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Few reports have described the prognostic value of measuring both B-type natriuretic peptides (BNP) and high-sensitivity troponin T (hs-TnT) in pediatric patients with complex congenital heart disease (CHD) undergoing surgery. We assessed demographic, hemodynamic, and laboratory data, including BNP and hs-TnT levels, for the prediction of cardiac adverse events in 85 patients. Cardiac adverse events were defined as death, cardiac arrest, worsening heart failure requiring inotropic agents and/or respiratory support, and unscheduled surgery/intervention either within or after 12 months of surgery. There were 17 cardiac adverse events. Of the demographic variables, low birth weight (

Multidetector-row computed tomography (MDCT) of the heart is a new diagnostic approach for the quantitative evaluation of the coronary artery in adults. However, in children, the quantitative analysis of each cardiac chamber has not been established. We attempt to clarify the feasibility and validation of ECG-gated MDCT as a quantitative diagnostic tool to assess the right and left ventricular volume in children. The study consisted of 16 patients who had definite right and left ventricle. After obtaining multislice images by MDCT, we measured the end diastolic volume of both the right and the left ventricle by direct calculation of the region of interest and calculation from the projected image of three-dimensional reconstruction by traditional formulas. The correlation between the two calculations for both ventricles is excellent (r = 0.99 for LV and 0.94 for RV, respectively). The correlations for ventricular volume between calculation of catheterization and calculation of MDCT is also good (r = 0.99 for LV 0.99 for RV, respectively). Volume measurement by ECG-gated MDCT of the right and left ventricles is well correlated with that by catheterization in children and can reduce the necessity for cardiac catheterization.

Two-dimensional tissue tracking makes it possible to detect myocardial strain in any direction. Consequently, this method is applicable for evaluation of myocardial dyssynchrony. This study enrolled 22 healthy volunteers (11 boys and 11 girls) ages 1.6 to 10.8 years (mean, 6.8 years). Echocardiography (subxiphoid right anterior oblique view) of the right ventricle was examined. Three tracking points were put on the right ventricle, and time-strain curves of the inflow tract (strain at the inlet) and the outflow tract (strain at the outlet) as well as time-strain curve of the pulmonary annulus diameter were made. The strain at the inlet was larger than the strain at the outlet (0.31 vs 0.15; p = 0.0003). The time to peak negative strain at the inlet was longer than at the outlet (0.48 vs 0.42 s; p = 0.001). The diameter of the pulmonary annulus shortened in systole, and the time to peak negative strain of the pulmonary annulus was longer than that of the outlet (0.48 vs 0.42; p = 0.001). There was no significant difference in the times between the pulmonary annulus and the inlet (0.48 vs 0.48; p = 0.78). Two-dimensional tissue tracking allows assessment for quantification of myocardial performance and timing of the right ventricle.