Background: Kawasaki Disease (KD) is an acute febrile vasculitis of early childhood and the leading cause of acquired heart disease in children. The most important complication of KD is coronary artery aneurysm that may lead to thrombosis and myocardial infarction, occurring in 25% of untreated cases. Fortunately, timely treatment decreases it to 2 -4%. There is no specific test for the diagnosis of KD, which is entirely based on clinical and laboratory criteria. Objectives: Since KD is very common in Iran and other Asian countries, it is necessary to get a clear picture on the frequency of KD related anomalies in the clinical and laboratory findings as well as the frequency of coronary aneurysms in our region. Patients and Methods: We retrospectively studied the medical records of all children discharged from the Besat Hospital, Hamedan, Iran, with a final diagnosis of KD, from 2004 to 2013. Outpatient documents were also studied. Demographic data, clinical features, laboratory and echocardiographic findings were also recorded onto the forms. Results: Seventy four patients, 43 (58.1%) males and 31 (41.9%) females, were discharged with a final diagnosis of KD, 77% of which were less than 5 years old. No seasonal variability was noticed in the study population. Among all cases, 44 (59.5%) were diagnosed as complete and 30 (40.5%) as incomplete KD. Conjunctivitis, considered as the most common clinical finding, occurred in 79% of patients, whereas peripheral erythema was the least common, corresponding to 23% of cases. Finger desquamation and leukocytosis occurred in 54% and 49.3% of cases, respectively. Amongst the timely-treated patients, 11 (14,8%) developed coronary artery aneurysm. Conclusions: Sex, age, and seasonal patterns of KD in Hamedan Province, IR Iran, are similar to other regions. However, finger desquamation is less prevalent, diminishing its value as a measure for patients' follow up. The most common supplementary laboratory criteria were leukocytosis, thrombocytosis and anemia, which were determined by a complete blood count. Coronary artery aneurysm in timely-treated patients was far more common compared to other studies, which may indicate the need for revising the golden time for initiating the treatment.

Context: Tetralogy of Fallot (TOF) is one of the most important congenital heart diseases that its prognosis can be improved by surgery. However, Right Ventricular (RV) function may be disrupted because of pulmonary regurgitation and other preoperative and intraoperative factors. Access to a simple and reproducible diagnostic index of RV function is important. Echocardiographic index of Right Ventricular Myocardial Performance (RVMPI) has been used as a simple and noninvasive method for the assessment of RV function. Evidence Acquisition: This article review was conducted utilizing PubMed, Web of Science, Scopus and Google Scholar databases with the keywords of "Right Ventricle (RV)", "Myocardial Performance Index (MPI)", and "Tetralogy of Fallot (TOF) repair or correction". Results: RVMPI as a non-geometric echocardiographic index was compared with other echocardiographic indices, QRS duration in ECG, Cardiac Magnetic Resonance (CMR) findings, and exercise capacity in the pediatric and adult studies. Conclusions: This narrative review suggested that RVMPI, especially the tissue Doppler-derived has been used as a useful index of RV function in the follow-up of the repaired TOF patients. However, more research, including systematic reviews are necessary to determine the potential implication of RVMPI in the assessment of RV dysfunction.

Introduction: Nephropathy as a consequence of congenital heart disease (CHD), especially cyanotic heart disease, has been detected since past decades. However, lack of a diagnostic method at early stages of the disease, caused patients referring when nephropathy is established and also complicated with severe proteinuria and renal failure. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is known as one of the newest biomarkers for early detection of renal parenchymal damage. In this study, we attempted to evaluate the role of urinary NGAL level in early detection of nephropathy in pediatrics with CHD. Objectives: The aim of this study was to evaluate urinary NGAL as a potential biomarker for the early detection of renal involvement in children with CHD. Patients and Methods: In this case–control study, urinary NGAL levels of 42 children with CHD (case group) and 42 healthy children (control group) with the matched ages were measured. Afterward, we compared mean urinary NGAL levels between these two groups to find a possible significant difference. Results: In this study, mean urinary NGAL level in patients with CHD and healthy children was 3.83 μg/mL and 1.87 μg/mL, respectively. Although the mean urine NGAL level was higher in children with CHD compared to healthy children, this difference was not statistically significant. Conclusion: in this study, it can be concluded that, urinary NGAL level cannot be used as an early diagnostic test of nephropathy in children with CHD.

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Background: Some of the severe diseases in the neonatal period lead to a myocardial injury that, if not detected promptly, would affect prognosis. Detection of acquired myocardial injury in the early stages of the diseases may be possible with simultaneous examination by echocardiography and determination of serum troponin I levels. Methods: In this cross-sectional study, between December 2016 and December 2018, myocardial function of 60 (33 males, 27 females) term neonates with a mean birth weight 3175.5 ± 441.18 grams who were at least 72 hours under ventilation, was studied using conventional and tissue Doppler echocardiography and measuring serum troponin I levels by ELFA method. Results: Mean and standard deviation of serum troponin I level, left and right MPI in neonates under study were 0.22 ± 0.64, 40.11 ± 0.11, and 0.41 ± 0.13, respectively. The correlation coefficient between serum troponin I level related to right MPI was +0.502 (P < 0.001) and left myocardial performance index was +0.524 (P < 0.001), and other criteria correlated to troponin I on right side of heart were Em, Sm, TAPSE, TR gradient in patients with PH was related to troponin I levels (P < 0.001). Conclusions: Serum level of troponin I is helpful in determination of right and left myocardial dysfunction especially in the presence of pulmonary hypertension in the neonates under mechanical ventilation.