BackgroundRight ventricular (RV) function is one of the important prognostic factors in patients with repaired Tetralogy of Fallot (TOF). We aimed to assess RV function by conventional echocardiography and two‐dimensional speckle tracking echocardiography (2D‐STE) in patients with repaired TOF.MethodsTwenty‐seven (male 17) adolescents and young adult patients (mean age 22.7 ± 6.7 years) operated on for TOF and age‐ and gender‐matched healthy controls were included. RV systolic function in both groups were evaluated by fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (RVMPI) and tricuspid annular peak systolic velocity by pulsed tissue Doppler (tricuspid S'), and also RV global longitudinal strain (RV GLS) obtained from STE. These results were compared with RV ejection fraction (RVEF) measured by cardiac magnetic resonance imaging (CMRI) performed within 3 months in patient group.ResultsSystolic RVGLS values were significantly lower in patients compared to controls (−17.4 ± 3.1% vs −25.6 ± 3%). Among the echocardiographic parameters, RVGLS had the best correlation with RV EF derived from CMRI (r: −.6). By receiver operating characteristics analysis (ROC), an RV GLS cutoff value of −17.4% had 75% sensitivity and 68.4% specificity in identifying RVEF <45% with an area under curve 0.743 (P < .05). The intra‐ and inter‐observer agreement for RV GLS was excellent.ConclusionRVGLS is an easy, effective, feasible, and reproducible tool in the evaluation of RV systolic function. So, RVGLS measurement by STE may be one of the routine echocardiographic parameters in the evaluation of RV systolic function in patients with repaired TOF.
Holter and EST have low predictive value in WPW risk stratification. However, TEEPS and EPS are extremely valuable in WPW risk stratification. TEEPS may reveal important and useful results for WPW risk determination, especially in small children not having undergone EPS in order to avoid its complications.
Although heart failure is managed medically most of the time, heart transplantation is still last resort for selected end-stage heart failure patients with noncompaction cardiomyopathy. Presently described for the first time is case of pediatric patient with noncompaction cardiomyopathy who was initially referred to our hospital for heart transplant but underwent PDA repair and improved clinically without need for heart transplant.
Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes during adolescence years. In this study, we aimed to present the clinical outcomes of smoking cessation project conducted in an Anatolian school in Kartal district of Istanbul, Turkey. Methods: Social and motivational studies were carried out on adolescent smokers after scanning in terms of smoking in an Anatolian school and 44 of these adolescents who are clinical requirements were evaluated and followed by Chest disease and child and adolescent mental health for six months. Carbonmonoxide (CO) measurements in the expiratory air and carboximeter (piCO smokerlyzer, Bedfont Scientific Ltd, England) were made at the first visit and follow-up. Simultaneously, K-SADS PL (Schedule for Schizophrenia and Affective disorders for School Age Children) was administered diagnostically in mental health evaluation. Results: A total of 44 adolescents, 13 girl (29.5%) and 31 boy (70.5%), with a mean age of 17.31 were followed up. The mean age of initiation of cigarette smoking was 14.2 ± 1 and 32 (82.7%) adolescent were found to have at least one smoker in their home. While 22.7% of adolescents did not try smoking cessation, 77.3% of them did. Six of these adolescents indicated that they did not smoke during the six months; 55.5% of these adolescents have at least one mental illness; the most common diagnoses were 25.0% (n = 11) of ADHD (Attention Deficit Hyperactivity Disorder) and 20% (10) of MD (Major Depression). While depression was significantly frequent in girls (p = 0.043), the frequency of ADHD was not significant in terms of gender. Depression presence was associated with early onset of cigarette smoking in males (p = 0.019), but not with females (p = 0.394). There was a statistically significant correlation between smoking cessation effort and age in the follow-up period (p = 0.022), and earlier adolescents stated that they wanted to quit smoking more. While there is no significant association between smoking cessation effort and mental disease, there was a statistically close relation with parent and sibling smoking (p = 0.07) and significant correlation with motivation and smoking cessation effort (p = 0.016). Conclusions: Smoking cessation work in adolescents is much more difficult than in adults. Biological and social factors and peer impact influence interventions. In our study, very few adolescents stated to quit smoking for 6 months, and the rate of psychiatric illnesses among adolescents and the presence of individuals smoking at home were found to be quite high. It has been the result of these factors also affecting the success of adolescents to start smoking and to quit smoking.
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