Pulse Wave Velocity as a Marker of Vascular Dysfunction and Its Correlation with Cardiac Disease in Children with End-Stage Renal Disease (ESRD)

Filip, Cristina; Cîrstoveanu, Cătălin; Bizubac, Mihaela; Căpitănescu, Andrei; Bălgrădean, Mihaela; Pavelescu, Carmen; Nicolescu, Alin; Ionescu, Marcela Daniela

doi:10.3390/diagnostics12010071

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Measurement of the MBL level at the onset of an infection is particularly recommended in children at high risk. For patients with significant comorbidities, such as asthma [50], congenital heart malformations [51], and chronic kidney disease [52], a timely and appropriate therapeutic approach is vital, as any acute infective episode can lead to potentially life-threatening decompensation. The blood level of MBL at the onset of an infection can identify deficiency, indicating higher risk, and thus ensure the selection of optimal treatment for this vulnerable patient group.…”

Section: Discussionmentioning

confidence: 99%

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

Taraș,

Mahler,

Bălgrădean

et al. 2023

Children

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Background: Community-acquired pneumonia (CAP) is one of the most significant childhood diseases worldwide and a leading infectious cause of death in children. This study aimed to evaluate the prognostic value of the inflammatory markers—C-reactive protein (CRP) and procalcitonin (PCT)—and the polymorphic glycoprotein mannose-binding lectin (MBL), deficiency of which is associated with severe infections, in the determination of the optimal type and timing of therapeutic intervention for CAP in childhood. Methods: Retrospective evaluation was conducted on a cohort of 204 children aged 4 months–17 years hospitalized with CAP. Their levels of CRP, PCT, and MBL were assessed for their association with a variety of outcomes, including the incidence of local and systemic complications, admission to the ICU, duration of antibiotic treatment and hospital stay, and death. Results: CRP and PCT proved to be better predictors of complications of CAP than MBL. The area under the curve (AUC) value was highest for PCT as a predictor of systemic complications (AUC = 0.931, 95%CI 0.895–0.967), while CRP (AUC = 0.674, 95%CI 0.586–0.761) performed best as a predictor of local complications (AUC = 0.674, 95%CI 0.586–0.761). Regarding admission to the ICU, CRP was the weakest predictor (AUC = 0.741), while PCT performed the best (AUC = 0.833), followed by MBL (AUC = 0.797). Sensitivity and specificity were calculated for the optimal threshold generated by receiver operating characteristic (ROC) curves, rendering sensitivity of 90% and specificity of 87% for PCT in assessing the risk of systemic complications, compared to sensitivity of 83% and specificity of 90% for CRP. MBL showed relatively high sensitivity (96%) but low specificity (25%) for predicting the need for ICU admission. Conclusions: Early measurement of CRP, PCT, and MBL provides clinicians with important information regarding the course and prognosis of children diagnosed with CAP, thus ensuring prompt, optimal therapeutic management.

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Section: Discussionmentioning

confidence: 99%

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

Taraș,

Mahler,

Bălgrădean

et al. 2023

Children

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“…The CAF's origin, course, and drainage can be examined [3]. Myocardial perfusion imaging with nuclear testing helps detect and quantify myocardial ischemia [27].…”

Section: Review Of Literaturementioning

confidence: 99%

“…Failure of the percutaneous procedure can be observed in large CAFs. Also, distal coil migration, incomplete closure, and complete closure of the native vessel blood supply with subsequent myocardial ischemia are possible [27].…”

Section: Review Of Literaturementioning

confidence: 99%

Management of a Rare Case of Multiple Coronary Artery Fistulas Associated with Ascending Aortic and Root Aneurysm: Case Report and Review of Literature

Robu,

Radulescu,

Nayyerani

et al. 2024

JCM

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Coronary artery fistulas draining into the left ventricle is a rare finding. They can be associated with other congenital cardiac anomalies like ventricular septal defect or tetralogy of Fallot. While most of them are asymptomatic, they can lead to severe cardiac complications like infective endocarditis, heart failure, or myocardial ischemia. Symptomatic coronary artery fistulas can be managed surgically or percutaneously. We present a case of a 61-year-old male patient with both left anterior descending artery and right coronary artery fistulas draining into the left ventricle associated with ascending aorta and root aneurysm. Preoperative assessment for myocardial ischemia and the size and location of the fistulas was performed. The echocardiography stress test was negative. Surgery consisted of replacement of the ascending aorta and reconstruction of the noncoronary sinus with a Dacron patch with aortic valve preservation and no intervention for the coronary artery fistulas. The surgical strategy was adapted for cardioplegia administration to compensate for the volume of coronary blood drained into the left ventricle and for better protection of the distal myocardium.

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“…With transplantation, some regression in LVM can also be seen [ 72 ], although hypertension and metabolic risks can lead to persistent changes, or deterioration over time [ 71 , 73 ]. A recent study has correlated LVM in children on dialysis with pulse wave velocity (PWV), a marker of vascular stiffness [ 74 ]. A direct causal relationship between PWV and LVM/LVH has not been established, and the correlation may simply reflect that hypertension is a common risk factor.…”

Section: The Natural History Of Cvd In Pediatric Kidney Failurementioning

confidence: 99%

Echocardiogram screening in pediatric dialysis and transplantation

et al. 2022

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Transthoracic echocardiography is commonly used to identify structural and functional cardiac abnormalities that can be prevalent in childhood chronic kidney failure (KF). Left ventricular mass (LVM) increase is most frequently reported and may persist post-kidney transplant especially with hypertension and obesity. While systolic dysfunction is infrequently seen in childhood chronic KF, systolic strain identified by speckle tracking echocardiography has been frequently identified in dialysis and it can also persist post-transplant. Echocardiogram association with long-term outcomes has not been studied in childhood KF but there are many adult studies demonstrating associations between increased LVM, systolic dysfunction, strain, diastolic dysfunction, and cardiovascular events and mortality. There has been limited study of interventions to improve echocardiogram status. In childhood, improved blood pressure has been associated with better LVM, and conversion from hemodialysis to hemodiafiltration has been associated with better diastolic and systolic function. Whether long-term cardiac outcomes are also improved with these interventions is unclear. Echocardiography is a well-established technique, and regular use in childhood chronic KF seems justified. A case can be made to extend screening to include speckle tracking echocardiography and intradialytic studies in high-risk populations. Further longitudinal studies including these newer echocardiogram modalities, interventions, and long-term outcomes would help clarify recommendations for optimal use as a screening tool.

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Pulse Wave Velocity as a Marker of Vascular Dysfunction and Its Correlation with Cardiac Disease in Children with End-Stage Renal Disease (ESRD)

Cited by 7 publications

References 30 publications

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

Management of a Rare Case of Multiple Coronary Artery Fistulas Associated with Ascending Aortic and Root Aneurysm: Case Report and Review of Literature

Echocardiogram screening in pediatric dialysis and transplantation

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