Congenital heart disease – a public health problem

Boia, Marioara; Romania, Pharmacy, Timisoara,; Costescu, Oana-Cristina; Cioboata, Daniela; Popoiu, Anca; Lungu, Nicoleta; Doandes, Florina; Manea, Aniko

doi:10.37897/rjp.2020.3.3

Cited by 3 publications

(6 citation statements)

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“…Written informed consent was also obtained from parents or guardians of children before inclusion in the study. We calculated a minimum required sample of 32 patients based on the Romanian pediatric populational proportion extracted from governmental reports of 3,895,000 children [14] and an incidence of 2.11% CHD in Romania, as reported in a recent study [15]. We used a 95% confidence level with a marginal error of 5%.…”

Section: Methodsmentioning

confidence: 99%

Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role

Chiperi,

Huţanu,

Tecar

et al. 2023

Clinics and Practice

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Introduction: The objectives of this study were to assess the role of neuromarkers like glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), protein S100 (pS100), and neuron-specific enolase (NSE) as diagnostic markers of acute brain injury and also as prognostic markers for short-term neurodevelopmental impairment. Methods: Pediatric patients with congenital heart defects (CHDs) undergoing elective cardiac surgery were included. Neurodevelopmental functioning was assessed preoperatively and 4–6 months postoperatively using the Denver Developmental Screening Test II. Blood samples were collected preoperatively and postoperatively. During surgery, regional cerebral tissue oxygen saturation was monitored using near-infrared spectroscopy (NIRS). Results: Forty-two patients were enrolled and dichotomized into cyanotic and non-cyanotic groups based on peripheric oxygen saturation. Nineteen patients (65.5%) had abnormal developmental scores in the non-cyanotic group and eleven (84.6%) in the cyanotic group. A good diagnostic model was observed between NIRS values and GFAP in the cyanotic CHD group (AUC = 0.7). A good predicting model was observed with GFAP and developmental scores in the cyanotic CHD group (AUC = 0.667). A correlation was found between NSE and developmental quotient scores (r = 0.09, p = 0.046). Conclusions: From all four neuromarkers studied, only GFAP was demonstrated to be a good diagnostic and prognostic factor in cyanotic CHD patients. NSE had only prognostic value.

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Section: Methodsmentioning

confidence: 99%

Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role

Chiperi,

Huţanu,

Tecar

et al. 2023

Clinics and Practice

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show abstract

“…A minimum required sample of patients was calculated with a 95% con dence level and a 5% marginal error and was represented by 32 patients based on Romanian pediatric population, proportion extracted from governmental reports (14) (3 895 000 children) and the incidence of CHD in Romanian pediatric population of 2.1% (15).…”

Section: Selecting the Patientsmentioning

confidence: 99%

Incidence of delayed psychomotor development in pediatric patients with congenital heart defects

Chiperi,

Tecar

2024

Preprint

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Introduction: Congenital heart defects (CHD) are the most commonly diagnosed group of malformations. CHD are associated with adverse neurodevelopmental outcome across lifespan that can manifest from the first year of life until adulthood. The aim of this study was to screen psychomotor performances of patients with unrepaired CHD. Methods This was a prospective study taken between 2020–2024. Children under 6 years with CHD and no previously known psychomotor impairment were dichotomized into two groups based on blood oxygen saturation (SpO2): cyanotic group (SpO2 < 95%) and non-cyanotic group (SpO2 > = 95%). Psychomotor developmental evaluation was done by Denver Developmental Screening Test II. Results The psychomotor development of 77 patients was evaluated in 4 domains (personal-social, fine motor, language, gross motor) and revealed that children considered normally developed, following the clinical examination, presented a delay in the neurological development after being evaluated with Denver test in 97% of those with cyanotic CHD and in 54% of those with non-cyanotic CHD. Gross motor and personal-social domains were the most affected in the both groups. General development and functionality scores were lower in the group with cyanotic CHD. Factors that correlated with neurological development were the prenatal diagnosis (p = 0.012) and the type of diet (p = 0.008). Conclusion The importance of psychomotor screening in children with CHD is overwhelming, considering that psychomotor delay was detected in a high percentage of children with unoperated CHD, considered normally developed at a clinical exam. Lower developmental scores were observed in those with cyanotic CHD. Prenatal diagnosis and diet were correlated with neurological development.

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“…Often the cause of CHD remains unknown. Pregnancy-related medical history is useful in diagnosing certain congenital heart diseases risk factors, such as biological teratogenic factors (rubella virus, cytomegalovirus, herpes viruses, and Coxsackie type B), physical, chemical, drug-related risk factor (antidepressants, amphetamines, anticonvulsants, certain antibiotics, lithium, retinoic acid) or traumatic factors [2][3][4]. CHDs can be associated with known genetic syndromes: Trisomy 13, 18, 21, Noonan syndrome, Turner syndrome, DiGeorge syndrome [2,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Signs and symptoms suggestive of CHD depend on the type of malformation, with some newborns being asymptomatic, while others present with nonspecific manifestations. All newborns with suspected CHD should be investigated during the neonatal period [2,3,5]. Echocardiography is the most important diagnostic modality for CHD and is readily available to the clinician.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Multidisciplinary Approach: A Retrospective Analysis of Congenital Heart Defects from a Tertiary Referral Centre In Bucharest-Romania

2024

Ann Case Report

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Background: Congenital heart defects (CHD) are a common type of internal birth defect affecting newborns globally, with a prevalence ranging from 0.8% to 1.2% of all live births. CHD are a significant cause of morbidity and mortality in newborns and children worldwide. They can range in severity from simple defects to complex defects that require multiple surgeries and ongoing medical management. The mortality rate for CHD has decreased over the last decades due to improved surgical techniques and medical management. However, they still represent an important public health problem. Prenatal detection and confirmation of the diagnosis after birth, or screening of newborns suspected of having a heart anomaly, allows for early and accurate diagnosis for timely optimal care. Material and methods: We conducted a retrospective cross-sectional study, over five years (2016)(2017)(2018)(2019)(2020), at Clinical Hospital of Obstetrics and Gynecology "Prof. Dr. P. Sârbu" in Bucharest, Romania, a level III maternity hospital. Patients were selected from the hospital database. Results: We included 375 patients, identified through prenatal or neonatal screening, that had clinically diagnosed, echocardiographic confirmed, and computerized angiographyconfirmed congenital heart malformations. In our study, the incidence of congenital heart malformations was 2%. Among the identified cases, 41 had complex CHD, and 13 newborns had various genetic syndromes associated, with Down syndrome being the most common. Out of the total patients, 27 were sent to cardiovascular surgery clinics during the neonatal period. Eight patients, especially preterm infants, died due to the complicated nature of the heart malformation and other conditions. Conclusions: In CHD evaluation, there should be a multidisciplinary team involved. In our clinic, the number of newborns with CHD has increased due to effective collaboration between obstetricians, neonatologists, and pediatric cardiologists. This facilitated intrauterine transfer at any gestational age to a higher-level maternity hospital, intending to diagnose, monitor, and treat heart anomalies. Our results demonstrate the effectiveness of a multidisciplinary team and support the inclusion of a pediatric population surveillance program in the national public health strategy.

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Congenital heart disease – a public health problem

Cited by 3 publications

References 0 publications

Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role

Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role

Incidence of delayed psychomotor development in pediatric patients with congenital heart defects

The Effect of Multidisciplinary Approach: A Retrospective Analysis of Congenital Heart Defects from a Tertiary Referral Centre In Bucharest-Romania

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