المؤلفون: Savis, Alexandra, Haseler, Emily, Beardsley, Hayley, Chowienczyk, Phil J., Simpson, John M., Sinha, Manish D.

المصدر: Kidney International Reports ; ISSN 2468-0249

مصطلحات موضوعية: Nephrology

الإتاحة: https://doi.org/10.1016/j.ekir.2024.02.007Test
https://api.elsevier.com/content/article/PII:S2468024924000962?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2468024924000962?httpAccept=text/plainTest

المؤلفون: Chivers, Sian, Cleary, Aoife, Knowles, Rachel, Babu-Narayan, Sonya V, Simpson, John M, Nashat, Heba, Dimopoulos, Konstantinos, Gatzoulis, Michael A, Wilson, Dirk, Prica, Milos, Anthony, James, Clift, Paul F, Jowett, Victoria, Jenkins, Petra, Khodaghalian, Bernadette, Jones, Caroline B, Hardiman, Antonia, Head, Catherine, Miller, Owen, Chung, Natali Ay, Mahmood, Umar, Bu'Lock, Frances A, Ramcharan, Tristan Kw, Chikermane, Ashish, Shortland, Jennifer, Tometzki, Andrew, Crossland, David S, Reinhardt, Zdenka, Lewis, Clive, Rittey, Leila, Hares, Dominic, Panagiotopoulou, Olga, Smith, Benjamin, Najih L, Muhammad, Bharucha, Tara, Daubeney, Piers Ef

المصدر: Open Heart , 10 (2) , Article e002356. (2023)

الوصف: Background: COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.// Objective: Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.// Methods: Multicentre UK study undertaken 1 March 2020–30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.// Results: There were 405 reported cases (127 paediatric/278 adult). In children (age <16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p<0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p<0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).// Conclusions: Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD.

وصف الملف: text

العلاقة: https://discovery.ucl.ac.uk/id/eprint/10174384/1/Chivers%20et%20al%20Open%20Heart%202023.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10174384Test/

الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10174384/1/Chivers%20et%20al%20Open%20Heart%202023.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10174384Test/

المؤلفون: Sinha, Manish D, Gu, Haotian, Douiri, Abdel, Cansick, Janette, Finlay, Eric, Gilbert, Rodney, Kerecuk, Larissa, Lunn, Andrew, Maxwell, Heather, Morgan, Henry, Shenoy, Mohan, Shroff, Rukshana, Subramaniam, Pushpa, Tizard, Jane, Tse, Yincent, Rezavi, Reza, Simpson, John M, Chowienczyk, Phil J

المصدر: Sinha , M D , Gu , H , Douiri , A , Cansick , J , Finlay , E , Gilbert , R , Kerecuk , L , Lunn , A , Maxwell , H , Morgan , H , Shenoy , M , Shroff , R , Subramaniam , P , Tizard , J , Tse , Y , Rezavi , R , Simpson , J M & Chowienczyk , P J 2023 , ' Intensive compared with less intensive blood pressure control to prevent adverse cardiac remodelling in children with chronic kidney disease (HOT-KID): a parallel-group, ....

الوصف: Background: Optimal target blood pressure to reduce adverse cardiac remodelling in children with chronic kidney disease is uncertain. We hypothesised that lower blood pressure would reduce adverse cardiac remodelling. Methods: HOT-KID, a parallel-group, open-label, multicentre, randomised, controlled trial, was done in 14 clinical centres across England and Scotland. We included children aged 2–15 years with stage 1–4 chronic kidney disease—ie, an estimated glomerular filtration rate (eGFR) higher than 15 mL/min per 1·73 m 2 —and who could be followed up for 2 years. Children on antihypertensive medication were eligible as long as it could be changed to angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) if they were not already receiving these therapies. Participants were randomly assigned (1:1) to standard treatment (auscultatory office systolic blood pressure target between the 50th and 75th percentiles) or intensive treatment (systolic target <40th percentile) by the chief investigator using a rapid, secure, web-based randomisation system. ACE inhibitors or ARBs were used as first-line agents, with the dose titrated every 2–4 weeks to achieve the target blood pressure levels. The primary outcome was mean annual difference in left ventricular mass index (LVMI) by echocardiography measured by a masked observer and was assessed in the intention-to-treat population, defined as all the children who underwent randomisation irrespective of the blood pressure reached. Secondary and safety outcomes were the differences between groups in mean left ventricular relative wall thickness, renal function, and adverse effects and were also assessed in the intention-to-treat population. This trial is registered with ISRCTN, ISRCTN25006406. Findings: Between Oct 30, 2012, and Jan 5, 2017, 64 participants were randomly assigned to the intensive treatment group and 60 to the standard treatment group (median age of participants was 10·0 years [IQR 6·8–12·6], 69 [56%] were male and 107 [86%] ...

الإتاحة: https://doi.org/10.1016/S2352-4642Test(22)00302-9
https://kclpure.kcl.ac.uk/portal/en/publications/fba1bf48-e26d-481b-8198-46af9645f72dTest
http://www.scopus.com/inward/record.url?scp=85144049648&partnerID=8YFLogxKTest

المؤلفون: Stephenson, Natasha, Pushparajah, Kuberan, Wheeler, Gavin, Deng, Shujie, Schnabel, Julia A, Simpson, John M

المصدر: Stephenson , N , Pushparajah , K , Wheeler , G , Deng , S , Schnabel , J A & Simpson , J M 2023 , ' Extended reality for procedural planning and guidance in structural heart disease - a review of the state-of-the-art ' , INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING , vol. 39 , no. 7 , pp. 1405-1419 . https://doi.org/10.1007/s10554-023-02823-zTest

الوصف: Extended reality (XR), which encompasses virtual, augmented and mixed reality, is an emerging medical imaging display platform which enables intuitive and immersive interaction in a three-dimensional space. This technology holds the potential to enhance understanding of complex spatial relationships when planning and guiding cardiac procedures in congenital and structural heart disease moving beyond conventional 2D and 3D image displays. A systematic review of the literature demonstrates a rapid increase in publications describing adoption of this technology. At least 33 XR systems have been described, with many demonstrating proof of concept, but with no specific mention of regulatory approval including some prospective studies. Validation remains limited, and true clinical benefit difficult to measure. This review describes and critically appraises the range of XR technologies and its applications for procedural planning and guidance in structural heart disease while discussing the challenges that need to be overcome in future studies to achieve safe and effective clinical adoption.

الإتاحة: https://doi.org/10.1007/s10554-023-02823-zTest
https://kclpure.kcl.ac.uk/portal/en/publications/d03b59c5-5c8a-466e-9675-375852fd8c44Test
http://www.scopus.com/inward/record.url?scp=85153745901&partnerID=8YFLogxKTest

المؤلفون: Day, Thomas G., Budd, Samuel, Tan, Jeremy, Matthew, Jacqueline, Skelton, Emily, Jowett, Victoria, Lloyd, David, Gomez, Alberto, Hajnal, Jo V., Razavi, Reza, Kainz, Bernhard, Simpson, John M.

المساهمون: Wellcome Trust

المصدر: Prenatal Diagnosis ; volume 44, issue 6-7, page 717-724 ; ISSN 0197-3851 1097-0223

الوصف: Background Artificial intelligence (AI) has the potential to improve prenatal detection of congenital heart disease. We analysed the performance of the current national screening programme in detecting hypoplastic left heart syndrome (HLHS) to compare with our own AI model. Methods Current screening programme performance was calculated from local and national sources. AI models were trained using four‐chamber ultrasound views of the fetal heart, using a ResNet classifier. Results Estimated current fetal screening programme sensitivity and specificity for HLHS were 94.3% and 99.985%, respectively. Depending on calibration, AI models to detect HLHS were either highly sensitive (sensitivity 100%, specificity 94.0%) or highly specific (sensitivity 93.3%, specificity 100%). Our analysis suggests that our highly sensitive model would generate 45,134 screen positive results for a gain of 14 additional HLHS cases. Our highly specific model would be associated with two fewer detected HLHS cases, and 118 fewer false positives. Conclusion If used independently, our AI model performance is slightly worse than the performance level of the current screening programme in detecting HLHS, and this performance is likely to deteriorate further when used prospectively. This demonstrates that collaboration between humans and AI will be key for effective future clinical use.

الإتاحة: https://doi.org/10.1002/pd.6445Test

المؤلفون: Day, Thomas G., Budd, Samuel, Tan, Jeremy, Matthew, Jacqueline, Skelton, Emily, Jowett, Victoria, Lloyd, David, Gomez, Alberto, Hajnal, Jo V., Razavi, Reza, Kainz, Bernhard, Simpson, John M.

المصدر: Prenatal Diagnosis; Jun2024, Vol. 44 Issue 6/7, p717-724, 8p

مستخلص: Background: Artificial intelligence (AI) has the potential to improve prenatal detection of congenital heart disease. We analysed the performance of the current national screening programme in detecting hypoplastic left heart syndrome (HLHS) to compare with our own AI model. Methods: Current screening programme performance was calculated from local and national sources. AI models were trained using four‐chamber ultrasound views of the fetal heart, using a ResNet classifier. Results: Estimated current fetal screening programme sensitivity and specificity for HLHS were 94.3% and 99.985%, respectively. Depending on calibration, AI models to detect HLHS were either highly sensitive (sensitivity 100%, specificity 94.0%) or highly specific (sensitivity 93.3%, specificity 100%). Our analysis suggests that our highly sensitive model would generate 45,134 screen positive results for a gain of 14 additional HLHS cases. Our highly specific model would be associated with two fewer detected HLHS cases, and 118 fewer false positives. Conclusion: If used independently, our AI model performance is slightly worse than the performance level of the current screening programme in detecting HLHS, and this performance is likely to deteriorate further when used prospectively. This demonstrates that collaboration between humans and AI will be key for effective future clinical use. Key points: What is already known on this topic? Artificial intelligence (AI) can be used to interpret medical images and make diagnoses, including detecting fetal congenital heart disease (CHD) by ultrasound.The sensitivity of the current English screening programme for fetal cardiac malformations is publicly available, but specificity is not reported. What this study adds? The current screening programme in our region is operating at a very high specificity for fetal hypoplastic left heart syndrome (HLHS).Using a curated retrospective dataset, it is possible to train AI models to detect HLHS with a performance approaching that of the current screening programme.Current AI models do not have high enough specificity to be used independently for screening for fetal CHD, meaning that human‐AI interaction when performing or interpreting ultrasound will be important to select cases for specialist referral. [ABSTRACT FROM AUTHOR]

: Copyright of Prenatal Diagnosis is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Freud, Lindsay R., Galloway, Stephanie, Crowley, T. Blaine, Moldenhauer, Julie, Swillen, Ann, Breckpot, Jeroen, Borrell, Antoni, Vora, Neeta L., Cuneo, Bettina, Hoffman, Hilary, Gilbert, Lisa, Nowakowska, Beata, Geremek, Maciej, Kutkowska-Kaźmierczak, Anna, Vermeesch, Joris R., Devriendt, Koen, Busa, Tiffany, Sigaudy, Sabine, Vigneswaran, Trisha, Simpson, John M., Dungan, Jeffrey, Gotteiner, Nina, Gloning, Karl Philipp, Digilio, Maria Cristina, Unolt, Marta, Putotto, Carolina, Marino, Bruno, Repetto, Gabriela, Fadic, Magdalena, Garcia-Minaur, Sixto, Achón Buil, Ana, Thomas, Mary Ann, Fruitman, Deborah, Beecroft, Taylor, Hui, Pui Wah, Oskarsdottir, Solveig, 1953, Bradshaw, Rachael, Criebaum, Amanda, Norton, Mary E., Lee, Tiffany, Geiger, Miwa, Dunnington, Leslie, Isaac, Jacqueline, Wilkins-Haug, Louise, Hunter, Lindsey, Izzi, Claudia, Toscano, Marika, Ghi, Tullio, McGlynn, Julie, Romana Grati, Francesca, Emanuel, Beverly S., Gaiser, Kimberly, Gaynor, J. William, Goldmuntz, Elizabeth, McGinn, Daniel E., Schindewolf, Erica, Tran, Oanh, Zackai, Elaine H., Yan, Qi, Bassett, Anne S., Wapner, Ronald, McDonald-McGinn, Donna M.

المصدر: American Journal of Obstetrics and Gynecology. 230(3)

مصطلحات موضوعية: Pediatrics, Pediatrik, 22q11.2 deletion syndrome, congenital heart disease, genetic syndrome, infant morbidity, infant mortality, perinatal outcome, prenatal diagnosis

الوصف: Background: The 22q11.2 deletion syndrome is the most common microdeletion syndrome and is frequently associated with congenital heart disease. Prenatal diagnosis of 22q11.2 deletion syndrome is increasingly offered. It is unknown whether there is a clinical benefit to prenatal detection as compared with postnatal diagnosis. Objective: This study aimed to determine differences in perinatal and infant outcomes between patients with prenatal and postnatal diagnosis of 22q11.2 deletion syndrome. Study Design: This was a retrospective cohort study across multiple international centers (30 sites, 4 continents) from 2006 to 2019. Participants were fetuses, neonates, or infants with a genetic diagnosis of 22q11.2 deletion syndrome by 1 year of age with or without congenital heart disease; those with prenatal diagnosis or suspicion (suggestive ultrasound findings and/or high-risk cell-free fetal DNA screen for 22q11.2 deletion syndrome with postnatal confirmation) were compared with those with postnatal diagnosis. Perinatal management, cardiac and noncardiac morbidity, and mortality by 1 year were assessed. Outcomes were adjusted for presence of critical congenital heart disease, gestational age at birth, and site. Results: A total of 625 fetuses, neonates, or infants with 22q11.2 deletion syndrome (53.4% male) were included: 259 fetuses were prenatally diagnosed (156 [60.2%] were live-born) and 122 neonates were prenatally suspected with postnatal confirmation, whereas 244 infants were postnatally diagnosed. In the live-born cohort (n=522), 1-year mortality was 5.9%, which did not differ between groups but differed by the presence of critical congenital heart disease (hazard ratio, 4.18; 95% confidence interval, 1.56–11.18; P<.001) and gestational age at birth (hazard ratio, 0.78 per week; 95% confidence interval, 0.69–0.89; P<.001). Adjusting for critical congenital heart disease and gestational age at birth, the prenatal cohort was less likely to deliver at a local community hospital (5.1% vs 38.2%; odds ratio, 0.11; 95% confidence interval, 0.06–0.23; P<.001), experience neonatal cardiac decompensation (1.3% vs 5.0%; odds ratio, 0.11; 95% confidence interval, 0.03–0.49; P=.004), or have failure to thrive by 1 year (43.4% vs 50.3%; odds ratio, 0.58; 95% confidence interval, 0.36–0.91; P=.019). Conclusion: Prenatal detection of 22q11.2 deletion syndrome was associated with improved delivery management and less cardiac and noncardiac morbidity, but not mortality, compared with postnatal detection.

الوصول الحر: https://gup.ub.gu.se/publication/337256Test

المؤلفون: Rücker, Beate, Vigneswaran, Trisha V., Zidere, Vita, Simpson, John M.

المصدر: Pediatric Cardiology; Apr2024, Vol. 45 Issue 4, p749-758, 10p

مصطلحات موضوعية: VENA cava superior, AORTIC coarctation, TRICUSPID valve

مستخلص: To report the prevalence of coarctation of the aorta (CoA) in fetuses with single left superior vena cava (SL-SVC) and to evaluate changes in echocardiographic measurements. Additionally, to report the prevalence of associated malformations. Retrospective observational study of fetuses diagnosed with SL-SVC between 2012 and 2021 at a tertiary fetal cardiology unit. In fetuses without intracardiac abnormalities, Z-scores of the ventricles, great arteries, and Doppler flow patterns are reported. We identified 47 fetuses with SL-SVC of which 8/47 (17%) had abnormal intracardiac anatomy. One fetus was lost to follow-up. Of those with normal intracardiac anatomy and postnatal follow-up (38), karyotype abnormalities were confirmed in 2/38 (5%) and ECA in 8/38 (21%). 33/38 were live-born. None developed CoA postnatally. Paired analysis of Z-scores between early and late scans of 24 fetuses showed that diameters of the right heart structures and Doppler flows of tricuspid valve increased significantly during pregnancy, while the left heart structures and flow patterns did not change. The median risk of CoA did not change between the early and the late scan. We did not observe CoA in this cohort. A degree of ventricular asymmetry was present, but this was due to right heart dominance rather than hypoplasia of left heart structures. This likely reflects redistribution of blood and does not appear to confer increased risk of CoA. Predictive models of the postnatal development of CoA which set the dimensions of right and left heart structures in relation might not be applicable in this situation. [ABSTRACT FROM AUTHOR]

: Copyright of Pediatric Cardiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Drury, Nigel E, Herd, Clare P, Biglino, Giovanni, Brown, Katherine L, Coats, Louise, Cumper, Michael J, Guerrero, Rafael R, Miskin, Alex, Murray, Sarah, Pender, Fraser, Rooprai, Sasha, Simpson, John M, Thomson, John DR, Weinkauf, Jara, Wootton, Julie, Jones, Timothy J, Cowan, Katherine

المصدر: Open Heart , 9 (2) , Article e002147. (2022)

الوصف: Objective To bring together patients, parents, charities and clinicians in a Priority Setting Partnership to establish national clinical priorities for research in children and adults with congenital heart disease. Methods The established James Lind Alliance methodology was used to identify and prioritise research on the management of congenital heart disease, focusing on diagnosis, treatment and outcomes. An initial open survey was used to gather potential uncertainties which were filtered, categorised, converted into summary questions and checked against current evidence. In a second survey, respondents identified the unanswered questions most important to them. At two final workshops, patients, parents, charities and healthcare professionals agreed the top 10 lists of priorities for child/antenatal and adult congenital heart disease research. Results 524 respondents submitted 1373 individual questions, from which 313 out of scope or duplicate questions were removed. The remaining 1060 questions were distilled into summary questions and checked against existing literature, with only three questions deemed entirely answered and removed. 250 respondents completed the child/antenatal survey (56 uncertainties) and 252 completed the adult survey (47 uncertainties). The questions ranked the highest by clinicians and non-clinicians were taken forward to consensus workshops, where two sets of top 10 research priorities were agreed. Conclusions Through an established and equitable process, we determined national clinical priorities for congenital heart disease research. These will be taken forward by specific working groups, a national patient and public involvement group, and through the establishment of a UK and Ireland network for collaborative, multicentre clinical trials in congenital heart disease.

وصف الملف: text

العلاقة: https://discovery.ucl.ac.uk/id/eprint/10192604/1/Research%20priorities%20in%20children%20and%20adults%20with%20congenital%20heart%20disease%20a%20James%20Lind%20Alliance%20Priority%20Setting%20Partnership.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10192604Test/

الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10192604/1/Research%20priorities%20in%20children%20and%20adults%20with%20congenital%20heart%20disease%20a%20James%20Lind%20Alliance%20Priority%20Setting%20Partnership.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10192604Test/

المؤلفون: Stephenson, Natasha, Pushparajah, Kuberan, Wheeler, Gavin, Deng, Shujie, Schnabel, Julia A., Simpson, John M.

مصطلحات موضوعية: info:eu-repo/classification/ddc, Article, preoperative imaging, virtual reality, 3D measurement tools, echocardiography, magnetic resonance imaging, computed tomography, measurement accuracy

وصف الملف: application/pdf

العلاقة: https://mediatum.ub.tum.de/1694876Test; https://mediatum.ub.tum.de/doc/1694876/document.pdfTest

الإتاحة: https://doi.org/10.3390/jimaging8110304Test
https://mediatum.ub.tum.de/1694876Test
https://mediatum.ub.tum.de/doc/1694876/document.pdfTest