: Alpha-blockade is used in a subset of paediatric cardiac surgeries and is independently associated with significant reductions in ICU length of stay, hospital length of stay, and mortality without significantly altering billed charges.

L.P. Montaña-Jimenez ◽  
P. Lasalvia ◽  
M. Diaz Puentes ◽  
M. Olaya-C

INTRODUCTION: Few studies exist that research the association between umbilical cord characteristics with cardiac malformations. In this study, we describe a population of newborns with congenital heart defects (CHD) and the frequency of presentation of umbilical cord (UC) alterations, based upon the hypothesis that the continuity of the cardio-placental circuit can be affected by similar noxas during early development. METHODS: We carried out a descriptive study at a hospital in Bogota based on clinical records from newborns with congenital heart disease with placental and UC pathology results. Group analyses were done according to the major categories of the ICD-10. RESULTS: We analyzed 122 cases and found that the most frequent alterations where hypercoiling (27.9%) and abnormal UC insertion (16.4%). Additionally, in almost every group of CHD, more than 65%of patients had some type of cord alteration. CONCLUSION: We discovered a high frequency of UC alterations in patients with CHD. This outcome suggests that a possible association exists between the two phenomena, further research is needed.

2021 ◽  
Jayaprakash Shenthar ◽  
Sanjai P. Valappil ◽  
Maneesh K. Rai ◽  
Bharatraj Banavalikar ◽  
Deepak Padmanabhan ◽  

2021 ◽  
pp. archdischild-2020-321390
Nurul Hidayah Amir ◽  
Dan M Dorobantu ◽  
Curtis A Wadey ◽  
Massimo Caputo ◽  
A. Graham Stuart ◽  

Exercise and physical activity (PA) have been shown to be effective, safe and feasible in both healthy children and children with congenital heart disease (CHD). However, implementing exercise training as an intervention is still not routine in children with CHD despite considerable evidence of health benefits and well-being. Understanding how children with CHD can safely participate in exercise can boost participation in PA and subsequently reduce inactivity-related diseases. Home-based exercise intervention, with the use of personal wearable activity trackers, and high-intensity interval training have been beneficial in adults’ cardiac rehabilitation programmes. However, these remain underutilised in paediatric care. Therefore, the aims of this narrative review were to synthesise prescribed exercise interventions in children with CHD, identify possible limitation to exercise training prescription and provide an overview on how to best integrate exercise intervention effectively for this population into daily practice.

2021 ◽  
Vol 8 ◽  
Awoere T. Chinawa ◽  
Josephat M. Chinawa ◽  
Chikahika Onyinyechi Duru ◽  
Bartholomew F. Chukwu ◽  
Ijeoma Obumneme-Anyim

Background: Malnutrition poses a great burden to children in the tropics. However, this seems to be accentuated in children with congenital heart disease.Objectives: The present study is therefore aimed at determining the nutritional status of children with congenital heart disease and to compare them with those without congenital heart disease.Methods: This is a cross-sectional study, where congenital heart disease was diagnosed by means of echocardiograph. Anthro software was used to calculate Z scores for weight for age (WAZ), height for age (HAZ), and weight for height (WHZ). Body mass index (BMI) was calculated by the formula BMI = Weight (Kg)/height (M2).Results: The body mass index-for-age z-score (BAZ) and height/length-for-age z-score (HAZ) were calculated for both subjects and controls to determine their nutritional status. It was observed that 38.5% (112/291) of the subjects were wasted (BAZ &lt; −2SD) compared to 6.25% (16/256) of the controls and the difference was statistically significant (χ2 = 81.2, p &lt; 0.001). Stunting (height/length-for-age z-score &lt; −2SD) was also observed in a greater proportion of subjects than controls as 37.8% (107/291) of subjects were stunted compared with 7.0% (18/256) of the controls (χ2 = 69.9, p &lt; 0.001). The under-five subjects had more cases of malnutrition than the controls of same age group as illustrated in Table 6. Whereas 42.9% (96/224) of the under-five subjects were wasted, only 6.2% (12/192) of the controls were wasted. On the other hand, 4.2% (8/192) of the under-five controls were obese compared to 0.9% (2/224) of the subjects of similar age group.Conclusion: Children with congenital heart disease present with varying degrees of malnutrition that is worse compared with children without congenital heart disease. The impact of malnutrition is worse among children under the age of five. Wasting is more prevalent in children with cyanotic heart disease compared with those with acyanotic congenital heart disease. Overweight and obesity were notable features of malnutrition in children with congenital heart disease, but this is worse in children without congenital heart disease.

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