Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study.

BACKGROUND: Evolution of left ventricle (LV) function in the pediatric OHT population has not been well described. Our hypothesis was that, in children following OHT without any rejection, there would be progressive normalization of LV size and function over 2 years. METHODS: LV function was evaluated using STE and conventional echo parameters at five time points in pediatric OHT patients without any rejection in the first 2 years following OHT and normal controls. LV global peak systolic longitudinal strain (LVPLS) and strain rate, LV peak systolic radial and circumferential strain (LVRS and LVCS), and strain rate were analyzed. RESULTS: We had twenty two patients with median age at OHT of 1.27 years ( IQR 0.19, 5.6 years). The LVPLS (mean ± SD) was abnormal in the post-OHT echocardiograms at 1 week (-12.4 ± 3.7) and 1 month (-13.9 ± 3.7) and significantly improved at 6 months (-15.8 ± 3.2), 1 year (-15.7 ± 3.1), and 2 years (-17.8 ± 2.8). However, LVPLS remained below the normal group even at 2 years following OHT (-21.3 ± 1.76). CONCLUSION: In children following OHT, despite the absence of rejection, strain values are significantly impaired in the initial months, improve progressively over the first 2 years but remain abnormal compared with healthy controls.

A study on quality of life in patients following myocardial infarction.

Subjective well being has been widely researched in the past few decades and in practical terms it is a term that encompasses the various ways people evaluate their lives including concepts such as life satisfaction, work and health etc. Since, it is well known, that psychological factors including stress, anxiety, poor sleeping habits etc are known to be important causes of life style disorders like myocardial infraction, we started with the hypothesis that subjective well being of post acute MI patients must be poorer compared to normal subjects in the same age group. A comparative study between normal subjects and post acute myocardial infarction patients was undertaken to compare their subjective well being and current mental health status, at Safdarjung Hospital, New Delhi using standardized questionnaires. The results showed significantly higher negative affect like inadequate mental mastery over immediate environment, perceived ill health including disturbed sleep, deficiency in social contacts, and a general ill being about life in the MI group (P<0.05). Regarding the positive emotions, the normal subjects showed a higher general well being positive affect, higher transcedence and higher perception of social support. (P<0.05). The GHQ also yielded significantly better sleeping habits, less anxiety, better perception of health and more satisfaction with life in the normal subjects compared to post acute MI patients. (P<0.05).

Large pseudoaneurysm following right ventricle to pulmonary artery homograft placement in an infant.

Pseudoaneurysm (PSA) is a known but rare complication of the right ventricle to pulmonary artery (RV-PA) conduits. The patient's clinical presentation can be variable ranging from asymptomatic to potential rupture. We describe an unusual case of a massive PSA in an infant who underwent RV-PA pulmonary homograft placement after relief of right ventricular outflow tract obstruction.