[Show abstract][Hide abstract] ABSTRACT: Objective. The objective of this study was to determine the frequency of pulmonary arterial hypertension (PAH) in congenital heart disease (CHD) with an isolated, large left-to-right shunt and to indicate the factors in the development of PAH. Methods. The pressure measurements in the cardiac chambers and the calculations based on the Fick's principle were compared among 3 separate groups of patients, respectively, with PAH, with hyperkinetic pulmonary hypertension (HPH), and with neither PAH nor HPH. Results. PAH was diagnosed in 30 (12.3%) patients, HPH in 35 (14.4%), while 177 (73.1%) were free of either. The highest risk for the development of PAH was found in the presence of perimembranous ventricular septal defect. A statistically significant difference was seen among these groups as to their left atrial pressure (p = 0.005) and the mean pulmonary arterial pressure (PAPmean; p < 0.001). While a correlation was present between RpI on one hand and age on the other (p = 0.014), a multiple linear regression could not evidence any correlation among age (p = 0.321), gender (p = 0.929). Conclusion. Our findings do not allow establishing a correlation between the duration of the high pulmonary flow and pulmonary vascular resistance increase or PAH development in isolated left-to-right shunts with congenital heart diseases.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE.: The aim of this study is to determine the relationship between the cardiac catheterization findings and pulsed-wave (PW) Doppler and Doppler tissue imaging (DTI) in pulmonary arterial hypertension patients with congenital heart disease with intracardiac shunts. DESIGN AND PATIENTS.: The present study aims to determine the relationship between the cardiac catheterization findings and PW Doppler and Doppler tissue imaging (DTI) in patients who have pulmonary arterial hypertension patients due to congenital heart disease with intracardiac shunts. Echocardiographic measurements were performed at the catheter angiography laboratory with concurrent catheterization. Left and right ventricle inflow velocities were recorded with PW Doppler and DTI studies. Maximum tricuspid regurgitation velocity (TS) was recorded in cases with measurable levels by continuous-wave Doppler. Moreover, the correlations among the echocardiographic values and invasive hemodynamic measures such as systolic pulmonary arterial pressure (PAPsystolic), mean pulmonary arterial pressure (PAPmean), diastolic pulmonary arterial pressure (PAPdiastolic) and pulmonary vascular resistance index (PVRI) were evaluated. RESULTS.: A negative correlation was found between TE'/TA' and PAPsystolic, PAPdiastolic and PAPmean (P = 0.008, r = -0.480; P = 0.001, r = -0.584; P = 0.001, r = -0.567, respectively). ME/ME' was also found to be negatively correlated with PAPdiastolic, PAPmean and PVRI (P = 0.002, r = -0.556; P = 0.005, r = -0.502; P = 0.027, r = -0.411, respectively). The concurrent use of TE'/TA' (cut-off value <2.6) and TS had a sensitivity of 79% and a specificity of 93% for distinguishing between patients with healthy controls. CONCLUSION.: When used in conjunction with conventional methods, TE'/TA' has the highest sensitivity and specificity in distinguishing between patients and healthy controls.
[Show abstract][Hide abstract] ABSTRACT: The present study aims to quantitatively evaluate the right ventricle (RV) function by means of transthoracic echocardiography in normal children and childhood congenital heart disease patients with pulmonary hypertension.
This study was conducted in a cohort including 40 healthy children and 30 pediatric patients with pulmonary hypertension who were diagnosed under close surveillance at the study center between October 2009 and November 2010.
Statistically significant differences were found between the patient and control groups for the right ventricle myocardial performance index (RVMPI), the left ventricle myocardial performance index (LVMPI), the tricuspid valve systolic flow velocity (Ts), the ratio of systolic pulmonary artery pressure to the right ventricle outflow tract systolic flow velocity time integral (sPAP/RVOT VTI), and the ratio of systolic pulmonary artery pressure to right ventricle outflow tract systolic flow velocity time integral × heart rate (sPAP/[RVOT VTI×HR]). When the children were divided into three groups based on their pulmonary vascular resistance significant differences emerged that predicted an increasing severity of RV dysfunction. Significant differences were also observed for the RVMPI, the LVMPI, and the Ts as well as for echocardiographic pulmonary flow (Qp) and systemic flow (Qs).
The present study demonstrates that echocardiographic parameters can be used for the quantitative detection of RV dysfunction in childhood congenital heart disease patients with high pulmonary artery pressure (systolic, diastolic, and mean) or pulmonary vascular resistance.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to assess the prevalence of persistent left superior vena cava (PLSVC) in patients with all types of congenital heart defects and to determine the congenital heart anomalies accompanying PLSVC.
The present study is based on a retrospective review of 1205 children who consecutively underwent cardiac catheterization from 2000 to 2007. In order to determine the existence of PLSVC, all the subjects routinely underwent superior vena cava (SVC) injection during angiography at the catheter laboratory of the study center.
The prevalence of PLSVC was computed to be 6.1% for the present study population. Transthoracic echocardiography was able to detect PLSVC in 32 children (2.6%) whereas angiography diagnosed PLSVC in 74 children (6.1%). The mean age of the patients with PLSVC was 40.09 ± 50.21 months. A communication between the right and left SVC was determined in 27% of the children who were diagnosed with PLSVC after angiography was performed (20 out of 74). A statistically significant association was present between PLSVC and other congenital cardiac anomalies, including ventricular septal defect (n= 42, 56.8%), atrial septal defect (n= 31, 41.9%), pulmonary stenosis (n= 19, 25.7%), atrioventricular septal defect (n= 10, 13.5%), patent ductus arteriosus (n= 6, 8.1%) and cor triatriatum (n= 3, 4.1%).
Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery.
Pediatrics International 08/2011; 53(6):1066-9. · 0.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: television, computer and other causes of increased inactivity are reported to be among the major causes of obesity. This cross-sectional study was aimed to evaluate the effect of television viewing and other daily activities on body mass index (BMI) z-score of early adolescents.
a total of 860 students and their parents (581) from different socioeconomic level schools were included. They were instructed to fill in a self-designed questionnaire. Weight and height were measured, and BMI z-scores were calculated.
BMI z-score was higher in boys and in those attending high socioeconomic level schools. Children with a BMI z-score >2SD watched television (2.5 ± 0.9 h/day) longer than those with <-2SD (1.6 ± 0.8 h/day) (P=0.027). The three categories (<-2SD, -2SD-2SD, >2SD) differed significantly according to maternal (P<0.05) and paternal (P<0.005) BMI. Linear logistic regression analysis revealed that socioeconomic level, maternal BMI and paternal BMI are factors affecting BMI z-score significantly.
genetic and/or family environment which may affect the nutrition and activity of adolescents seems to be the most important factor affecting their BMI z-score.
World Journal of Pediatrics 02/2011; 7(1):37-40. · 1.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We evaluated the behavioral effects of television (TV) viewing in 860 young adolescents as reported by parents (n=581) on Child Behavior Checklist (CBCL). The mean duration of TV viewing was 2.32 ± 1.77 hours/day according to parents and
2.08 ± 1.41 hours/day according to self report (r=0.37, P<0.0001). The linear regression analysis revealed a statistically significant relation between socioeconomic status (P=0.019) and aggressive behavior score of CBCL (P=0.016) and parent reported TV viewing hours. Self reported TV viewing for more than 2 hours was significantly associated
with social problem score (OR 1.17; 95% CI:1.016–1.349; P=0.030) and having a TV in bedroom (OR:1.706; 95% CI: 1.065–2.731, P=0.026).
Indian pediatrics 01/2011; 48(3):229-231. · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A neonatal case of left ventricular non-compaction associated with trisomy 18: Left ventricular noncompaction (LVNC) is a rare congenital cardiomyopathy and exact etiology is still unknown. Trisomy 18 is the second most common autosomal trisomy in live-born infants. LVNC has been described in association with other dysmorphic features, association with trisomy 18 has not been reported previously in a neonate. LVNC broadens the cardiac anomalies associated with trisomy 18.
[Show abstract][Hide abstract] ABSTRACT: We evaluated the behavioral effects of television (TV) viewing in 860 young adolescents as reported by parents (n=581) on Child Behavior Checklist (CBCL). The mean duration of TV viewing was 2.32 ± 1.77 hours/day according to parents and 2.08 ± 1.41 hours/day according to self report (r=0.37, P <0.0001). The linear regression analysis revealed a statistically significant relation between socioeconomic status (P=0.019) and aggressive behavior score of CBCL (P=0.016) and parent reported TV viewing hours. Self reported TV viewing for more than 2 hours was significantly associated with social problem score (OR 1.17; 95% CI:1.016-1.349; P=0.030) and having a TV in bedroom (OR:1.706; 95% ;CI: 1.065-2.731, P=0.026).
Indian pediatrics 11/2010; 48(3):229-31. · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Behçet's disease is a systemic vasculitis affecting arterioles and venules and is characterized by recurrent oral ulcers, genital ulcers and ocular inflammation. It can involve any organ but joints, skin, central nervous system and gastrointestinal tract are the most common sites. Here we report an 11-year-old Behçet's disease patient presenting with attacks of myositis accompanied by epididymoorchitis and periodic fever attacks as well as a separate attack of thrombophlebitis.
The Turkish journal of pediatrics 50(1):78-80. · 0.56 Impact Factor