Comparison of echocardiographic aortic stiffness index measurements and pulse wave velocity measurements in obese and overweight children.

BACKGROUND: Aortic/arterial stiffness is a reliable, independent predictor and a risk factor for cardiovascular mortality. Arterial stiffness is assessed by pulse wave velocity and echocardiography. The purpose of this study is to analyse aortic/arterial stiffness in patients using echocardiographic and pulse wave velocity techniques. MATERIALS AND METHODS: The participants of this study consisted of 62 patients who presented to the Gazi University Pediatric Endocrinology and Pediatric Cardiology outpatient clinics, including 21 obese, 20 overweight, and 21 normal-weight patients. Echocardiography was performed on all patients, and echocardiographic measurements were compared to pulse wave velocity measurements. RESULTS: The mean (min-max) arterial strain measurements were 0.146 ± 0.0 (0.06-0.3) in the obese group and 0.106 ± 0.0 (0.05-0.18) in the overweight group. In comparison to the overweight group, the obese group had greater arterial strain measurements. The pulse wave velocity measurements in the obese and overweight groups were greater than those in the normal weight group (p > 0.05). Elastic modulus and aortic stiffness ß index values were shown to be positively correlated with pulse wave velocity measurements in the obese group (r = 0.56, r = 0.53, respectively; p = 0.008, p = 0.01, respectively). Systolic and diastolic blood pressure measurements were correlated with pulse wave velocity measurements in the obese group (r = 0.98, p = 0.0001, respectively). CONCLUSION: In our study, echocardiographic aortic measurements showing the vessel wall were correlated with pulse wave velocity measurements. Echocardiographic evaluation should be included in the routine follow-up of patients because pulse wave velocity measurement devices are not available in all centres, echocardiography is available in many centres, it is easily applicable, and it facilitates the follow-up of patients.

Early Echocardiographic Findings of Pulmonary Hypertension-specific Therapy in Children.

Objective: Echocardiography is a very useful tool for the diagnosis and evaluation of pulmonary hypertension (PH). This study was planned to investigate whether echocardiographic (ECHO) data of patients with PH are effective in the follow-up and course of treatment. Methods: A retrospective analysis of the data from 26 PH patients was performed. Analyses were performed on the data of the patients, including their demographics and ECHO findings. The ECHO measurements of the patients were labeled as 0 (beginning of the PH specific therapy), 1 (on the 15th day of the therapy), 2 (one month after the previous echocardiogram). Results: The left ventricle ejection fraction (EF) (p=0.05) and fractional shortening (FS) (p=0.038) values in ECHO2 were significantly higher than those in ECHO1. Aortic velocity-time integral1 (VTI1) was significantly higher than aortic VTI0 (p=0.001; p<0.01), and tricuspid annular plane systolic excursion2 (TAPSE2) was significantly higher than TAPSE0 (p=0.046). Moreover, right ventricular ejection time1 (RVET1) was significantly higher than RVET0 (p=0.034), and left ventricular ejection time1 (LVET1) was significantly higher than LVET0 (p=0.003). Conclusions: This study provides information on ECHO parameters that improve during the initial stages of therapy. Based on the results of our study, even at the beginning of treatment, there were increases in right and left ventricular filling, EF, and FS. Clinical deterioration of PH can be detected early/before the clinical status of the patient worsens with detailed examinations using echocardiography.

Successful treatment of two cases of acute myocarditis with colchicine.

Colchicine is an FDA-approved medicine that has been used for many years to prevent and treat gout flares as well as familial mediterranean fever. It is also used off-label to treat pericarditis, calcium pyrophosphate illness, and Behçet's syndrome. There are additional studies on the use of colchicine, which is accepted as the standard treatment for pericarditis in adults, post-pericardiotomy syndrome, post-operative and post-ablation atrial fibrillation, coronary artery disorders, prior to percutaneous coronary procedures, and myocarditis. Colchicine appears to be a promising oral cardiovascular treatment targeting the inflammatory axis, owing to its low cost and moderate side-effect profile. Our aim is to emphasise that colchicine treatment, which has a strong and effective anti-inflammatory effect profile, should be kept in mind in addition to conventional treatment in childhood myocarditis.

Subcutaneous use of treprostinil in pediatric pulmonary hypertension patients: A report of three cases.

Treprostinil was approved by the United States Food and Drug Administration for use in the treatment of pulmonary arterial hypertension in 2002. Intravenous or subcutaneous treprostinil is used in pulmonary arterial hypertension patients in the functional classes of II-IV to alleviate exercise-related symptoms, or in cases where epoprostenol treatment should be reduced due to side effects. In this article, we describe three pediatric cases of pulmonary arterial hypertension in whom subcutaneous treprostinil was used.