Noninvasive imaging of congenital cardiovascular defects

Ciancarella, Paolo; Ciliberti, Paolo; Santangelo, Teresa; Secchi, Francesco; Stagnaro, Nicola; Secinaro, Aurelio

doi:10.1007/s11547-020-01284-x

Cited by 20 publications

(9 citation statements)

References 75 publications

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“…With the improvement of surgical technology, the survival rate of children with congenital heart disease (CHD) has significantly increased ( 1 , 2 ). This in turn has led to a new generation of adolescents who may be prone to the development of heart failure due to residual lesions after correction or palliation of their cardiac defect ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Volume Overload Initiates an Immune Response in the Right Ventricle at the Neonatal Stage

Cui

Sun

Zhu

et al. 2021

Front. Cardiovasc. Med.

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Background: Pulmonary regurgitation caused by the correction or palliation of pediatric tetralogy of Fallot (TOF) leads to chronic right ventricular (RV) volume overload (VO), which induces adolescent RV dysfunction. A better understanding of the molecular mechanism by which VO initiates neonatal RV remodeling may bring new insights into the post-surgical management of pediatric TOF.Methods and Results: We created a fistula between the abdominal aorta and inferior vena cava on postnatal day 1 (P1) using a rat model to induce neonatal VO. Echocardiography revealed that the velocity and velocity- time-integral of the pulmonary artery (PA) were significantly elevated, and hematoxylin and eosin (H&E) staining showed that the diameter of the RV significantly increased. RNA-seq analysis of the RV on P7 indicated that the top 10 enriched Gene Ontology (GO) terms and the top 20 enriched terms in the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were associated with immune responses. Flow-cytometric analysis demonstrated that the number of CD4+and CD8+ immune cells were significantly augmented in the VO group compared with the sham group.Conclusions: A neonatal cardiac VO rat model on P1 was successfully created, providing a platform for studying the molecular biology of neonatal RV under the influence of VO. VO - induces an immune response at the neonatal stage (from P1 to P7), suggesting that immune responses may be an initiating factor for neonatal RV remodeling under the influence of VO and that immunosuppressants may be used to prevent pediatric RV remodeling caused by VO.

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Section: Introductionmentioning

confidence: 99%

Volume Overload Initiates an Immune Response in the Right Ventricle at the Neonatal Stage

Cui

Sun

Zhu

et al. 2021

Front. Cardiovasc. Med.

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“…Fontan pathway and pulmonary arteries may sometimes be visualized in case of good acoustic windows. Nevertheless, CCT or CMR should be performed to rule out any issues with certainty, allowing for unrestricted visualization of all structures ( 13 ).…”

Section: How To Image the Fontan Circuit?mentioning

confidence: 99%

“…However, CMR also has some drawbacks, mainly represented by the long scanning times, which necessitate general anesthesia in uncooperative patients (such as under 7–8 years of age) and make the exam difficult to perform in clinically unwell subjects. In addition, image quality can be limited by arrhythmia and CMR is not suitable in patients suffering from claustrophobia and in the presence of unsafe metallic devices ( 13 ).…”

Section: How To Image the Fontan Circuit?mentioning

confidence: 99%

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Cardiac Imaging in Patients After Fontan Palliation: Which Test and When?

et al. 2022

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The Fontan operation represents the final stage of a series of palliative surgical procedures for children born with complex congenital heart disease, where a “usual” biventricular physiology cannot be restored. The palliation results in the direct connection of the systemic venous returns to the pulmonary arterial circulation without an interposed ventricle. In this unique physiology, systemic venous hypertension and intrathoracic pressures changes due to respiratory mechanics play the main role for propelling blood through the pulmonary vasculature. Although the Fontan operation has dramatically improved survival in patients with a single ventricle congenital heart disease, significant morbidity is still a concern. Patients with Fontan physiology are in fact suffering from a multitude of complications mainly due to the increased systemic venous pressure. Consequently, these patients need close clinical and imaging monitoring, where cardiac exams play a key role. In this article, we review the main cardiac imaging modalities available, summarizing their main strengths and limitations in this peculiar setting. The main purpose is to provide a practical approach for all clinicians involved in the care of these patients, even for those less experienced in cardiac imaging.

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“…With the improvement of surgical technology, the survival rate of children with congenital heart disease (CHD) has significantly increased (1,2). This in turn has led to a new generation of adolescents who may be prone to the development of heart failure due to residual lesions after correction or palliation of their cardiac defect (3,4).…”

Section: Introductionmentioning

confidence: 99%

Data_Sheet_1.DOCX

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Noninvasive imaging of congenital cardiovascular defects

Cited by 20 publications

References 75 publications

Volume Overload Initiates an Immune Response in the Right Ventricle at the Neonatal Stage

Volume Overload Initiates an Immune Response in the Right Ventricle at the Neonatal Stage

Cardiac Imaging in Patients After Fontan Palliation: Which Test and When?

Data_Sheet_1.DOCX

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