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3. Left Ventricular Rotational Mechanics in Children After Heart Transplantation

Author

Nawaytou, Hythem M, Yubbu, Putri, Montero, Andrea E, Nandi, Deipanjan, O'Connor, Matthew J, Shaddy, Robert E, and Banerjee, Anirban

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Heart Disease, Cardiovascular, Adolescent, Age Factors, Biomechanical Phenomena, Case-Control Studies, Child, Echocardiography, Doppler, Pulsed, Exercise Test, Exercise Tolerance, Female, Graft Rejection, Heart Transplantation, Humans, Male, Myocardial Contraction, Observer Variation, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Stress, Mechanical, Time Factors, Torsion, Mechanical, Treatment Outcome, Ventricular Dysfunction, Left, Ventricular Function, Left, hemodynamics, mechanics, pediatrics, torsion, transplantation, Clinical Sciences, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

Left ventricular (LV) dysfunction after orthotopic heart transplantation (OHT) is multifactorial and can be an indicator of graft rejection or coronary artery vasculopathy. Analysis of rotational mechanics may help in the early diagnosis of ventricular dysfunction. Studies describing the left ventricular rotational strain in children after OHT are lacking. It is important to establish the baseline rotational mechanics in pediatric OHT to pursue further studies in this population. Rotational strain measured by speckle tracking was compared in 32 children after OHT, with no evidence of active rejection or coronary artery vasculopathy with 35 age-matched normal controls. Twelve OHT patients and 13 controls underwent moderate exercise with pre- and postexercise echocardiography. Torsion, slope of the systolic limb of the torsion-radial displacement loop, and the untwist rate were significantly higher in OHT patients (torsion: median 2.7°/cm [Q1-Q3, 2.3-3.2] versus 2.3°/cm [Q1-Q3, 1.9-2.7]; P=0.03, torsion-radial displacement loop: 2.7°/mm [Q1-Q3, 2.1-3.6] versus 2.0°/mm [Q1-Q3, 1.6-2.7]; P=0.008, indexed peak untwist rate: -21.6°/s/cm [Q1-Q3, -24.3 to -15.7] versus -17.1°/s/cm [Q1-Q3, -19.6 to -13.3]; P=0.01). Contrary to controls, OHT recipients were unable to increase torsion with exercise (OHT: 2.8°/cm [2.7-3.2] versus 3°/cm [2.4-3.5]; P=0.81, controls: 2.2°/cm [2-2.6] versus 3°/cm [2.4-3.7]; P=0.01, pre and post exercise, respectively). The systolic slope of the torsion-radial displacement loop relationship decreased with exercise in most OHT patients. Baseline rotational strain in OHT patients is higher than normal with a blunted response to exercise. The slope of torsion-radial displacement loop, and its response to exercise, may serve as a marker of left ventricular dysfunction in OHT patients.

Published
2016

5. Early outcomes for low-risk pediatric heart transplant recipients and steroid avoidance: A multicenter cohort study (Clinical Trials in Organ Transplantation in Children - CTOTC-04)

Author

Lamour, Jacqueline M., Mason, Kristen L., Hsu, Daphne T., Feingold, Brian, Blume, Elizabeth D., Canter, Charles E., Dipchand, Anne I., Shaddy, Robert E., Mahle, William T., Zuckerman, Warren A., Bentlejewski, Carol, Armstrong, Brian D., Morrison, Yvonne, Diop, Helena, Iklé, David N., Odim, Jonah, Zeevi, Adriana, and Webber, Steven A.

Published
2019
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6. Study rationale, design, and pretransplantation alloantibody status: A first report of Clinical Trials in Organ Transplantation in Children-04 (CTOTC-04) in pediatric heart transplantation

Author

Zuckerman, Warren A., Zeevi, Adriana, Mason, Kristen L., Feingold, Brian, Bentlejewski, Carol, Addonizio, Linda J., Blume, Elizabeth D., Canter, Charles E., Dipchand, Anne I., Hsu, Daphne T., Shaddy, Robert E., Mahle, William T., Demetris, Anthony J., Briscoe, David M., Mohanakumar, Thalachallour, Ahearn, Joseph M., Iklé, David N., Armstrong, Brian D., Morrison, Yvonne, Diop, Helena, Odim, Jonah, and Webber, Steven A.

Published
2018
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17. List of Contributors

Author

Adachi, Iki, primary, Akam-Venkata, Jyothsna, additional, Almond, Christopher S., additional, Anderson, Jeffrey B., additional, Ballweg, Jean, additional, Bansal, Neha, additional, Benhase, Christine, additional, Bernstein, Daniel, additional, Blume, Elizabeth D., additional, Burchill, Luke J., additional, Burch, Michael, additional, Burki, Sarah, additional, Byrnes, Jonathan W., additional, Cabrera, Antonio G., additional, Cannon, Bryan, additional, Canter, Charles E., additional, Chang, Anthony C., additional, Colan, Steven D., additional, Conway, Jennifer L., additional, David Xu, Weining, additional, Davies, Ryan R., additional, Denfield, Susan W., additional, Dipchand, Anne I., additional, Donofrio, Mary T., additional, Dreyer, William J., additional, Driscoll, David J., additional, Eastaugh, Lucas, additional, Everitt, Melanie D., additional, Fang, James C., additional, Faulkner, Theresa J., additional, Floh, Alejandro A., additional, Franco, Vivian I., additional, Fraser, Charles D., additional, Friedberg, Mark K., additional, Fynn-Thompson, Francis, additional, George, Kristen, additional, Gillespie, Matthew J., additional, Glatz, Andrew C., additional, Goldberg, David J., additional, Goldstein, Stuart L., additional, Hanke, Samuel, additional, Hendricks, Karen, additional, Hershberger, Ray, additional, Hijazi, Ziyad M., additional, Hoffman, Timothy M., additional, Holzer, Ralf J., additional, Hussey, Alexander, additional, Indik, Julia H., additional, Ing, Frank, additional, Ivy, Dunbar, additional, Jacquiss, Robert D.B., additional, Jaeggi, Edgar T., additional, Jean-St.-Michel, Emily, additional, Jeewa, Aamir, additional, Jefferies, John L., additional, Johnson, Jason, additional, Johnson, Jonathan N., additional, Kaddourah, Ahmad, additional, Kantor, Paul F., additional, Kim, Jeffrey J., additional, Kindel, Steven J., additional, Kirklin, James K., additional, Kuhn, Bernhard, additional, Lail, Jennifer, additional, Lavine, Kory J., additional, Lin, Kimberly Y., additional, Lipshultz, Steven E., additional, Lorts, Angela, additional, Maher, Kevin O., additional, Mann, Douglas L., additional, Marcus, Frank I., additional, Margossian, Renee, additional, Marino, Bradley S., additional, Mathew, Jacob, additional, Maul, Tim, additional, Mestroni, Luisa, additional, Miyamoto, Shelley D., additional, Morales, Ana, additional, Morales, David L.S., additional, Naim, Maryam Y., additional, Nakano, Stephanie J., additional, Nandi, Deipanjan, additional, Nelson, David P., additional, O’Byrne, Michael L., additional, O’Connor, Matthew J., additional, Opotowsky, Alexander R., additional, Pagani, Francis D., additional, Pahl, Elfriede, additional, Penny, Daniel J., additional, Price, Jack F., additional, Puggia, Ilaria, additional, Ravishankar, Chitra, additional, Redington, Andrew N., additional, Rome, Jonathan J., additional, Rosenthal, David N., additional, Rossano, Joseph W., additional, Ross, Heather J., additional, Ross, Robert D., additional, Rowland, Teisha J., additional, Ryan, Thomas D., additional, Schumacher, Kurt R., additional, Schwartz, Matthew C., additional, Schwartz, Steven M., additional, Shaddy, Robert E., additional, Shah, Maully J., additional, Simmonds, Jacob, additional, Simpson, Kathleen E., additional, Sinagra, Gianfranco, additional, Sublett, Juli, additional, Sullivan, Patrick, additional, Suradi, Hussam, additional, Sutcliffe, David L., additional, Takao, Cheryl, additional, Taylor, Michael, additional, Thiruchelvam, Timothy, additional, Thrush, Philip T., additional, Towbin, Jeffrey A., additional, Tweddell, James S., additional, Urschel, Simon, additional, VanderPluym, Christina J., additional, Wackel, Philip, additional, Wallen, Jack, additional, Wearden, Peter, additional, Weintraub, Robert G., additional, Weiss, Scott L., additional, West, Shawn, additional, Willerson, James T., additional, Wilmot, Ivan, additional, Wilson, Judith, additional, Yuerek, Mahsun, additional, and Zinn, Matthew, additional

Published
2018
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18. Preface

Author

Jefferies, John L., primary, Chang, Anthony C., additional, Rossano, Joseph W., additional, Shaddy, Robert E., additional, and Towbin, Jeffrey A., additional

Published
2018
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25. Abstract 15964: First Year Outcomes for Low Immunologic Risk Pediatric Heart Transplant Recipients Managed With a Steroid Avoidance Protocol: Results From a Multicenter Prospective Cohort Study (CTOTC-04)

Author

Lamour, Jacqueline M, Mason, Kristen L, Hsu, Daphne T, Feingold, Brian, Blume, Betsy D, Canter, Charles E, Dipchand, Ann I, Shaddy, Robert E, Mahle, William T, Zuckerman, Warren A, Bentlejewski, Carol, Armstrong, Brian D, Morrison, Yvonne, Diop, Helena, Ikle, David N, Odim, Jonah, Zeevi, Adriana, and Webber, Steven A

Published
2017

35. Role of βI[superscript two]-blocker therapy in pediatric heart failure

Author

Patel, Akash R and Shaddy, Robert E

Subjects
Congenital heart disease -- Drug therapy -- Health aspects, Cardiovascular agents -- Health aspects, Genetic disorders -- Drug therapy -- Health aspects, Pediatrics -- Health aspects, Cardiac patients -- Drug therapy -- Health aspects, Heart failure -- Drug therapy -- Health aspects, Company business management, Health, New York Heart Association -- Management
Abstract

Heart failure is becoming an increasingly common and significant problem in the field of pediatric cardiology. The numerous types of cardiomyopathies, and more recently, long-term survival of patients with congenital heart disease, have added to a growing patient population. Over the last several decades, our knowledge base regarding mechanisms of disease and therapeutic intervention in adult patients with heart failure has drastically changed. The most recent and important breakthrough in the pharmacologic treatment of heart failure has been the particular role of ββ-blocker therapy. This medication has led to significant improvements in survival and symptoms in adults, with less convincing findings in limited studies in pediatrics. The ability to study the benefits of this therapy in patients has been challenging owing to the heterogeneity of the patient population and lack of large sample sizes. However, as we investigate the mechanisms behind the disease process, the differences that exist between disease conditions and ages, and the significant alterations that may exist at the molecular and genetic level, our understanding of ββ-blocker therapy in pediatric heart failure will improve, and ultimately may lead to patient-specific therapy., Author(s): Akash R Patel [sup.1] , Robert E Shaddy [sup.[[dagger]â ]] [sup.2] Keywords *⢠[beta]β-blocker; carvedilol; congenital heart disease; heart failure; pediatric Heart failure in the pediatric population continues to [...]

Published
2010
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40. Carvedilol for children and adolescents with heart failure: a randomized controlled trial

Author

Shaddy, Robert E., Boucek, Mark M., Hsu, Daphne T., Boucek, Robert J., Canter, Charles E., Mahony, Lynn, Ross, Robert D., Pahl, Elfriede, Blume, Elizabeth D., Dodd, Debra A., Rosenthal, David N., Burr, Jeri, LaSalle, Bernie, Holubkov, Richard, Lukas, Mary, Ann, and Tani, Lloyd Y.

Subjects
Children -- Health aspects, Heart failure -- Drug therapy
Abstract

The paper analyses the effects on children and adolescents receiving carvedilol for treatment of heart failure. Carvedilol is not shown to be beneficial to them.

Published
2007

44. Rheumatic fever in children younger than 5 years: is the presentation different?

Author

Tani, Lloyd Y., Veasy, L. George, Minich, L. LuAnn, and Shaddy, Robert E.

Abstract

Objective. To review our experience with children who presented with rheumatic fever (RF) before 5 years of age and to compare their presentation with that of older children. Methods. The cardiology database was reviewed to identify patients who were younger than 5 years and had a diagnosis RF using the Jones criteria from January 1985 through March 2000. Patient age, sex, date and age at presentation, and the major Jones criteria fulfilled were noted. When carditis was present, its severity was judged to be moderate to severe when there was radiographic cardiomegaly and/or clinical congestive heart failure. The clinical presentation of patients who presented in the first 5 years of life were compared with the presentation of those whose RF was diagnosed after 5 years of age. Clinical findings at follow-up evaluation and echocardiographic findings both at presentation and at follow-up were noted for the children who were younger than 5 years at presentation. Results. Of 541 cases of RF seen from January 1985 through March 20000, 27 (5%) were in children who were younger than 5 years (median: 4.0 years; range: 1.9-4.9 years). Major Jones criteria at presentation were arthritis in 17, carditis in 14, chorea in 3, and erythema marginatum in 3. The carditis was mild in 4 and moderate to severe in 10 patients. Compared with older children, younger children were more likely to present with moderate to severe carditis, arthritis without carditis or chorea, or the rash of erythema marginatum and were less likely to have chorea. The incidence of carditis was similar in the 2 groups as was the ratio of boys to girls. At follow-up (9.6 [+ or -] 5.6 years), 69% of younger children who presented with carditis have clinical rheumatic heart disease. Subclinical, echocardiographically detected valvular abnormalities were detected both at presentation (33% of all children with RF before 5 years of age) and at follow-up (55% of those who initially had carditis). Conclusions. Approximately 5% of children with RF were younger than 5 years at diagnosis. Compared with older patients, children who presented before 5 years of age were more likely to have moderate to severe carditis and to present with arthritis or the rash of erythema marginatum and were less likely to have chorea. Chronic rheumatic heart disease was common in young children who presented with carditis. Long-term follow-up is necessary to determine the outcome for young children with subclinical echocardiographic evidence of valvular disease. Pediatrics 2003;112:1065-1068; rheumatic fever., ABBREVIATION. RF, rheumatic fever. Rheumatic fever (RF) is a leading cause of acquired heart disease in children and young adults in many parts of the world. (1,2) Although less common [...]

Published
2003

46. Contributors

Author

Aiello, Vera Demarchi, primary, Habshan, Fahad Al, additional, Anderson, Page A.W., additional, Anderson, Robert H., additional, Apitz, Christian, additional, Baker, Edward J., additional, Barron, David J., additional, Becker, Anton E., additional, Bédard, Elisabeth, additional, Benson, Lee N., additional, Blume, Elizabeth D., additional, Bonhoeffer, Philipp, additional, Bradley, Timothy J., additional, Braudis, Nancy J., additional, Brawn, William J., additional, Brizard, Christian, additional, Brown, Nigel, additional, Bruneau, Benoit G., additional, Bryant-Stephens, Tyra, additional, Burn, John, additional, Charakida, Marietta, additional, Cheung, Yiu-fai, additional, Colman, Jack M., additional, Daubeney, Piers E.F., additional, Davis, Andrew M., additional, Deanfield, John E., additional, Dearani, Joseph A., additional, Derrick, Graham, additional, Dipchand, Anne I., additional, Dominguez, Troy E., additional, Eastaugh, Lucas J., additional, Ebels, Tjark, additional, Elliott, Martin J., additional, Elliott, Perry, additional, Ellis, Toni, additional, Elzenga, Nynke, additional, English, Robert F., additional, Ettedgui, José A., additional, Friedman, Alan H., additional, Gandy, Kimberly L., additional, Gardiner, Helena M., additional, Gatzoulis, Michael A., additional, Grosse-Wortmann, Lars, additional, Gruber, Peter J., additional, Halcox, Julian P., additional, Haworth, Sheila G., additional, Hlavacek, Anthony M., additional, Hoffman, George M., additional, Horowitz, Estela S., additional, Hoschtitzky, J. Andreas, additional, Heroniz, Estela S., additional, Humpl, Tilman, additional, Hutter, Damian, additional, Jaeggi, Edgar T., additional, Jones, Timothy J.J., additional, Kaski, Juan Pablo, additional, Khambadkone, Sachin, additional, Kohr, Lisa M., additional, Lee, Whal, additional, Loukogeorgakis, Stavros P., additional, McBride, Michael G., additional, McCrindle, Brian W., additional, McNamara, Patrick J., additional, Mertens, Luc L., additional, Moorman, Antoon F.M., additional, Coelho Mota, Cleonice C., additional, Mussatto, Kathleen, additional, Newburger, Jane, additional, O'Leary, Patrick W., additional, Paridon, Stephen M., additional, Penny, Daniel J., additional, Qureshi, Shakeel A., additional, Rabinovitch, Marlene, additional, Redington, Andrew N., additional, Reid, Christopher J.D., additional, Reidy, John F., additional, Rigby, Michael L., additional, Rychik, Jack, additional, Salih, Caner, additional, Schulze-Neick, Ingram, additional, Sermer, Mathew, additional, Shaddy, Robert E., additional, Shekerdemian, Lara, additional, Shillingford, Amanda J., additional, Shirali, Girish S., additional, Silverman, Norman H., additional, Silversides, Candice K., additional, Sinha, Manish D., additional, Siu, Samuel C., additional, Smallhorn, Jeffrey F., additional, Srivastava, Deepak, additional, Stephens, Paul, additional, Stephenson, Elizabeth A., additional, Szwast, Anita L., additional, Taib, Rohayati, additional, Tulzer, Gerald, additional, Tweddell, James, additional, Uemura, Hideki, additional, Vanderwal, Patrick, additional, Vogel, Michael C., additional, Webb, Gary D., additional, Webber, Steven A., additional, Wernovsky, Gil, additional, Wilkinson, James L., additional, and Yoo, Shi-Joon, additional

Published
2010
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