Paediatric Cardiology – Pubmed Results

CONCLUSION: Elderly patients with non-valvular AF with SA ≤ 3.6 g/dL show a higher risk of MACE and non-cardiovascular mortality.

The cardiovascular system is among the earliest functional systems in fetal development, playing a central role in maintaining circulation and ensuring oxygen and nutrient delivery. The fetal heart undergoes continuous maturation in anatomical configuration, hemodynamics, and biventricular coupling throughout gestation. Recent advances in ultrasound imaging-including Doppler, tissue doppler imaging (TDI), and two- and three-dimensional speckle tracking-have enabled comprehensive assessment of...

CONCLUSIONS: Current evidence underscores substantial gaps in understanding the natural history and optimal management of diabetic foot disease in dialysis-dependent ESKD. Future research should prioritise well-designed prospective studies to delineate dialysis-specific risk pathways, incorporate robust stratification by dialysis modality, and evaluate interventions targeting ischaemia and limb preservation. Standardisation of outcome reporting, particularly for healing durability and...

CONCLUSIONS: This prospective observational study found that different ventilation strategies influenced catheter-tissue interaction and procedural metrics during pediatric RF ablation. Notably, HFLTV ventilation was linked to higher contact force metrics. Additional research is necessary to verify these results.

CONCLUSIONS: This study will provide insight into the prevalence of MetS, ED, and accelerated aging, as well as potentially modifiable risk factors, including those that have not been previously examined, among survivors of HSCT for hematological malignancies in childhood. The findings will inform surveillance guidelines and support the development of health behavioral and anti-inflammatory interventions to mitigate the risk of these severe late effects.

CONCLUSIONS: By evaluating real-world implementation challenges, FitPreV will provide foundational evidence to guide larger-scale effectiveness trials studying personalized prevention approaches into national primary care settings.

CONCLUSION: Venous thrombosis is frequent among neonates hospitalized in neonatal intensive care units, but its frequency appears to be highly variable depending on the population studied, whether clinically unsuspected thromboses are considered, and study design. Future work is urgently needed to prevent thrombosis in this population.

CONCLUSION: This case highlights that TRAS may present without hypertension and underscores the importance of careful surveillance, particularly in children transplanted outside regulated transplant programs.

CONCLUSIONS: Multimodal machine learning models combining proteomic and clinical data enable early identification of hypertensive complications. Growth/differentiation factor 15, adaptor protein 3 complex subunit σ-2, and tumor necrosis factor receptor superfamily member 10B may serve as potential biomarkers for risk prediction and early intervention.

CONCLUSIONS: Despite increasing post-Norwood ECMO use, survival outcomes remain poor. Identified risk factors may inform prospective risk stratification strategies, early identification of high-risk patients, and evidence-based decision-making regarding ECMO initiation, continuation, or withdrawal in this vulnerable population. Significant heterogeneity across studies precluded meta-analysis, highlighting the need for standardized reporting in future research.

CONCLUSIONS: The patient-tailored internet-delivered cognitive behavioral therapy program reduced stress and anxiety symptoms in patients with myocardial infarction with nonobstructive coronary arteries or TS and normalized anxiety symptoms in a greater proportion of treated patients than controls. Exploratory analyses indicated that patients with TS may experience greater benefit from the internet-delivered cognitive behavioral therapy intervention, but this warrants further research.

CONCLUSIONS: Our findings demonstrate that integrating conventional risk factors, polygenic risk scores, and proteomic data improves CAD risk prediction. This study highlights the utility of proteomics in precision cardiovascular medicine and simplified risk stratification tools.

This study investigated the predictive value of red blood cell distribution width (RDW) stent length for in-stent restenosis (ISR) drug-eluting stent implantation in patients with acute myocardial infarction. Reliable predictors of restenosis remain limited, highlighting the need for accessible clinical markers. A total of 170 patients who underwent stent implantation were included and classified into restenosis and nonrestenosis groups based on follow-up coronary angiography at 12 months....

The association of atherogenic index of plasma (AIP) control level with hypertension onset in children was still unclear. This study aimed to investigate the association between AIP control levels and risk of childhood hypertension. We obtained data from 12,800 students participating in a national, multi-center, school-based health lifestyle intervention program aimed at combating obesity. AIP was calculated using the formula log(10)(TG/HDL-C), and was categorized into five clusters based on...

CONCLUSIONS: These finding demonstrate that the precision of TOE for detecting a PFO in real world clinical practice is considerably lower than generally believed.

Gastrointestinal (GI) involvement of IgA vasculitis (IgAV) has various clinical presentations from isolated abdominal pain to severe gastrointestinal bleeding. The aim of this study is to determine the incidence of GI involvement in children with IgAV and identify the predictors of severe GI involvement. Medical records of IgAV patients with GI involvement from 30 centers in Türkiye between 2014 and 2024 were retrospectively reviewed. Patients were classified into two groups according to the...

CONCLUSIONS: HALP is independently associated with IVIG resistance in children with KD and demonstrated good performance for early risk stratification, particularly in patients aged ≤ 6 months and ≥ 48 months. As a simple and readily available biomarker, HALP may serve as a useful complementary tool in routine pediatric clinical practice.

The anti-apoptotic genes DAD-1 and HAX-1 and the pro-apoptotic GZMB gene have a significant role in the regulation of apoptosis in heart tissue. However, investigation into these genes and their proteins in the pathogenesis of cardiovascular diseases remains limited. The aim was to characterize the association between the presence and distribution of pro-apoptotic and anti-apoptotic genes and their proteins in the right atrial appendage affected by coronary heart disease (CHD) and aortic valve...

HeartMate 3 (HM3) has demonstrated excellent outcomes in adults, and its use in pediatric patients has recently increased. In small pediatric patients, previous studies have mainly focused on whether the device can be accommodated within the thoracic cavity. However, the physiological suitability of pump flow relative to body size and the potential mechanical effects of the device have not been well investigated. A 12-year-old girl (height 138 cm, weight 28.9 kg, body surface area 1.07 m²) with...

CONCLUSIONS: LAMT-PVR is a feasible and safe alternative to redo sternotomy for selected post-TOF patients. This approach provides direct access to the pulmonary artery with reduced surgical trauma and favorable early outcomes.

Multiple myeloma (MM) develops through asymptomatic precursor stages characterized by progressive remodeling of the bone marrow (BM) immune microenvironment and disruption of bone homeostasis. To delineate changes in natural killer (NK) cell states during disease evolution, we investigated coordinated immune-tumor remodeling by integrating NK cell functional states with plasma cell-intrinsic susceptibility programs derived from CRISPR-based screens across healthy donors (HD), monoclonal...

Heart failure (HF) is a complex and heterogeneous clinical syndrome defined by progressive structural, functional, and molecular alterations in the myocardium, representing a significant global health challenge. Beyond haemodynamic compromise, HF arises from intricate interactions among neurohormonal activation, chronic inflammation, oxidative stress, mitochondrial dysfunction, impaired calcium handling, and extracellular matrix remodelling. These processes drive maladaptive cardiac remodelling...

Endothelial dysfunction is a key characteristic of many diseases, including atherosclerosis, hypertension, heart failure, stroke, cancer, acute respiratory distress syndrome (ARDS), peripheral vascular disease, coronavirus 2019 (COVID-19), and pulmonary arterial hypertension (PAH). To improve understanding of the roles of endothelial cells (ECs) in health and disease, EC-specific genome editing technologies have been developed in recent years. Therapeutic strategies that aim to restore a healthy...

CONCLUSION: In children with CKD, ambulatory hypertension is associated with elevated risk of LVH and increased LVMI. However, there was significant heterogeneity among the included studies with respect to study design and definition of outcomes. Timely detection of hypertensive target organ injury is imperative to mitigate future cardiovascular disease in pediatric CKD patients.Prospero Registration: CRD 42023426891.

CONCLUSIONS: Hypocalcaemia may be associated with higher odds of post-induction hypotension in trauma patients; however, our findings require corroboration across a larger multi-centre prospective observational study. If corroborated, a randomised controlled trial is warranted to establish the utility of calcium replacement for the prevention of post-induction hypotension.

Congenital diaphragmatic hernia (CDH) is a complex neonatal condition characterized by pulmonary hypoplasia and pulmonary hypertension, requiring specialized ventilatory management from birth through postoperative care. This article synthesizes the current evidences and evolving strategies for optimizing respiratory support in CDH, emphasizing the importance of gentle ventilation to minimize lung injury and improve outcomes. We discuss delivery room resuscitation protocols, initial ventilator...

Extracorporeal membrane oxygenation (ECMO) has revolutionized neonatal care, providing lifesaving support for cardiorespiratory failure. Miniaturized circuits and improved cannulae expanded ECMO eligibility to smaller and more complex infants. Indications now extend beyond respiratory failure to include structural and acquired heart disease and extracorporeal cardiopulmonary resuscitation. Contemporary anticoagulation strategies, incorporating multimodal monitoring and alternative agents, seek...

Hypoxemic respiratory failure is a common reason for admission to the neonatal intensive care unit for term and late preterm infants. Some infants have rare disorders due to genetic mechanisms including surfactant dysfunction disorders, alveolar capillary dysplasia with misalignment of the pulmonary veins, and other developmental lung disorders that result in more severe, persistent, and even fatal disease. In this article, we summarize clinical characteristics of the most common causes of...

Marfan syndrome (MS), Loeys-Dietz syndrome (LDS), Beals-Hecht syndrome (BHS), Ehlers-Danlos syndrome (EDS), and individuals with undifferentiated connective tissue disease (UCTD) exhibit phenotypic overlap, suggesting a likelihood of genotypic coexistence. Our objective was to evaluate genetic variants (GVs), encoding 174 genes related to aortopathies, cardiomyopathies, arrhythmias, structural heart disease, and hypercholesterolemia, and their relationship to clinical and cardiovascular damage...

Proprotein convertase subtilisin/kexin type 9 (PCSK9) acts as a pleiotropic modulator of inflammation. This study aimed to investigate the role and underlying mechanism of PCSK9 in Kawasaki disease (KD)-associated vasculitis. A Candida albicans water-soluble fraction (CAWS)-induced murine vasculitis model (n = 5-8 mice per group) and CAWS-stimulated RAW 264.7 macrophages (n = 3-8 independent experiments) were used. PCSK9 was pharmacologically inhibited in vivo with SBC-115076 and in vitro with...

Ubiquitin-specific protease 20 (USP20) belongs to the ubiquitin-specific protease (USP) family, which represents the largest subfamily of deubiquitinating enzymes. It plays a critical role in regulating cellular signaling transduction, maintaining protein stability, and influencing the development of various diseases. This study revealed that USP20 expression was significantly upregulated in transverse aortic constriction (TAC)-induced hypertrophic hearts and in angiotensin II (AngII)-stimulated...

Left cardiac sympathetic denervation (LCSD) via video-assisted thoracoscopy (VATS) is an effective therapy for drug-refractory malignant arrhythmias in congenital long QT syndromes and requires meticulous perioperative planning in children with automatic implantable cardioverter-defibrillators (AICDs). We describe what is likely the first paediatric VATS-LCSD performed in Pakistan. A boy in early childhood with Jervell and Lange-Nielsen syndrome, severe QT prolongation and recurrent ventricular...

CONCLUSION: The TCM interventions included in this review may provide short-term benefits in clinical response and selected renal-related laboratory outcomes in children with IgAVN, without increasing the observed incidence of adverse events. High-quality randomized trials with standardized outcomes, structured safety monitoring, and longer follow-up are needed.

RATIONALE: Primary ciliary dyskinesia (PCD) is easily underdiagnosed in children without laterality defects. We report 2 pediatric cases of PCD, highlighting a candidate pathogenic synonymous RSPH4A variant and a possible modifier effect of NFE2L2 on DNAH9-related disease.

CONCLUSIONS: Fontan-related lymphatic complications develop in 1 out of 4 patients by 20 years of age, and they are associated with older age, renal dysfunction, thromboembolism, and arrhythmia. Patients with LC have higher rates of transplantation and death. Our findings indicate that elevated central venous pressure, rather than systolic cardiac or atrioventricular valve function, is associated with these complications.

CONCLUSIONS: Malnutrition involvement in CKM-attributed deaths increased over time despite declining overall CKM deaths, highlighting malnutrition as an underrecognized component of end-of-life vulnerability in CKM and supporting integration of nutritional assessment and supportive care in high-burden populations and regions.

An 8-month-old infant that presented to our service with signs of increased intracranial pressure, seizures and radiographic findings of multiple intracranial cavernomas, most notably a left temporal cavernoma that had bled and was causing significant local mass effect. Outside the CNS, the infant had cutaneous manifestations of cavernous malformation syndromes. Surgical resection of the left temporal haemorrhage was pursued, and the infant recovered well. Subacute management involved ongoing...

CONCLUSIONS AND RELEVANCE: In this comparative effectiveness research study, the rate of PDA pharmacotherapy failure was high among extremely preterm infants, with no observed differences in effectiveness between commonly used pharmacotherapy regimens. Compared with conservative management, pharmacotherapy was associated with lower mortality and higher BPD and NEC odds; however, confounding by contraindication and survival bias cannot be ruled out.

CONCLUSIONS AND RELEVANCE: This cohort study found a marked inpatient health care and economic burden for VTE among children and adolescents. Mortality risk was significantly increased among infants younger than 1 year. Studies are needed to provide evidence-based support for the safety and effectiveness of medical interventions for children and adolescents with VTE.

Henoch-Schönlein purpura (HSP), also known as immunoglobulin A vasculitis, is a common systemic vasculitis in children. Although its pathogenesis remains unclear, recent studies suggest that the gut microbiota may play a significant role in its initiation and progression. In patients with HSP, gut microbiota dysbiosis and associated metabolic alterations are linked to impaired intestinal barrier integrity, activation of the innate immune system, and dysregulation of adaptive immune cell subsets;...

CONCLUSION: Our results suggest that untreated women with type IIHBS have a high risk of pregnancy complications, which might warrant thromboprophylaxis regardless of VTE risk.

CONCLUSIONS: HbA1c is a key associated factor for pediatric DR, but its estimated effect is significantly affected by publication bias and high heterogeneity, and the pooled effect became non-significant after bias correction. Therefore, conclusions should be drawn cautiously.

CONCLUSIONS: CBA recurrence is rare following appropriate treatment, which challenges conventional pathogenic models. The long-term prognosis is determined by cardiac status rather than neurological factors. With 571.9 person-years of observation, we provided robust evidence that recurrence is genuinely rare, and we propose a structured management algorithm derived from our institutional experience.

CONCLUSIONS: Supervised fine-tuning of LLMs with CoT offers an effective approach for automated PHD detection within unstructured data in the electronic medical record. While CoT-enhanced models demonstrated improved internal performance and more balanced classification, they did not consistently achieve higher accuracy in external validation, highlighting trade-offs between accuracy and class balance. These findings highlight the promise of LLM-based approaches for clinical text phenotyping...

CONCLUSIONS: One in four early CCS lives with food insecurity. These children concurrently experience multiple cardiovascular risk factors and suboptimal dietary quality. Interventions targeting food and nutrition insecurity and other modifiable cardiovascular risk factors have potential to mitigate late effects and advance equity in survivorship outcomes.

Trisomy 21 (T21) results in Down syndrome (DS), a condition associated with a high prevalence of pulmonary complications. Pulmonary hypertension (PH) is a significant comorbidity in individuals with T21. Inflammation is a well-established driver of PH, and growing evidence implicates platelets as active contributors to inflammatory-mediated pulmonary vascular disease and PH. In T21, increased interferon (IFN) signaling resulting from an additional IFN receptor gene locus contributes to immune...

Despite growing interest in tricuspid regurgitation (TR), evidence remains insufficient to define the optimal timing of intervention and therapeutic strategies, highlighting the need for robust experimental models. Existing large animal models of TR use diverse approaches and can be grouped into two categories: direct valvular interventions targeting the tricuspid leaflets, annulus, or chordae, and indirect induction through mechanisms such as increased right ventricular loading, pulmonary...

CONCLUSION: Our study shows that approximately one out of every 10 patients in the population may have cardiological problems and 2.3% of these patients have major cardiac problems. Therefore, we recommend that all pediatric patients undergo a detailed cardiac evaluation at least once in the early stages of their lives.

CONCLUSIONS: Circulating EVs reflect cirrhosis severity and are suggestive of progressive thrombo-inflammatory, endothelial, and tissue-remodelling changes. However, EVs were not independently associated with clinical outcomes.

The purpose of this study is to clarify the role of LINC01094 in acute cerebral infarction (ACI) and to explore its potential molecular mechanisms. A total of 121 patients with ACI and 133 healthy controls were enrolled in this study. The expression levels of LINC01094, miR-499a-5p, and inflammatory markers (CRP, IL-6) were measured using RT-qPCR. The levels of MDA, SOD, and ROS were measured using commercial assay kits. The diagnostic value of LINC01094 for ACI was evaluated using ROC curve...