Purpose:To determine the inter-and intraobserver reproducibility of cardiac magnetic resonance (CMR)-derived measurements of right ventricular (RV) mass, volume, and function in patients with normal and dilated ventricles. Materials and Methods:CMR studies of 60 patients in three groups were studied: a normal RV group (N ϭ 20) and two groups with RV dilation-atrial septal defect (ASD) (N ϭ 20) and repaired tetralogy of Fallot (TOF) (N ϭ 20). Two independent observers analyzed each study on two separate occasions. Inter-and intraobserver reproducibility of biventricular mass, volume, ejection fraction (EF), and stroke volume (SV) measurements were calculated.Results: High intraclass correlation coefficients (ICC) were found for interobserver (ICC ϭ 0.94 -0.99) and intraobserver (ICC ϭ 0.96 -0.99) comparisons of RV and left ventricular (LV) mass, volume, and SV measurements. RV and LV EF measurements were less reproducible (ICC ϭ 0.79 -0.87). RV mass measurements were significantly less correlated than the respective LV measurements. Small but statistically significant differences in correlation were noted in RV measurements across groups. Conclusion:Except for RV mass, inter-and intraobserver reproducibility of RV size and function measurements is high and generally comparable to that in the LV in patients with both normal and dilated RV.

SummaryContext As a result of the introduction of treatment with glucocorticoids and mineralocorticoids, now 60 years ago, congenital adrenal hyperplasia has become a lifelong chronic disease. Whether long-term treatment of the disease leads to long-term side effects remains unknown. In this respect, especially cardiovascular risk seems to be important. Evidence synthesis We reviewed the reported prevalence of conventional cardiovascular risk factors, i.e. obesity, insulin resistance, high blood pressure and dyslipidaemia in patients with congenital adrenal hyperplasia. Overall, the studies suggest a tendency towards an increased body mass index and fat mass, the presence of insulin resistance and hypertension, although data are relatively scarce and obtained in heterogeneous populations. Conclusions Our findings suggest that adult CAH patients tend to have a cluster of metabolic risk factors, which are consistent with the metabolic syndrome. This notion may have consequences for the care for this group of patients.

Hyperthyroidism caused by Graves’ disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults – antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association guideline provides new recommendations for the management of pediatric GD with and without orbitopathy. Clinicians should be alert that GD may present with behavioral changes or declining academic performance in children. Measurement of serum TSH receptor antibodies is recommended for all pediatric patients with hyperthyroidism. Management recommendations include the first-line use of a prolonged course of methimazole/carbimazole ATD treatment (3 years or more), a preference for dose titration instead of block and replace ATD, and to avoid propylthiouracil use. Where definitive treatment is required either total thyroidectomy or RAI is recommended, aiming for complete thyroid ablation with a personalized RAI activity. We recommend avoiding RAI in children under 10 years of age but favor surgery in patients with large goiter. Pediatric endocrinologists should be involved in all cases.