جستجوی مقالات مرتبط با کلیدواژه "congenital heart disease" در نشریات گروه "پزشکی"

This study aimed to comprehensively analyze the overall congenital heart disease (CHD) prevalence in live births and children in Iran, along with evaluating the spatial distribution of CHD birth prevalence across various geographical regions within the country. 

A Bayesian hierarchical meta-analysis (PROSPERO 2022: CRD42022331281) was performed to determine the pooled prevalence. A systematic search was conducted using Web of Science, ScienceDirect, PubMed, Iranian Research Institute for Information Science and Technology (IranDoc), Scientific Information Database (SID), and Magiran until October 4, 2023. Cross-sectional and cohort studies in both English and Persian languages, focusing on the age range of 0-10 years, were considered for the study population. The study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) Risk of Bias tool. Heterogeneity was assessed by I2 and τ2 statistics, and publication bias by Egger’s and Begg’s tests.

  The meta-analysis included 62 studies, revealing an overall CHD prevalence of 2.5 per 1000 births. Over time, CHD birth prevalence in Iran has consistently increased. Spatial distribution analysis, including spatial autocorrelation and local spatial autocorrelation, indicated no spatial clustering (P = .46) or aggregation (P = .65) among Iran’s provinces. Geographic disparities were significant (P = .000), with the northern and eastern regions showing the highest and lowest CHD prevalence, respectively. 

The overall CHD prevalence in Iran is lower than global rates, but it continues to rise. Furthermore, there are variations in birth prevalence among different regions of Iran. Environmental, genetic, socioeconomic, and diagnostic accessibility differences are possibly involved in regional variation. The limitations like heterogeneity among studies, the potential inaccuracy of reports due to limited use of accurate diagnostic methods in some studies, and the absence of population-based models to investigate prevalence, underscore the urgent need for standardized diagnostic approaches, and the utilization of population-wide birth defect registries to accurately assess CHD prevalence in Iran.

Dextrocardia is an intrinsic cardiac malposition where the base-apex axis is oriented toward the right side. Diagnosing these abnormalities is crucial for the appropriate treatment of associated anomalies. Advances in CT angiography techniques have enabled a comprehensive study of cardiovascular structures.

This study aims to identify the association of cardiac anomalies in various types of dextrocardia.

Patients with a confirmed diagnosis of dextrocardia who underwent contrast-enhanced cardiac CT angiography were included in the study. All patients had previously undergone echocardiography with equivocal findings. The type of dextrocardia (based on the Arcilla and Gasul classification), along with septal, atrial, ventricular, aortic, pulmonary artery and vein, systemic veins, and non-cardiac anomalies, were evaluated.

Thirty-five cases of dextrocardia (18 males and 17 females) were included in this study, with a mean patient age of 24 months. Among these, 23 cases were classified as type 3, 8 as type 1, and 4 as type 2. The most common anomalies across all types were septal defects, with ventricular septal defects being the most prevalent in type 1, while atrioventricular septal defects (AVSD) were the most common in types 2 and 3. In type 3, left transposition of the great arteries (L-TGA), right isomerism, and AVSD were significantly more frequent, occurring concurrently in 65.2% of patients. Additionally, more than 50% of the cases had a concomitant pulmonary artery anomaly.

A correlation may exist between the occurrence of AVSD, L-TGA, right isomerism, and pulmonary artery anomalies in type 3 dextrocardia.

Tetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart defect. Pulmonary regurgitation (PR) is a common sequela following most surgical repairs for TOF. Tadalafil might reduce pulmonary vascular resistance after Tetralogy of Fallot total correction (TOFTC).

This study evaluated the efficacy of tadalafil in reducing PR volume and improving heart function among TOFTC children with severe PR, using transthoracic echocardiography, particularly focusing on changes in N-terminal pro-b-type natriuretic peptide (NT-proBNP).

The present study was conducted on TOFTC patients consecutively between September 2019 and August 2020 at Shiraz University of Medical Sciences, Shiraz, Iran. M-mode and two-dimensional (2D) Doppler echocardiography were performed, and NT-proBNP levels were measured in 20 patients before and one month after tadalafil administration. SPSS version 23.0 was utilized to analyze all results.

The patients' ages ranged from 25 to 128 months. The mean age and weight of the patients were 67.9 ± 34.5 months and 21.1 ± 6.9 kg, respectively. Tadalafil administration did not significantly improve Doppler and tissue Doppler parameters; however, it increased the pulmonary valve pressure gradient and velocity-time integral. Additionally, tadalafil had no significant effect on improving NT-proBNP levels. The Spearman correlation test did not show any significant correlation between the pulmonary valve pressure gradient and velocity-time integral with age, weight, and NT-proBNP.

Tadalafil increased the pulmonary valve pressure gradient and velocity-time integral in TOFTC patients with severe PR; however, it did not affect NT-proBNP levels or tissue Doppler parameters.

Most cases of congenital coronary artery fistula (CAF) resolve spontaneously, symptomatic patients with severe shunting require surgical intervention. Our aim is to evaluate success rate and outcome of CAFs treatment using transcatheter interventional methods.This retrospective study conducted on 28 CAF patients who were referred to Rajaie Cardiovascular Medical and Research Center in Tehran between 2015 and 2020. Baseline characteristics were collected by assessing hospital records, and patients were followed up annually for long-term evaluation. All of 28 patients gone throughtranscatheter closure of CAF. In 23 patient’s it was proximal type (82.1%) and in 5 patients was distal type (17.9%). In 11 patients, the fistula originated from the RCA (39.3%) and in 11 patients, it originated from the LAD and Diagonal. Most common drainage site was the pulmonary artery (82.1%). Coil used in 23 patients(82.1%). PDA occluder (7.1%) for 2 patients. VSD occluder for one patient (3.6%) and VSD+PDA occluder combination was used for one patient (3.6%). Procedure failure was in only one patient. Non-significant remaining shunt in the injection immediately after the procedure was seen in 4 patients (14.3%), which was reduced during the follow-up. None of the patients had significant shunt or clinical symptoms during long-term follow-up. As for complications, fistula dissection occurred in only one patient.The transcatheter interventional approach for the treatment of CAFs leads to favorable long-term results.

Bardet-Biedl syndrome (BBS) (MIM 209900) is a genetic disorder with a wide spectrum of clinical manifestations including retinal dystrophy, hypogenitalism, polydactyly, obesity, renal abnormalities and mental retardation. We describe a 13-year-old girl, a known case of Bardet-Biedl syndrome, who was going to undergo hysterectomy due to hydrometrocolpous. She was homozygous autosomal recessive for gene BS57. She was obese and had impaired vision, renal abnormality, borderline intelligence, recurrent urinary tract infection, menstrual problems, normal secondary sex chrematistics and corrected polydactylies. She had also big nose, thin upper lip, slightly everted lower lip, small mouth and retrognathia. Her electrocardiography showed incomplete right bundle branch block. We identified atrioventricular septal defect (AVSD). In conclusion, physicians who deal with cases who suffered from Bardet-Biedl syndrome, should be vigilant about seeking for identification of cardiac anomalies such as partial AVSD. This leads to earlier identification of the existing cardiovascular disease which facilitates appliance of curative measures.

Congenital Heart Disease (CHD) is one of the leading causes of infant mortality with some problems in the heart's structure at birth. One of the most common congenital heart diseases is the septal defect, in which there is a hole in the wall (septum). Although the etiology of CHD is mainly unknown, numerous studies have suggested both genetic and environmental factors contribute to the development of this disease. This study aims to investigate the frequency of -964 A>G polymorphism (rs153109) in the IL27 gene in infants with CHD in Yazd province, Iran. The study included 30 infants with CHD. We genotyped the IL27 polymorphism by using the PCR- Sequencing technique. Data revealed that the frequencies of AA, AG, and GG among the population of Yazd province were 40%, 40%, and 20%, respectively. The frequency of A and G alleles were 60% and 40%, respectively. The higher frequency of the A allele in patients with CHD compared to the G allele suggests that the A allele may increase atrial septal defect and ventricular septal defect susceptibility in Yazd province. It is recommended that the presence of the A allele and AG genotype be used as a predictor for the development of septal defects.

Congenital heart defects (CHDs) are among the most common birth disorders worldwide. Human research has produced mixed results regarding the impact of zinc on this population. Children with CHD often exhibit hyperparathyroidism and vitamin D deficiency.

This study aims to assess the levels of serum vitamin D and zinc in children with CHD and compare them to those of a control group.

In this case-control study, we included children with CHD (N = 53) who were admitted to Bandar Abbas Children's Hospital from June 22 to December 21, 2018. The study's inclusion criteria were an age range from one month to 14 years and a CHD confirmation via echocardiography. A control group of children without CHD (n = 53) was also evaluated. We collected demographic information from participants and took 4cc blood samples from the children to measure their serum levels of vitamin D and zinc.

The study found no significant difference in serum vitamin D levels between the two groups (P = 0.242). However, the mean serum zinc level was significantly lower in CHD patients compared to the controls, indicating a moderate effect size (SMD = -0.67, 95% confidence interval [CI] -1.06 to -0.28). The frequency of deficiency and insufficiency in serum vitamin D levels was similar between both groups (P = 1.000 and P = 0.767, respectively). Nevertheless, CHD children were 4.31 times more likely to suffer from zinc deficiency than the control group (OR = 4.31, 95% CI 1.52 to 13.31). Moreover, a simultaneous insufficiency of zinc and vitamin D levels was observed exclusively in CHD children (P = 0.006).

The study observed a zinc deficiency in children with CHD, while no significant differences were found in the deficiency and insufficiency of serum vitamin D levels between children with CHD and the control group. Future longitudinal studies are necessary to verify these findings.

Congenital heart disease is the most common type of birth defect in infancy with incidence of 8 to 12 per 1000 live births in India. Pulse oximetry has emerged as a good screening tool in the recent past in many countries being noninvasive and cost effective. This study aimed at estimating the accuracy of pulse oximetry as a standard screening method to detect congenital heart diseases (CHD) in neonates.

This prospective observational study was conducted in a tertiary referral medical college hospital from December 2018 to June 2020. Pulse oximetry readings were taken of 1603 asymptomatic neonates breathing in room air from right hand and either foot after 24 hours of birth. Pulse oximetry was considered positive if oxygen saturation in room air measured <95% or difference between right hand and foot was more than 3% persistently for 3 readings as per the standard American Academy of Pediatrics algorithm. Neonates with positive pulse oximetry or those with persistent abnormal clinical examination underwent echocardiography.

Of the term neonates (n=1603) screened, incidence of CHD was 0.7 per 1000 live births and critical CHD was 0.3 per 1000 live births. The sensitivity, specificity, positive predictive value, and negative predictive value of pulse oximetry to detect any CHD were 70.6%, 98.8%, 38.7%, and 99.7%, major CHD was found to be 60%, 98.4%, 19.4%, and 99.7%, and critical CHD to be 85.7%, 98.4%, 19.4%, and 99.9%, respectively. Pulse oximetry had significant positive correlation with abnormal clinical examination (R=0.29, p<0.001) and ECHO findings in detecting CHD (R=0.49, p<0.001). Regression model to evaluate whether abnormal clinical examination and positive pulse oximetry are significant predictors of CHD detected by ECHO was statistically significant (R2 =0.34, p value <0.001) and both were significant independent predictors (p<0.001).

Pulse oximetry screening is a useful tool for detecting congenital heart diseases in newborns.

The progress of cardiac surgery in children and the increase in the survival of children with Congenital Heart Disease (CHD) has led to consider another issue called a neurodevelopmental disorder. In this study, 53 children with CHD were evaluated in terms of development with the Essence Q questionnaire, Otoacoustic Emission (OAE), and Auditory Brainstem Response (ABR) regarding these patients’ hearing and risk factors. The Essence Q scores were also examined

In this prospective, cross-sectional study, the researchers included 53 children diagnosed with CHD. Initially, each child underwent ABR and OAE tests. Subsequently, data on potential risk factors associated with neurodevelopmental delay were collected. A trained project associate administered the Essence Q questionnaire, using parents’ information as a guide. Following data collection, this study proceeded with an in-depth analysis of the information.

Thirty-six boys (67.92%) and 17 girls (32.08%) with CHD were included in the study. The mean age of children was 2/23+_8.11. The mean Essence Q score for boys was 7.48+_2.57.
Moreover, the average score for girls was 2.23 8.11. According to this questionnaire, 39 patients (73.58%) had hyperactivity disorder,46 patients (86.79%) had behavioral disorders, and ten patients (16.98%) had a motor delay. Unlike previous studies, all patients had normal OAE and ABR hearing.

This study demonstrated that factors such as developmental delay in the first year, a known genetic disease, and a history of seizures significantly impacted the Essence Q score. However, elements like prematurity, the use of ventilation, abnormalities on the dorsum, and the number of days post surgery did not significantly affect the Essence Q score. Essence Q can be a reliable tool in screening for neurodevelopment in children with CHD

Aortopulmonary window (APW) is a rare congenital heart disease. In general, surgical closure is the mainstay of treatment. There are few case reports describing transcatheter closure of an APW. Here we report a case of a APW device closure under general anaesthesia by a multifunctional occluder device in a three-year-old boy.

Children with congenital heart disease (CHD) are prone to weakening and underweight. 

We aimed to evaluate the effect of high-density formula on weight gain and gastrointestinal intolerance in CHD children following heart surgery.

All randomized clinical trials (RCTs) on weight gain following heart surgery in CHD children were systematically searched on Web of Science, PubMed, and Scopus databases by related keywords from 1990/01/01:2022/12/30. Papers in languages other than English were excluded. Among 11 trials that evaluated the effect of a high-density formula on weight, 6 studies were excluded due to their study samples (older than 2 years) and using macronutrients to enrich the formula.

Finally, 5 eligible trials with a total of 278 participants were included in this systematic review. The follow-up duration ranged from 5 to 30 days. Among 5 included studies, 4 indicated that feeding with high-density or concentrated formula can improve weight gain in children with CHD compared to the standard formula. Diarrhea was the most common gastrointestinal complication associated with the high-density formula, although its frequency was low.

Feeding with a high-density formula or concentrated standard formula could be an inexpensive and practical way to fulfill the nutritional requirements of CHD children following surgery, which can lead to more weight gain without any significant gastrointestinal side effects.

Children with congenital heart diseases (CHDs) often require cardiac surgery, whose outcome depends on many preoperative, intraoperative, and postoperative factors.

We aimed to investigate the factors associated with in-hospital mortality among patients undergoing pediatric heart surgery for CHDs.

This retrospective cross-sectional study included patients younger than 18 years who underwent cardiac surgery due to CHDs at the Children’s Medical Center of Tehran University of Medical Sciences and were admitted to the open-heart surgery intensive care unit (OH-ICU) between March 2018 and March 2019. Patients with incomplete records were excluded. The collected data included age (months), weight (kg), type of congenital defect, duration of intensive care unit (ICU) stay, cardiopulmonary bypass (CPB) time, aortic cross-clamping (XCT) time, postoperative (day 1) platelet count and neutrophil-to-lymphocyte ratio (NLR), and mortality.

This study included 275 CHD patients who underwent cardiac surgery. The mean age and weight were 32.54 ± 37.4 months and 11.01 ± 8.43 kg, respectively. Those who died were younger (P = 0.05) and had lower weights (P = 0.001). An inverse relationship existed between thrombocytopeniaandmortality. TheNLRwashigher in thosewhosurvived(mean4.08 vs. 2.87), while the deceased patients had an extended duration of hospitalization, longer CPB time, and longer XCT time.

Younger age, lower body weight, lower NLR ratio, lower platelet count, longer intraoperative CPB time, and XCT time were not associated with increased in-hospital mortality following cardiac surgery for CHDs. The Risk Adjustment for Congenital Heart Surgery (RACHS-1) score was not significantly related to mortality. Also, CPB and XCT times were significantly longer in cyanotic than in non-cyanotic patients. Cyanotic patients also had significantly lower platelets than non-cyanotic patients after the operation. Large, multicenter studies are needed to further investigate the predictors of mortality following surgery for CHDs.

Double inlet left ventricle (DILV) is a rare congenital cardiac malformation that is defined as an anomaly with univentricular atrioventricular (AV) connection, and single ventricular morphology. This variation can be associated with the inlet and outlet cardiac abnormalities. In the current report, we present a case of Holms heart, as a rare variant of double-inlet left ventricle.