Comparison of QT dispersion before and after PDA device closure in pediatrics.

BACKGROUND: Numerous studies have shown that QT dispersion (QTd) can be a suitable criterion for risk assessment of arrhythmia in patients with congenital heart disease. Pulmonary arterial hypertension (PAH) increases the risk of cardiac arrhythmia by changing ventricular repolarization homogeneity. In this study, we assessed QTd changes after PDA device closure and the effect of PAH on these changes. METHODS: Between October 2018 and March 2021, 97 patients (48 males; 49 females; mean age 31.36 ± 4.26 months; range 3 months to 14 years) who satisfied the primary inclusion criteria and did not meet the exclusion criteria and underwent PDA device closure intervention were included in the study. Echocardiography was performed before the procedure. QT corrected (QTc), and QTd and PR intervals were measured according to the patients' standard 12-lead ECGs in two periods, preoperative (1 day) and after (3 months). RESULTS: In the general group, QTc and QTd decreased significantly after PDA closure. Based on our classification of the patients in two groups of high PAP and normal PAP, the three parameters QTc, QTd, and PR interval were assessed separately in the two groups. All three parameters decreased significantly in the normal PAP and high PAP groups. CONCLUSIONS: However, a left-to-right shunt through the patent ductus arteriosus can affect ventricular repolarization; this effect seems to be particularly more significant when there is pulmonary hypertension.

Arterial tortuosity syndrome presented as nonvisualization of thoracic aorta in preoperative transthoracic echocardiogram: A case report.

Arterial tortuosity syndrome is a rare genetic disorder characterized by dilation, elongation, and significant tortuosity of major arteries. Approximately 100 cases of this disorder have been reported worldwide, including 3 reports in Iran. We describe a case of arterial tortuosity syndrome suspected during the preoperative evaluation for hypertrophic pyloric stenosis, where the thoracic aorta was not visualized appropriately in transthoracic echocardiography. Our report focuses on identifying the disease through diagnostic imaging.

Signal Processing of Heart Rate for Predicting Sepsis in Premature Neonates.

The heart rate characteristic (HeRO score) is a figure derived from the analysis of premature neonate's electrocardiogram signals, and can be used to detect infection before the onset of clinical symptoms. The United States and Europe accept this diagnostic technique, but we require more tests to prove its efficacy. This method is not accepted in other developed countries so far. The present study aimed to investigate changes in the heart characteristics of two neonates in Akbar Abadi Hospital in Tehran. Experts chose one newborn as a sepsis case, and the other neonate was healthy. The results were analyzed and compared with previous studies. In this research, a group of five neonates was selected randomly from the neonatal intensive care unit, and cardiac leads were attached to them for recording heart rates. We selected two neonates from the five cases, as a case (proven sepsis) and control, to analyze heart rate variability (HRV). Then, we compared the differences in the heart rate of both neonates. Analysis of HRV of these two neonates showed that the pattern of HRV is compatible with reports from US studies. Considering the results of this study, heart rates and their analysis can provide useful indicators for mathematical modeling before the onset of clinical symptoms in newborns.

A Comparison Between MRIT2 and NT-ProBNP in Early Detection of Heart Diseases in Thalassemia Major Patients: A Cross-Sectional Study.

One of the most common causes of mortality in major thalassemia is cardiac complications. Despite existence of several methods for diagnosis of cardiac complications in thalassemia, this sequel persists as a major problem in these patients. The aim of this study is to compare the level of serum NT-ProBNP and cardiac MRI T2* in early detection and treatment of cardiac disorders in beta thalassemia major patients. 35 major thalassemic patients on regular transfusion were selected in our center from 2013 to 2014. All of the patients were at least 8 years old. NT-ProBNP and MRIT2* analyses were carried out for these patients, and consequently the findings were compared together and analyzed. There is a strong correlation between NT-ProBNP and MRIT2* (p value < 0.001) in early detection of cardiac disorders. NT-ProBNP is an important marker for diagnosis of cardiac complications before emergence of heart failure in thalassemic patients. Given the findings of this study, it is recommended that this marker be used on a regular basis for thalassemic patients on regular transfusion.

Hyperglycemia in VLBW infants; incidence, risk factors and outcome.

BACKGROUND: Neonatal hyperglycemia, which is relatively common in very low birth weight (VLBW) infants, is associated with increased risk of morbidity and mortality. OBJECTIVE: To study the incidence of neonatal hyperglycemia, associated risk factors and the outcome of it in VLBW infants hospitalized in a level III NICU in Tehran. METHODS: All VLBW newborns admitted to the NICU of Mahdieh Hospital from April 2009 to March 2011 were considered eligible for this retrospective study. All relevant prenatal and perinatal data, as well as details of the hospital stay until discharge or death, were extracted from the case notes and analyzed. RESULTS: Hyperglycemia (blood suger above 150 mg/dL) was observed in 179 (31.7%) of the 564 VLBW infants included in the study; 48 infants (26.8%), had received insulin. Risk factors included: low gestational age, (OR = 4.07, 95% CI = 2.09-7.93, P < 0.001), extremely low birth weight (ELBW) , (OR = 5.97, 95% CI = 3.77-9.44, P < 0.001), dopamine administration (OR = 2.19, 95% CI = 1.32-3.65, P = 0.003), intralipid (OR = 1.52, 95% CI = 1.04-2.22, P = 0.03), Low APGAR score at 5 minutes (OR = 4.44, 95% CI = 2.48-7.94, P < 0.001), RDS and its complications (OR = 4.20, 95% CI = 2.55-6.93, P < 0.001), were independently associated with hyperglycemia. Other findings with hyperglycemia were: high incidence of IVH >grade II (OR = 2.88, 95% CI = 1.28-6.49, P = 0.01), hospital stay more than 28 days in survivors,(OR = 3.56, 95% CI = 2.02-6.25, P < 0.001), mortality (OR = 4.42, 95% CI = 3.00-6.52, P < 0.001) and more retinopathy of prematurity (ROP ≥ stage II) in survivors (OR = 2.05, 95% CI = 1.11-3.78, P = 0.02). CONCLUSION: Neonatal hyperglycemia developed in approximately one-third of our VLBW neonates. Relative prevalence and associated findings underscore the need for preventive measures and prompt management.