Pediheart: Pediatric Cardiology Today

This week's episode is co-branded with the SADS Foundation and we review a recent work by the team at U. of Washington on a comparison between the ECG and the AHA 14 point evaluation recommendation for the identification of cardiac diseases that may predispose to sudden death amongst high school athletes. We speak with Dr. Jonathan Drezner of U. of Washington about this important work and he offers many insights into the pluses and minuses of both the history and physical approach as well as the ECG. Referenced in the podcast also is https://uwsportscardiology.org/e-academy/. doi: 10.1161/JAHA.119.012235

This week's episode is co-branded with the SADS Foundation and we review a recent work by the team at U. of Washington on a comparison between the ECG and the AHA 14 point evaluation recommendation for the identification of cardiac diseases that may predispose to sudden death amongst high school athletes. We speak with Dr. Jonathan Drezner of U. of Washington about this important work and he offers many insights into the pluses and minuses of both the history and physical approach as well as the ECG. Referenced in the podcast also is https://uwsportscardiology.org/e-academy/. doi: 10.1161/JAHA.119.012235

This week we review a recent report from the CTOTC-04 study group assessing the impact of novel anti-rejection approaches which generally markedly reduce or remove steroids in the prevention of rejection. How are rejection rates affected by such an approach? Did incidences of diabetes or PTLD differ when using this form of steroid reduced approach in the 'low immunological risk' subset of patients undergoing heart transplantation? We speak with the first author of this work, Professor of Pediatrics, Dr. Jacqueline Lamour of The Albert Einstein College of Medicine. Dr. Lamour provides deep insights this week! doi: 10.1016/j.healun.2019.06.006

This week we review a recent report from the CTOTC-04 study group assessing the impact of novel anti-rejection approaches which generally markedly reduce or remove steroids in the prevention of rejection. How are rejection rates affected by such an approach? Did incidences of diabetes or PTLD differ when using this form of steroid reduced approach in the 'low immunological risk' subset of patients undergoing heart transplantation? We speak with the first author of this work, Professor of Pediatrics, Dr. Jacqueline Lamour of The Albert Einstein College of Medicine. Dr. Lamour provides deep insights this week! doi: 10.1016/j.healun.2019.06.006

Identification of the tetralogy of Fallot patient at risk for ventricular arrhythmias might be the 'holy grail' of ACHD and still today the best predictors are unclear. This week we review a novel approach to this problem - the development of personalized computational models to effectively perform 'virtual EP studies' and predict reentrant ventricular arrhythmia risk in repaired TOF patients. We speak with Dr. Mark Cartoski, Assistant Professor of Pediatrics at Nemours duPont Children's Hospital about a recent work he co-authored on this topic. Can VT be predicted on a computer rather than with catheters in the heart? doi: 10.1016/j.hrthm.2019.10.002

Identification of the tetralogy of Fallot patient at risk for ventricular arrhythmias might be the 'holy grail' of ACHD and still today the best predictors are unclear. This week we review a novel approach to this problem - the development of personalized computational models to effectively perform 'virtual EP studies' and predict reentrant ventricular arrhythmia risk in repaired TOF patients. We speak with Dr. Mark Cartoski, Assistant Professor of Pediatrics at Nemours duPont Children's Hospital about a recent work he co-authored on this topic. Can VT be predicted on a computer rather than with catheters in the heart? doi: 10.1016/j.hrthm.2019.10.002

This week we review a recent work from the team at Children's National in DC and the NIH on the use of 3D fusion of MRI images with fluoroscopy to help inform interventional procedures. Does this form of "XFM" fusion improve outcomes and reduce radiation or contrast usage? Are there procedures in which this form of imaging might be best applied? We review these and other questions with the first author of this work, Dr. Elena Amin of UCSF. doi: 10.1002/ccd.28324

This week we review a recent work from the team at Children's National in DC and the NIH on the use of 3D fusion of MRI images with fluoroscopy to help inform interventional procedures. Does this form of "XFM" fusion improve outcomes and reduce radiation or contrast usage? Are there procedures in which this form of imaging might be best applied? We review these and other questions with the first author of this work, Dr. Elena Amin of UCSF. doi: 10.1002/ccd.28324

This week we review a recent small work on the impact of fetal diagnosis of congenital heart disease on the psychological well being of families. Does the fetal prenatal diagnosis and counseling result in less stress in comparison to the families of those diagnosed in the postnatal period? We review this and other questions regarding prenatal counseling with Dr. Miwa Geiger - Director of Fetal Cardiology at Mount Sinai Kravis Children's Hospital and Ms. Michele Cafone, MSN, RN, CPNP - Clinical Nurse Coordinator of The Fetal Heart Program at Sinai. Two top experts on counseling to address some important and provocative questions. doi: 10.1017/S1047951119001781

This week we review a recent small work on the impact of fetal diagnosis of congenital heart disease on the psychological well being of families. Does the fetal prenatal diagnosis and counseling result in less stress in comparison to the families of those diagnosed in the postnatal period? We review this and other questions regarding prenatal counseling with Dr. Miwa Geiger - Director of Fetal Cardiology at Mount Sinai Kravis Children's Hospital and Ms. Michele Cafone, MSN, RN, CPNP - Clinical Nurse Coordinator of The Fetal Heart Program at Sinai. Two top experts on counseling to address some important and provocative questions. doi: 10.1017/S1047951119001781

This week we explore an important paper from CHOP on the optimal approach to repair for Tetralogy of Fallot (TOF). Is there a benefit to a staged approach versus primary complete repair? Are there factors that might influence this decision of approach? We speak with Assistant Professor of Pediatrics Dr. Laura Mercer Rosa of The University of Pennsylvania about her recent large PHIS database study. doi: 10.1016/j.jacc.2019.05.057.

This week we explore an important paper from CHOP on the optimal approach to repair for Tetralogy of Fallot (TOF). Is there a benefit to a staged approach versus primary complete repair? Are there factors that might influence this decision of approach? We speak with Assistant Professor of Pediatrics Dr. Laura Mercer Rosa of The University of Pennsylvania about her recent large PHIS database study. doi: 10.1016/j.jacc.2019.05.057.

This week we celebrate Children's Cardiomyopathy Awareness Month by reviewing a recent work from PACES on the impact of obesity on ventricular thickness in hypertrophic cardiomyopathy. Does obesity enhance thickness of HCM patients similarly to those without HCM? How does obesity affect risk for SCD in this condition? We review these and other questions with Dr. Seshadri Balaji, Professor of Pediatrics at OHSU. We speak also with Ms. Lisa Yue of the Children's Cardiomyopathy Foundation. What have been the foundation's greatest achievements? What are its present goals? Ms. Yue shares with us the inspiring story of how she and her husband started this important organization supporting pediatric cardiomyopathy research throughout the US. doi: 10.1007/s00246-019-02145-9

This week we celebrate Children's Cardiomyopathy Awareness Month by reviewing a recent work from PACES on the impact of obesity on ventricular thickness in hypertrophic cardiomyopathy. Does obesity enhance thickness of HCM patients similarly to those without HCM? How does obesity affect risk for SCD in this condition? We review these and other questions with Dr. Seshadri Balaji, Professor of Pediatrics at OHSU. We speak also with Ms. Lisa Yue of the Children's Cardiomyopathy Foundation. What have been the foundation's greatest achievements? What are its present goals? Ms. Yue shares with us the inspiring story of how she and her husband started this important organization supporting pediatric cardiomyopathy research throughout the US. doi: 10.1007/s00246-019-02145-9

This week we review the impact of conduit size on exercise capacity in the single ventricle Fontan patient. Is there an optimal sized conduit for the Fontan patient? What is the role of formal exercise stress testing in the evaluation and monitoring of the Fontan patient? We review these questions and more with Associate Professor of Medicine at UT Southwestern - Dr. Ari Cedars. doi: 10.1007/s00246-019-02190-4