Congenital Heart Disease In Children Research Articles

THE IMPORTANCE OF ULTRASONOGRAPHY IN THE DETECTION OF CONGENITAL HEART DISEASES IN CHILDREN

Over the last few years, remarkable progress has been made in the field of congenital heart diseases. Improvements considering diagnostic modalities, especially imaging, in surgical and interventional techniques, as well as in postoperative therapy and care, have contributed to a significant reduction in mortality and morbidity. One of the most important applications of medical imaging techniques in children is the detection and treatment of congenital heart anomalies. Objective of this article is to show the importance of ultrasonography in the detection of congenital heart diseases in children. The study was conducted on children with simple and complex congenital heart diseases and was conducted on the Pediatric Clinic, UKCS. The research is descriptive on a representative sample. In our study, 166 children were observed, of which 148 children (77 boys, 71 girls) with simple congenital heart diseases, and 18 children (8 boys, 10 girls) with complex congenital heart diseases. Out of the total number of observed children, 115 had a surgical correction, 97 children with simple congenital heart diseases (45 boys, 52 girls) and 18 children with complex congenital heart diseases (8 boys, 10 girls). The number of children monitored through the Cardiac Counseling Center who didn’t undergo surgical correction was 51, all with simple congenital heart diseases. Out of the total number of observed children who were frequently coming for follow-ups, 28 children had changes on the ECG, and 138 of them had no changes on the ECG, 93 were surgically treated, and 73 of them were on conservative therapy. Based on the results of the research, we conclude that ultrasonography is an important method in the detection and treatment of congenital heart diseases.

Paediatrics congenital heart disease is associated with plasma miRNAs.

Congenital heart disease (CHD) are the most common malformations from birth. The severity of the different forms of CHD varies extensively from superficial mild lesions with follow-up for decades without any treatment to complex cyanotic malformations requiring urgent surgical intervention. microRNAs have been found to be crucial in cardiac development, giving rise to possible phenotypes in CHD. We aimed to evaluate the expression of miRNAs in 86 children with CHD and divided into cyanotic and non-cyanotic heart defects and 110 controls. The miRNAs expression of miR-21-5p, miR-155-5p, miR-221-3p, miR-26a-5p, and miR-144-3p were analyzed by RT-qPCR. In addition, the expressions of the miRNAs studied were correlated with the clinical characteristics of both the children and the mothers. The expression levels of miR-21-5-5p, miR-15-5p5, miR-221-3p, and miR-26-5p significantly differed between CHD and control subjects. Moreover, miR-21-5p levels were higher in patients with cyanotic versus non-cyanotic CHD patients. The expression levels of miRNAs of pediatric patients with CHD could participating in the development of cardiac malformations. Additionally, the high expression of miR-21-5p in cyanotic CHD children may be related to greater severity of illness relative to non-cyanotic CHD. This study adds to knowledge of the association between microRNAs and congenital heart disease in children. The expression levels of miR-21-5-5p, miR-15-5p5, miR-221-3p, and miR-26-5p of pediatric patients with CHD could be involved in the development and phenotype present in pediatric patients. miR-21-5p may help to discriminate between cyanotic and non-cyanotic CHD. In the future, the miRNAs studied could have applications as clinical biomarkers.

Cardiac Surgery-Associated Acute Kidney Injury in Children after Cardiopulmonary Bypass

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a complication of cardiopulmonary bypass surgery that frequently occurs in children. The increased availability of pediatric cardiac surgery leads to yearly increases in congenital heart disease (CHD) procedures performed worldwide. The number of complications, including pediatric CSA-AKI, has also increased. Children with CSA-AKI have worse postoperative periods and require more complex post-op intensive care. Thus, the timely commencement of interventions to prevent and to treat kidney injury in CHD children are one of a leading goals of pediatric cardiac intensive care.

Development and validation of a questionnaire to measure the congenital heart disease of children's family stressor.

Families of children with congenital heart disease (CHD) face tremendous stressors in the process of coping with the disease, which threatens the health of families of children with CHD. Studies have shown that nursing interventions focusing on family stress management can improve parents' ability to cope with illness and promote family health. At present, there is no measuring tool for family stressors of CHD. The items of the scale were generated through qualitative interviews and a literature review. Initial items were evaluated by seven experts to determine content validity. Factor analysis and reliability testing were conducted with a convenience sample of 670 family members. The criterion-related validity of the scale was calculated using scores on the Self-Rating Anxiety Scale (SAS). The CHD Children's Family Stressor Scale consisted of six dimensions and 41 items. In the exploratory factor analysis, the cumulative explained variance of the six factors was 61.085%. In the confirmatory factor analysis, the six factors in the EFA were well validated, indicating that the model fits well. The correlation coefficient between CHD Children's Family Stressor Scale and SAS was r = 0.504 (p < 0.001), which indicated that the criterion-related validity of the scale was good. In the reliability test, Cronbach's α coefficients of six sub-scales were 0.774-0.940, and the scale-level Cronbach's α coefficient value was 0.945. The study indicates that the CHD Children's Family Stressor Scale is valid and reliable, and it is recommended for use in clinical practice to assess CHD children's family stressors.

Pulmonary hypertension in congenital heart disease of children

Background: Pulmonary arterial hypertension is the dreaded complication of congenital heart disease with left-right shunt. The aim of this study was to describe the epidemio-clinical aspects of PAH associated with congenital heart disease. Methods: This was a retrospective descriptive multicentre study over a 2-year period (1 January 2020 to 31 December 2021) conducted in three University Hospitals in Antananarivo. Hospitalized children with congenital left-right shunt heart disease were included. Results: A total of 74 cases were recruited. The sex ratio was 0.7. The mean age of the children was 10.9 (SD=18.2) months. The mean age of onset of heart disease was 8 (SD=13.6) months. Heart disease was dominated by ventricular septal defect (51.3%), patent ductus arteriosus (39.2%), and atrioventricular canal (8.1%). PAH was encountered in 49 cases (66.2%). The majority of children with PAH were under 12 months of age (71.4%) and malnourished (70.2%). According to the type of heart disease, PAH was encountered in all complete CAVs, in 76.3% of CIVs and in 55.2% of PCAs. Eseinmenger's syndrome was present in 4% of cases, and the death rate was 20.3%. Conclusions: Improved management of children with congenital heart disease is needed, both in terms of diagnosis and surgical treatment, to prevent the onset of PAH.

Playing for cognition: investigating the feasibility and user experience of a virtual reality serious game for cognitive assessment in children with congenital heart disease

BackgroundIn order to facilitate the development and implementation of innovative technology in clinical practice, it is important to understand the user experience of end-users. Virtual Reality (VR) offers the possibility to assess cognitive functioning in a dynamic environment that simulates real-world situations. The purpose of this cross-sectional study was to investigate the feasibility of a VR Serious Game for cognitive assessment in school-aged children with congenital heart disease (CHD). The sub-aims were two-fold: (1) to objectively evaluate the feasibility of the VR Serious Game in children with CHD in comparison to typically developing (TD) children and (2) to explore the user experience of both groups following their interaction with the VR Serious Game.ResultsA total of 101 children participated in this study; 98 children were included in the final analysis (CHD: n = 54; TD: n = 47). The VR Serious Game appeared feasible for both children with CHD and TD children, with 88% children completing the innovative VR assessment without encountering any issues. There were no discernible differences in completion rates between groups. Children with CHD reported significantly lower scores than TD children on three user experience scales: Engagement, Flow and Presence. Nonetheless, the scores for Engagement and Flow were still considered "moderate to good". Both groups reported minimal adverse physiological reactions.ConclusionsThe findings suggested that the VR Serious Game was feasible for children with CHD and that the user experience was positive. Future research should investigate the effectiveness of the VR Serious Game compared with a conventional or digital neuropsychological assessment, prioritising the development of novel outcome measures that can better estimate and explain the impact of cognitive impairment on daily functioning.

Anemia in Children with Congenital Heart Disease: A Finding from Low-Resource Setting Hospitals.

Congenital heart disease (CHD) is the most common birth defect. Anemia is the prevailing manifestation of micronutrient deficiency. It has been demonstrated that anemia in children increases morbidity and has a negative impact on psychomotor development. Despite its negative consequences, which have been documented for a long time in clinical practice, the issue does not gain sufficient attention in developing countries, specifically in children with CHD. Thus, this study is aimes to assess the prevalence of anemia and the factors associated in children with CHD. Institutional-based cross-sectional study was conducted on CHD children at selected governmental hospitals in Addis Ababa, Ethiopia, from February to March 2021. During this period, 373 children with acyanotic and cyanotic heart disease between 0 months and 15 years of age were included in this study. All children were assessed using structured questionnaires and anthropometric measurements. Recent hemoglobin results that are avaliable in the medical charts of children were used to diagnose anemia. The data were analyzed using SPSS version 25. From randomly included 373 children with CHD, 298 (79.9%) had acyanotic congenital heart disease (ACHD) and 75 (20.1%) had cyanotic congenital heart disease (CCHD). Twenty-five (33.3%) CCHD and 192 (64.4%) ACHD cases of children were malnourished. The most common type of CCHD and ACHD defects were ventricular septal defects and tetralogy of fallout, respectively. Overall, the prevalence of anemia in ACHD and CCHD was 24.5% and 72%, respectively. In children with ACHD, the frequency of anemia was reported to be significantly higher in the malnourished group than in the well-nourished. A high prevalence of anemia is observed in children with CHD. This study highly suggests further evaluation to determine the frequency and complications of blood indices and other hematological impairments in ACHD, CCHD, and children with both problems. Moreover, the findings of this study on illness profiles in children with CHD prompt further research into the cellular and molecular mechanisms underlying immune system dysfunction.

CHD-CXR: a de-identified publicly available dataset of chest x-ray for congenital heart disease.

Congenital heart disease is a prevalent birth defect, accounting for approximately one-third of major birth defects. The challenge lies in early detection, especially in underdeveloped medical regions where a shortage of specialized physicians often leads to oversight. While standardized chest x-rays can assist in diagnosis and treatment, their effectiveness is limited by subtle cardiac manifestations. However, the emergence of deep learning in computer vision has paved the way for detecting subtle changes in chest x-rays, such as lung vessel density, enabling the detection of congenital heart disease in children. This highlights the need for further investigation. The lack of expert-annotated, high-quality medical image datasets hinders the progress of medical image artificial intelligence. In response, we have released a dataset containing 828 DICOM chest x-ray files from children with diagnosed congenital heart disease, alongside corresponding cardiac ultrasound reports. This dataset emphasizes complex structural characteristics, facilitating the transition from machine learning to machine teaching in deep learning. To ascertain the dataset's applicability, we trained a preliminary model and achieved an area under the receiver operating characteristic curve (ROC 0.85). We provide detailed introductions and publicly available datasets at: https://www.kaggle.com/competitions/congenital-heart-disease.

Congenital Heart Disease among Children Undergoing Echocardiography in the Department of Paediatrics of Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Congenital heart disease in children are a major cause of infant mortality and morbidity. It is important to detect and manage these disorders timely as they are preventable. The objective of this study was to find out proportion of congenital heart disease in children in paediatric department in a tertiary hospital.Methods: This is a descriptive cross-sectional study carried out in the Department of Paediatric at Nepal Medical College and Teaching Hospital where all children (0-18 years) suspected to have congenital heart disease who underwent echocardiography were studied over a period of 1 year (2020-2021). The presence or absence of congenital heart disease were confirmed by echocardiography performed by paediatric cardiologist. The socioeconomic variables,clinical features and echocardiography findings were noted.Results: Out of total 249 patients,the proportion of patients diagnosed to have cardiac disorders was 73 with male predominance of 165 (66.26%). The most common age group was found to be neonates 111 (44%).The notable clinical features were murmur 47 (18.87%), tachypnoea 27 (10.84%) ,tachycardia 27 (10.84%) and cyanosis 9 (3.61%), clubbing 2 (0.80%), oedema 1 (0.40%), hypertension 9 (3.65%), murmur 47 (18.87%).Out of the total, there were 49 (19.67%) cases of acyanotic congenital heart disease, and 27 (10.84%) cases of cyanotic congenital heart disease.Conclusions: Our study focuses on early recognition of cardiac diseases which is crucial for preventing morbidity and mortality.

Epidemiological Survey of Congenital Heart Disease Among Children Aged from 2 to 18 in Suo County, Nagqu, Tibet.

Lin, Tian, Huaping Jia, Yunming Li, Yongxing Xu, Bei Zhao, Dong Zheng, Hongfeng Yan, Meihui Zhao, Yanlei Li, Liping Xia, Fengxia Zhou, Cuiping Liu, Ke Ma, Ma Mi, and Jianwen Gu. Epidemiological survey of congenital heart disease among children aged from 2 to 18 in Suo County, Nagqu, Tibet. High Alt Med Biol. 00:000-000, 2024. Background: Studies have reported the prevalence of congenital heart disease (CHD) in parts of Tibet, but relative epidemiological surveys are rare. We aimed to explore the prevalence of CHD in children and its relationship with family history in Suo County, Nagqu, Tibet, an altitude of 3,980 meters. Methods: We recruited 4,002 children aged 2-18 years. Subjects underwent a family history investigation, cardiac auscultation, and clinical manifestation examination and then received echocardiographic screening. Results: The prevalence of CHD among children in Suo County was 0.97% (39 cases), much higher than the prevalence at sea level. The most common subtype was atrial septal defect, accounting for 53.9% of CHD, followed by patent ductus arteriosus (33.3%) and ventricular septal defect (12.8%). We also found that children whose mothers had previously borne children with CHD had a higher risk of CHD than those without (p = 0.002); other factors related to CHD during pregnancy, such as smoking, drinking, drug use, and viral infection, showed no statistical differences between children with and without CHD. Conclusions: The prevalence of CHD in children in Suo County is much higher than at low altitude, consisting mostly of simple forms with left-to-right shunt, with rare complex CHD. These results support implementing diagnostic and treatment plans to prevent CHD in Suo County.

Clinical Features and Cardiac Anomalies of Children with Down Syndrome. A Literature Report

Background: Clinical diagnosis of Down syndrome is based on the characteristic features and associated malformations. Nonetheless, there is significant individual diversity in the clinical presentation. Not every physical characteristic may be present, particularly in infants. At the same, congenital heart abnormalities (CHD) remain a major predictor of death in children with Down syndrome (DS) despite improvements in surgical therapy for these conditions. The effects of DS vary from person to person, with some people having a significant impact while others are well and capable of living unassisted as adults. So, this study is done to understand the pattern of clinical features and cardiac anomalies in various research reports.Aim: This scoping review aims to describe the frequency and distribution of clinical features and cardiac anomalies in children with Down syndrome and to consider the clinical implications of this knowledge.Methods: Medline, CINHAL, and PubMed databases were searched electronically to identify pertinent articles from 2000 to 2023. Children with Down syndrome and cardiac comorbidities aged 18 years or younger met the inclusion criteria. Articles that were not peer-reviewed or written in English were disqualified at the title or abstract level.Results: Literature revealed that the common physical and dysmorphic features found in individuals with Down syndrome include flat facial profile, epicanthal folds, upward slanting eyes, hypotonia, small ears, short neck, protruding tongue, small hands and feet, brushfield spots, sandal gap, and short stature. It's important to note that while these physical features are commonly associated with Down syndrome, not all individuals will exhibit every characteristic, and the severity can vary greatly among individuals.A high prevalence of CHD was reported in DS children from a group where consanguinity was relatively frequent. The prevalence of congenital heart disease in children with Down syndrome is the highest reported, especially when the researchers have used diagnostic ultrasound. VSD and AVSD, followed by persistent ductus arteriosus, and tetralogy of Fallot are the most common CHD in DS children. Recent research suggests that though the incidence of CHD in DS children has remained stable over time, there may be trends in some forms of CHD, with a rise in isolated, less severe kinds and a reduction in complicated, more severe ones. Individuals with Down syndrome can lead fulfilling lives with appropriate support and resources.Conclusion: All neonates with a new diagnosis or suspicion of DS must undergo comprehensive screening, which includes clinical examination, ECG, and echocardiography in the second trimester combined with fetal echocardiography when the fetal ultrasonography raises the likelihood of an abnormality. Literature proves that regardless of the existence of DS, early CHD repair is advised for newborns susceptible to biventricular surgery. For the most part, DS is not linked to an increased perioperative risk for CHD.Understanding DS heterogeneity will help professionals provide better prenatal counseling, assist parents in establishing focused early interventions to improve daily activities and the quality of life for their children, and assist policy-makers in providing and allocating resources for disability services. A sustaining commitment to scientific and clinical research studies is necessary to enhance the quality of life and survival for DS patients from infancy into adulthood.

The evaluation of the SMAD1 rs1016792 polymorphism and gene expression on pulmonary hypertension due to congenital heart disease in children: a preliminary study

Smad Family Member (SMAD), a protein family responsible for transducing the signal induced by TGF-β into the nucleus, is thought to play a role in the pathology of many heart diseases. Therefore, we aimed to evaluate the influence of the SMAD1 rs1016792 polymorphism and gene expression on pulmonary arterial hypertension (PAH) due to congenital heart disease (CHD) in children. A total of 90 children, 45 of whom were PAH-CHD children and 45 healthy children, were included in the study. Patients were selected from those who were diagnosed and followed in the Department of Pediatric Cardiology.The SMAD1 rs1016792 genotyping and expression analysis was performed using a real-time polymerase chain reaction (RT-PCR)-based system. It was determined that the left ventricular end-diastolic diameter (LVEDD) value was lower in the patient group than in the control group, while the pulmonary artery pressure (PAP) value was higher in the patient group than in the control group. When the SMAD1 gene expression level was examined, a statistically significant difference was found between the patient and control groups. Patients had decreased SMAD1 expression compared to controls (p˂0.001). We found no significant difference between the patient and control groups in terms of SMAD1 rs1016792 genotype distribution or allele frequency (p > 0.05). There was no difference between genotype distribution and SMAD1 expression levels in the groups. In this study, we showed for the first time that SMAD1 expression is decreased in children with PAH-CHD. These results will be a preliminary step toward understanding the role of SMAD1 in the etiopathogenesis of CHD.

Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial

BackgroundNew “noncardiac” problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD.MethodsChildren aged 0–5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis.ResultsAfter 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p < 0.0001, FMQ p = 0.02, TMQ p < 0.001). The physical developments in height, weight, and circumferences of the upper-arm, chest, and head were also significantly improved by exercise (all p < 0.017). No significant improvements in the bone strength or the cardiac structure and function were found among patients in the intervention group (all p > 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period.ConclusionsCustomized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes.Trial registrationA home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. (http://www.chictr.org.cn/, ChiCTR-IOR-16007762, January 14, 2016).

Application of a modified clinical classification for pulmonary arterial hypertension associated with congenital heart disease in children: emphasis on atrial septal defects and transposition of the great arteries. An analysis from the TOPP registry.

A proportion of patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) do not fit in the current classification. We aimed to analyse the applicability of an adapted clinical classification of PAH-CHD to pediatric patients using the TOPP-1 registry (Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension) and focus on atrial septal defects (ASD) and transposition of the great arteries (TGA). Hemodynamic and clinical data of all patients with PAH-CHD in the TOPP cohort were reviewed. Patients were classified according to predefined ABCDE categories (A: Eisenmenger syndrome, B: left-to-right shunt, C: coincidental defects, including all ASDs, D: corrected CHD, E: TGA), or as complex CHD (group 5), by 2 independent investigators. In case of disagreement, a third reviewer could either settle a final decision, or the patient was deemed not classifiable. Survival curves were calculated for each group and compared to idiopathic PAH patients of the registry. A total of 223 out of 531 patients in the registry had PAH-CHD, and 193 were categorized to the following groups: A 39(20%), B 27(14%), C 62(32%) including 43 ASDs, D 58(30%), E 7(4%), whereas 6 patients were categorized as group 5, and 10 patients were unable to be classified. No survival difference could be demonstrated between the groups. This modified classification seems to be more applicable to pediatric PAH-CHD patients than the previous classification, but some patients with PAH-CHD who never had a shunt remain unclassifiable. The role of ASD in pediatric PH should be reconsidered.

Role of miRNA in Cardiovascular Diseases in Children-Systematic Review.

The number of children suffering from cardiovascular diseases (CVDs) is rising globally. Therefore, there is an urgent need to acquire a better understanding of the genetic factors and molecular mechanisms related to the pathogenesis of CVDs in order to develop new prevention and treatment strategies for the future. MicroRNAs (miRNAs) constitute a class of small non-coding RNA fragments that range from 17 to 25 nucleotides in length and play an essential role in regulating gene expression, controlling an abundance of biological aspects of cell life, such as proliferation, differentiation, and apoptosis, thus affecting immune response, stem cell growth, ageing and haematopoiesis. In recent years, the concept of miRNAs as diagnostic markers allowing discrimination between healthy individuals and those affected by CVDs entered the purview of academic debate. In this review, we aimed to systematise available information regarding miRNAs associated with arrhythmias, cardiomyopathies, myocarditis and congenital heart diseases in children. We focused on the targeted genes and metabolic pathways influenced by those particular miRNAs, and finally, tried to determine the future of miRNAs as novel biomarkers of CVD.

The detailed profile of congenital heart diseases in 254 children with Down syndrome in Saudi Arabia

BackgroundDown syndrome is the most common chromosomal abnormality in humans. It is associated with several congenital anomalies, including a spectrum of congenital heart diseases. Understanding the true prevalence and distribution of congenital heart diseases is essential for health resource planning, outcomes, and family counseling.This study aimed to assess the prevalence and distribution of congenital heart disease in children with Down syndrome. It is a retrospective cohort review that included all patients treated at King Abdulaziz University Hospital. Frequencies were estimated using the SPSS software and comparisons were made using Student’s t test.ResultsThe ages of the 254 subjects ranged from less than 1 year to 53 years. Of these, 44.5% were female and 40.6% were Saudi nationals. Congenital heart disease was present in 66.5% with a significant difference between Saudi nationals 44.6%) and non-Saudi nationals 71.5% (P = 0.01). The atrioventricular septal defect was the most common pathology, representing 33.1% of all congenital heart diseases followed by perimembranous ventricular septal defect 18.9%, and right ventricular pathology 10.2%.ConclusionThe prevalence of congenital heart diseases in Saudi children with Down Syndrome is similar to that reported worldwide. Septal defects and right-sided pathologies are the dominant forms of congenital heart diseases, with atrioventricular septal defect and perimembranous ventricular septal defect representing the most common pathologies.

Precision Diagnosis: An Automated Method for Detecting Congenital Heart Diseases in Children from Phonocardiogram Signals Employing Deep Neural Network

Precision Diagnosis: An Automated Method for Detecting Congenital Heart Diseases in Children from Phonocardiogram Signals Employing Deep Neural Network

Стоматологічний статус дітей з вродженими вадами серця і магістральних судин в Україні

Introduction: Congenital heart disease (CHD) is one of the most common congenital defect worldwide. The increase in the number of patients with CHD creates a group of people with individual special care needs, including dental care. Purpose: to evaluate oral health conditions (oral hygiene, caries experience, periodontal health) in children with CHD and compare their caries experience with the one of the group of healthy children in Ukraine. Materials and methods: Fifty-eight children with congenital heart disease and eighty healthy children aged 3-15 years were enrolled in this study. According to their age and period of dentition, all the children were subdivided into 3 groups: with primary, mixed and permanent dentition. Caries experience, oral hygiene, periodontal health and dental developmental defects were assessed. A one-sample Kolmogorov-Smirnov test and an independent-measures t-Test were used. All statistical analyses were performed using the statistical software (SPSS version 26.0, SPSS Inc.). The statistical significance was set at 5%. Results and discussion: The caries experience of children with CHD and healthy children in primary dentition was 4.0 and 6.4 respectively. The highest DMFT was registered in children with CHD in mixed (4.7) and permanent (4.6) dentitions. 33,3% of children with primary dentition and up to 52,9% in mixed dentition had poor oral hygiene. Conclusions: According to limitation of this epidemiological study, there were no significant differences in caries experience of children with congenital heart disease and healthy children in primary and mixed dentitions. These findings indicate the importance of preventive dental care and appropriate treatment of children with CHD. Key words: congenital heart disease, oral health, children, caries, airway volume, dentoalveolar abnormalities.

Assessment of oral bacteria potentially associated with the mobile microbiome in children with congenital heart disease.

In this case-control study, we aimed to investigate the specific oral pathogens potentially associated with the mobile microbiome in children with congenital heart disease (CHD). Caries, oral hygiene and gingival indices were evaluated in 20 children with CHD and a healthy control group, and venous blood samples and saliva were collected. Using quantitative polymerase chain reaction (qPCR), blood samples were analyzed for the presence of bacterial DNA to determine the mobile microbiome, and saliva samples were analyzed to identify and quantify target microorganisms, including Streptococcus mutans (Sm) and its serotype k (Smk), Fusobacterium. nucleatum (Fn), Porphyromonas gingivalis (Pg), Scardovia wiggsiae (Sw) and Aggregitibacter actinomycetemcomitans (Aa) and its JP2 clone (JP2). The findings were analyzed by Mann Whitney U, chi-square, Fisher's exact and Spearman's Correlation tests. Bacterial DNA was identified in two blood samples. No significant differences were found between the groups regarding the presence and counts of bacteria in saliva. However, the CHD group exhibited significantly lower caries and higher gingival index scores than the control group. The presence of Pg and Aa were significantly associated with higher gingival index scores. Sm and Smk counts were significantly correlated with caries experience. A positive correlation was found between Fn and total bacteria counts. In conclusion, the mobile microbiome, which has been proposed as a potential marker of dysbiosis at distant sites, was very rare in our pediatric population. The counts of target microorganisms which are potentially associated with the mobile microbiome did not differ in children with CHD and healthy children.

Epidemiological investigation of congenital heart diseases among children during the years 2016 to 2021

Background: Congenital heart disease is a type of birth defect that affects about 1% of babies born each year and is the leading cause of death in infancy that is diagnosed at birth or later in life. Due to the high importance of this issue and high mortality and morbidity, the aim of this study was epidemiological investigation of congenital heart diseases in children during 2016 to 2021. Methods: In this cross-sectional analytical study, all children admitted to Bo Ali Hospital in Ardabil with primary diagnosis of congenital heart disease or secondary diagnosis during hospitalization along with all children referred to the clinic of this hospital with diagnosis of congenital heart disease were included in the study. Results: A total of 449 children with congenital heart disease were included in the study. 235 cases (52.33%) were boys, 35 cases (7.79%) had diabetic mothers and 12 cases (2.6%) had obese mothers. 20 cases (4.4%) were the result of multiple pregnancy and 31 cases (6.9%) were preterm. Significantly, preterm birth was more in children with cyanotic disease (p=0.036) and multiple births and maternal diabetes and aneuploidy were more in children with cyanotic disease compared to Asianotic children (p value equal to 0.008 respectively and 0.001 and 0.001). Conclusions: The frequency of congenital heart diseases, gender composition and related risk factors such as preterm birth and maternal diabetes were aligned and similar to domestic and foreign studies. Maternal diabetes and preterm birth can be considered as risk factors for congenital heart diseases.