Publications by authors named "Michael P DiLorenzo"

Arterial tortuosity syndrome (ATS) is an ultra-rare arteriopathy with a cardiovascular phenotype of vascular tortuosity, elongation, dilation, and stenosis. In 14 patients with ATS, aortic and pulmonary artery longitudinal growth, phenotypes, and interventions were evaluated. Medical records and images of 14 patients with ATS (defined as biallelic SLC2A10 variants with consistent phenotypes) were reviewed.

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Background: Although there are data on fractional flow reserve CT (CT-FFR) assessment for anomalous aortic origin of coronary artery (AAOCA) in adults, reports in children are limited.

Methods: Cardiac CT angiograms of patients ages 4-21 years with AAOCA performed from 2010 to 2021 ​at a single center were retrospectively identified. Characteristics historically considered high-risk -slit-like ostium, interarterial course, or intramural segment-, symptoms suggestive of ischemia, or positive provocative testing were correlated with reduced CT-FFR values of <0.

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Background: Multisystem Inflammatory Syndrome in Children is characterized by high rates of acute cardiovascular involvement with rapid recovery of organ dysfunction. However, information regarding long-term sequelae is lacking. We sought to characterize the systolic function and myocardial tissue properties using cardiac magnetic resonance (CMR) imaging in a multicenter observational cohort of Multisystem Inflammatory Syndrome in Children patients.

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Background: Systemic right ventricular (sRV) physiology occurs in patients with congenitally corrected transposition of the great arteries (ccTGA) and D-TGA post atrial switch repair, and the natural history is of progressive sRV dysfunction. No study has assessed longitudinal changes in sRV remodeling by serial cardiovascular magnetic resonance (CMR).

Methods: Patients evaluated at two adult congenital heart disease centers and who underwent ≥2 CMR exams were studied.

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Hematopoietic stem cell transplant (HSCT) is a potentially curative therapy for children with sickle cell disease (SCD). The effects of HSCT on ventricular function are not well characterized in children with SCD. Echocardiograms from children with SCD who underwent HSCT between 2007 and 2017 were retrospectively analyzed before and 1-year after HSCT.

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Article Synopsis
  • The study investigated the clinical features and long-term outcomes of myocarditis linked to COVID-19 vaccination, focusing on 333 affected patients under 30 compared to 100 with MIS-C.
  • Findings indicated that C-VAM patients were mostly young white males, experienced milder symptoms initially, but had higher rates of myocardial injury as shown by cardiac imaging.
  • Despite a generally benign course and no reported cardiac deaths during follow-up, 60% of patients still showed evidence of myocardial injury after approximately six months.
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Background: Cardiovascular magnetic resonance (CMR) is used to diagnose myocarditis in adults and children based on the original Lake Louise criteria (LLC) and more recently the revised LLC. The major change included in the revised LLC was the incorporation of parametric mapping, which significantly increases the sensitivity and specificity of diagnosis. Subsequently, scientific statements have recommended the use of parametric mapping in the diagnosis of myocarditis in children.

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Article Synopsis
  • * Most CMR research in children consists of small studies, making it hard to draw strong conclusions about their heart health.
  • * The publication discusses challenges faced in PCHD CMR research and offers guidance for developing larger, collaborative studies to improve understanding and care for these patients.
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Pediatric ECG standards have been defined without echocardiographic confirmation of normal anatomy. The Pediatric Heart Network Normal Echocardiogram Z-score Project provides a racially diverse group of healthy children with normal echocardiograms. We hypothesized that ECG and echocardiographic measures of left ventricular (LV) dimensions are sufficiently correlated in healthy children to imply a clinically meaningful relationship.

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  • The study examined trends in cardiac CT (CCT) usage among pediatric and congenital heart disease (CHD) patients by conducting a survey across North American pediatric cardiology centers in 2022, reflecting on practices from 2011 to 2021.
  • Results indicated a significant increase in CCT performance, with 98% of centers conducting CCT in 2021 compared to 73% in 2011, and a notable rise in centers performing over 100 CCTs annually.
  • Despite the increase, there is considerable variation in CCT practices among centers regarding technology use, staffing, and educational training for fellows, and common barriers to CCT usage include concerns about radiation exposure and anesthesia needs.
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  • The study aimed to assess how diagnostic cardiovascular procedure volumes rebounded in the U.S. and abroad during the year after COVID-19 hit, relying on data from 669 facilities worldwide.
  • In the early pandemic (April 2020), procedure volumes dropped significantly but showed a better recovery in U.S. facilities by April 2021 compared to non-U.S. facilities, although high-income non-U.S. countries showed similar recovery rates as the U.S.
  • Regional variations within the U.S. were noted, with the Midwest having the highest recovery rate, but no specific factors were found to predict recovery levels from the initial drop in procedure volumes.
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Diastolic dysfunction after repair for Tetralogy of Fallot (TOF) is associated with adverse long-term outcomes. Right atrial (RA) mechanics as a proxy of right ventricular (RV) diastolic function in the early post-operative period after surgical repair for TOF has not been reported. We sought to evaluate RA and RV strain prior to hospital discharge after TOF repair and to identify important patient factors associated with strain using a machine learning method.

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Pulmonary vein stenosis (PVS) in children is a challenging condition with poor outcomes. Post-operative stenosis can occur after repair of anomalous pulmonary venous return (APVR) or stenosis within native veins. There is limited data on the outcomes of post-operative PVS.

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Progress in the field of congenital heart surgery over the last century can only be described as revolutionary. Recent improvements in patient outcomes have been achieved through refinements in perioperative care. In the current and future eras, the preservation and restoration of myocardial health, beginning with the monitoring of tissue remodeling, will be central to improving cardiac outcomes.

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Article Synopsis
  • * In a cohort of 78 neonates, the results showed that d-TGA patients had worse left ventricular global longitudinal strain (LV GLS) immediately after surgery compared to healthy controls, but their heart function improved by 12 months post-op.
  • * The study found no significant correlation between troponin levels and LV GLS recovery, indicating that troponin may not be a reliable indicator for predicting heart function in the early and mid-term after
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Background: Accelerometry is an emerging option for real-time evaluation of functional capacity in patients with pulmonary arterial hypertension (PAH). This prospective pilot study assesses the relationship between functional capacity by accelerometry and right ventricular measurements on echocardiography for this high-risk cohort.

Methods: Patients with PAH were prospectively enrolled and underwent 6-Minute Walk Test and cardiopulmonary exercise testing.

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Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe life-threatening manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that often presents with acute cardiac dysfunction and cardiogenic shock. While recovery from acute illness is excellent, the long-term myocardial impact is unknown.

Objective: To compare cardiac MRI findings in children 6-9 months after their hospitalization with MIS-C against MRI findings in healthy controls to assess for residual myocardial disease.

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Background: Serum biomarkers of myocardial fibrosis are considered markers of adverse outcome in adults with heart disease. Associations between biomarkers and clinical parameters in tetralogy of Fallot (TOF) has been understudied. We compared serum biomarker profiles with clinical and cardiac magnetic resonance (CMR) parameters of ventricular remodeling in patients with repaired TOF.

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Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe life-threatening manifestation of SARS-CoV-2 infection. Acute cardiac dysfunction and resultant cardiogenic shock are common in children with MIS-C. While most children recover rapidly from acute illness, the long-term impact on the myocardium and cardiac function is unknown.

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Aims: Predicting risk in individuals with a systemic right ventricle (SRV) remains difficult. We assessed the value of cardiac MRI (CMR) for predicting death, heart transplantation (HT), or need for a ventricular assist device (VAD) in adults with D-transposition of the great arteries (DTGA) post Mustard/Senning and in adults with congenitally corrected transposition of the great arteries (ccTGA) at two large academic centres.

Methods And Results: Between December 1999 and November 2020, 158 adult patients with an SRV underwent CMR.

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Background: In spring 2020, a novel hyperinflammatory process associated with severe acute respiratory syndrome coronavirus 2 multisystem inflammatory syndrome in children (MIS-C) was described. The long-term impact remains unknown. We report longitudinal outcomes from a New York interdisciplinary follow-up program.

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Article Synopsis
  • A 3-year-old child with Loeys-Dietz Syndrome (LDS) had a small patent ductus arteriosus and a dilated aorta but showed no symptoms.
  • During routine heart imaging, a large ductal aneurysm was discovered, which was successfully removed.
  • This case highlights the importance of advanced imaging techniques for monitoring and managing patients with LDS.
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