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Krmek N, Környei L, Kralik I, Delić-Brkljačić D, Milošević M, Rode M, Kocsis F, Radeljić V. X-ray Doses in Relation to Body Mass, Indication, and Substrate During Pediatric Electrophysiological Procedures on the Heart. Pediatr Cardiol 2024; 45:804-813. [PMID: 38411709 DOI: 10.1007/s00246-024-03428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/21/2024] [Indexed: 02/28/2024]
Abstract
The main goal of this study is to determine typical values of dose area product (DAP) and difference in the effective dose (ED) for pediatric electrophysiological procedures on the heart in relation to patient body mass. This paper also shows DAP and ED in relation to the indication, the arrhythmia substrate determined during the procedure, and in relation to the reason for using radiation. Organ doses are described as well. The subjects were children who have had an electrophysiological study done with a 3D mapping system and X-rays in two healthcare institutions. Children with congenital heart defects were excluded. There were 347 children included. Significant difference was noted between mass groups, while heavier children had higher values of DAP and ED. Median DAP in different mass groups was between 4.00 (IQR 1.00-14.00) to 26.33 (IQR 8.77-140.84) cGycm2. ED median was between 23.18 (IQR 5.21-67.70) to 60.96 (IQR 20.64-394.04) µSv. The highest DAP and ED in relation to indication were noted for premature ventricular contractions and ventricular tachycardia-27.65 (IQR 12.91-75.0) cGycm2 and 100.73 (IQR 53.31-258.10) µSv, respectively. In arrhythmia substrate groups, results were similar, and the highest doses were in ventricular substrates with DAP 29.62 (IQR 13.81-76.0) cGycm2 and ED 103.15 (IQR 60.78-266.99) µSv. Pediatric electrophysiology can be done with very low doses of X-rays when using 3D mapping systems compared to X-rays-based electrophysiology, or when compared to pediatric interventional cardiology or adult electrophysiology.
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Affiliation(s)
- Nikola Krmek
- University of Zagreb, School of Medicine, Zagreb, Croatia.
| | - László Környei
- Gottsegen National Cardiovascular Center, Hungarian Paediatric Heart Center, Budapest, Hungary
| | | | | | | | - Mirta Rode
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Flóra Kocsis
- Gottsegen National Cardiovascular Center, Hungarian Paediatric Heart Center, Budapest, Hungary
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2
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Martín F, Janssen S, Rodrigues V, Sousa J, Santiago JL, Rivas E, Stocker J, Jackson R, Russo F, Villani MG, Tinarelli G, Barbero D, José RS, Pérez-Camanyo JL, Santos GS, Bartzis J, Sakellaris I, Horváth Z, Környei L, Liszkai B, Kovács Á, Jurado X, Reiminger N, Thunis P, Cuvelier C. Using dispersion models at microscale to assess long-term air pollution in urban hot spots: A FAIRMODE joint intercomparison exercise for a case study in Antwerp. Sci Total Environ 2024; 925:171761. [PMID: 38494008 DOI: 10.1016/j.scitotenv.2024.171761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
In the framework of the Forum for Air Quality Modelling in Europe (FAIRMODE), a modelling intercomparison exercise for computing NO2 long-term average concentrations in urban districts with a very high spatial resolution was carried out. This exercise was undertaken for a district of Antwerp (Belgium). Air quality data includes data recorded in air quality monitoring stations and 73 passive samplers deployed during one-month period in 2016. The modelling domain was 800 × 800 m2. Nine modelling teams participated in this exercise providing results from fifteen different modelling applications based on different kinds of model approaches (CFD - Computational Fluid Dynamics-, Lagrangian, Gaussian, and Artificial Intelligence). Some approaches consisted of models running the complete one-month period on an hourly basis, but most others used a scenario approach, which relies on simulations of scenarios representative of wind conditions combined with post-processing to retrieve a one-month average of NO2 concentrations. The objective of this study is to evaluate what type of modelling system is better suited to get a good estimate of long-term averages in complex urban districts. This is very important for air quality assessment under the European ambient air quality directives. The time evolution of NO2 hourly concentrations during a day of relative high pollution was rather well estimated by all models. Relative to high resolution spatial distribution of one-month NO2 averaged concentrations, Gaussian models were not able to give detailed information, unless they include building data and street-canyon parameterizations. The models that account for complex urban geometries (i.e. CFD, Lagrangian, and AI models) appear to provide better estimates of the spatial distribution of one-month NO2 averages concentrations in the urban canopy. Approaches based on steady CFD-RANS (Reynolds Averaged Navier Stokes) model simulations of meteorological scenarios seem to provide good results with similar quality to those obtained with an unsteady one-month period CFD-RANS simulations.
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Affiliation(s)
- F Martín
- CIEMAT, Research Center for Energy, Environment and Technology, Avenida Complutense 40, 28040 Madrid, Spain.
| | - S Janssen
- VITO NV, Flemish Institute for Research and Technology, Boeretang 200, 2400 Mol, Belgium
| | - V Rodrigues
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - J Sousa
- VITO NV, Flemish Institute for Research and Technology, Boeretang 200, 2400 Mol, Belgium
| | - J L Santiago
- CIEMAT, Research Center for Energy, Environment and Technology, Avenida Complutense 40, 28040 Madrid, Spain
| | - E Rivas
- CIEMAT, Research Center for Energy, Environment and Technology, Avenida Complutense 40, 28040 Madrid, Spain
| | - J Stocker
- Cambridge Environmental Research Consultants (CERC), UK
| | - R Jackson
- Cambridge Environmental Research Consultants (CERC), UK
| | - F Russo
- ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, 40129 Bologna, Italy
| | - M G Villani
- ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, 40129 Bologna, Italy
| | - G Tinarelli
- ARIANET S.r.l., via Crespi 57, 20159 Milano, Italy
| | - D Barbero
- ARIANET S.r.l., via Crespi 57, 20159 Milano, Italy
| | - R San José
- Computer Science School, Technical University of Madrid (UPM), Campus de Montegancedo, s/n, 28660 Madrid, Spain
| | - J L Pérez-Camanyo
- Computer Science School, Technical University of Madrid (UPM), Campus de Montegancedo, s/n, 28660 Madrid, Spain
| | - G Sousa Santos
- NILU - The Climate and Environmental Research Institute, Norway
| | - J Bartzis
- University of Western Macedonia (UOWM), Dept. of Mechanical Engineering, Sialvera & Bakola Str., 50132 Kozani, Greece
| | - I Sakellaris
- University of Western Macedonia (UOWM), Dept. of Mechanical Engineering, Sialvera & Bakola Str., 50132 Kozani, Greece
| | - Z Horváth
- SZE, Széchenyi István University, Győr, Hungary
| | - L Környei
- SZE, Széchenyi István University, Győr, Hungary
| | - B Liszkai
- SZE, Széchenyi István University, Győr, Hungary
| | - Á Kovács
- SZE, Széchenyi István University, Győr, Hungary
| | | | - N Reiminger
- AIR&D, Strasbourg, France; ICUBE Laboratory, UMR 7357, CNRS/University of Strasbourg, F-67000 Strasbourg, France
| | - P Thunis
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - C Cuvelier
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Gubó E, Plutzer J, Molnár T, Pordán-Háber D, Szabó L, Szalai Z, Gubó R, Szakál P, Szakál T, Környei L, Bede-Fazekas Á, Kalocsai R. Correction to: A 4‑year study of bovine reproductive hormones that are induced by pharmaceuticals and appear as steroid estrogenic pollutants in the resulting slurry, using in vitro and instrumental analytical methods. Environ Sci Pollut Res Int 2024; 31:9868. [PMID: 38225503 PMCID: PMC10824878 DOI: 10.1007/s11356-024-31992-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
- Eduárd Gubó
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary.
- reAgro Research and Development Ltd., Győrújbarát, Hungary.
| | - Judit Plutzer
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
| | - Tibor Molnár
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
- University of Szeged, Faculty of Science and Informatics, Szeged, Hungary
| | - Dóra Pordán-Háber
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
- reAgro Research and Development Ltd., Győrújbarát, Hungary
| | - Lili Szabó
- Geographical Institute, HUN-REN Research Centre for Astronomy and Earth Sciences, Budapest, Hungary
- Department of Environmental and Landscape Geography, Institute of Geography and Earth Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- MTA Centre of Excellence, HUN-REN CSFK, Budapest, Hungary
| | - Zoltán Szalai
- Geographical Institute, HUN-REN Research Centre for Astronomy and Earth Sciences, Budapest, Hungary
- Department of Environmental and Landscape Geography, Institute of Geography and Earth Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- MTA Centre of Excellence, HUN-REN CSFK, Budapest, Hungary
| | - Richard Gubó
- SynCat@Beijing, Synfuels China Technology Co. Ltd., Leyuan South Street II, No.1, Huairou District, Beijing, 101407, China
- National Energy Center for Coal to Liquids, Synfuels China Co., Ltd., Beijing, 101400, China
| | - Pál Szakál
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
| | - Tamás Szakál
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
| | - László Környei
- Department of Mathematics and Computational Sciences, Széchenyi István University, Győr, Hungary
| | - Ákos Bede-Fazekas
- Department of Environmental and Landscape Geography, Institute of Geography and Earth Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- HUN-REN Centre for Ecological Research, Institute of Ecology and Botany, Vácrátót, Hungary
| | - Renátó Kalocsai
- Albert Kázmér Faculty, Széchenyi István University, Vár tér 2., 9200, Mosonmagyaróvár, Hungary
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Gubó E, Plutzer J, Molnár T, Pordán-Háber D, Szabó L, Szalai Z, Gubó R, Szakál P, Szakál T, Környei L, Bede-Fazekas Á, Kalocsai R. A 4-year study of bovine reproductive hormones that are induced by pharmaceuticals and appear as steroid estrogenic pollutants in the resulting slurry, using in vitro and instrumental analytical methods. Environ Sci Pollut Res Int 2023; 30:125596-125608. [PMID: 38006481 PMCID: PMC10754748 DOI: 10.1007/s11356-023-31126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
The main objective of the research was to study the environmental "price" of the large-scale, milk production from a rarely known perspective, from the mapping of the estrogenic footprint (the amount of oestrus-inducer hormonal products, and the generated endoestrogens) in the resulting slurry in a dairy cow farm. These micropollutants are endocrine-disrupting chemicals (EDCs) and can be dangerous to the normal reproductive functions even at ng/kg concentration. One of them, 17ß-estradiol, has a 20,000 times stronger estrogenic effect than bisphenol-A, a widely known EDC of industrial origin. While most studies on EDCs are short-term and/or laboratory based, this study is longitudinal and field-based. We sampled the slurry pool on a quarterly basis between 2017 and 2020. Our purpose was testing the estrogenic effects using a dual approach. As an effect-based, holistic method, we developed and used the YES (yeast estrogen screen) test employing the genetically modified Saccharomyces cerevisiae BJ3505 strain which contains human estrogenic receptor. For testing exact molecules, UHPLC-FLD was used. Our study points out that slurry contains a growing amount of EDCs with the risk of penetrating into the soil, crops and the food chain. Considering the Green Chemistry concept, the most benign ways to prevent of the pollution of the slurry is choosing appropriate oestrus-inducing veterinary pharmaceuticals (OIVPs) and the separation of the solid and liquid parts with adequate treatment methods. To our knowledge, this is the first paper on the adaptation of the YES test for medicine and slurry samples, extending its applicability. The adapted YES test turned out to be a sensitive, robust and reliable method for testing samples with potential estrogenic effect. Our dual approach was successful in evaluating the estrogenic effect of the slurry samples.
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Affiliation(s)
- Eduárd Gubó
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary.
- reAgro Research and Development Ltd., Győrújbarát, Hungary.
| | - Judit Plutzer
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
| | - Tibor Molnár
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
| | - Dóra Pordán-Háber
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
- reAgro Research and Development Ltd., Győrújbarát, Hungary
| | - Lili Szabó
- Research Centre for Astronomy and Earth Sciences, Hungarian Academy of Sciences, Geographical Institute, Budapest, Hungary
| | - Zoltán Szalai
- Research Centre for Astronomy and Earth Sciences, Hungarian Academy of Sciences, Geographical Institute, Budapest, Hungary
| | - Richard Gubó
- SynCat@Beijing, Synfuels China Technology Co. Ltd., Leyuan South Street II, No.1, Huairou District, Beijing, 101407, China
- National Energy Center for Coal to Liquids, Synfuels China Co., Ltd., Beijing, 101400, China
| | - Pál Szakál
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
| | - Tamás Szakál
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
| | - László Környei
- Department of Mathematics and Computational Sciences, Széchenyi István University, Győr, Hungary
| | - Ákos Bede-Fazekas
- Department of Environmental and Landscape Geography, Eötvös Lóránd University, Budapest, Hungary
| | - Renátó Kalocsai
- Albert Kázmér Faculty, Széchenyi István University, Vár Tér 2, 9200, Mosonmagyaróvár, Hungary
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Mladoniczky S, Nagy Z, Földesi C, Som Z, Bálint HO, Környei L, Ruzsa D, Fődi E, Simor T, Kardos A. Case series of catheter-based arrhythmia ablation in 13 pregnant women. Clin Cardiol 2023; 46:942-949. [PMID: 37408170 PMCID: PMC10436797 DOI: 10.1002/clc.24072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Catheter ablation is a rarely used procedure to treat arrhythmias during pregnancy. HYPOTHESIS In the case of maternal arrhythmia during pregnancy, zero-fluoroscopic catheter ablation is preferable to medical treatment. METHODS Between April 2014 and September 2021, we examined the demographic data, procedural parameters, and fetal and maternal outcomes in pregnant women undergoing ablation at the Gottsegen National Cardiovascular Center and University of Pécs Medical School, Heart Institute. RESULTS Fourteen procedures (14 electrophysiological studies [EPS], 13 ablations) performed on 13 pregnant women (age 30.3 ± 5.2 years, primipara n = 6) were studied. During EPS, 12 patients had inducible arrhythmias. Atrial tachycardia was confirmed in three, atrioventricular re-entry tachycardia via manifest accessory pathway (AP) in three, and via concealed AP in one case. Atrioventricular nodal re-entry tachycardia was confirmed in three and sustained monomorphic ventricular tachycardia in two cases. Eleven radiofrequency ablation (84.6%) and two cryoablation (15.4%) were performed. The electroanatomical mapping system was used in all cases. Transseptal puncture was performed in two cases (15.4%) due to left lateral APs. The mean procedure time was 76.0±33.0 minutes. All procedures were performed without fluoroscopy. No complications occurred. During the follow-up, arrhythmia-free survival was achieved in all cases, but in two patients, we used antiarrhythmic drugs (AADs) to achieve it. APGAR score was within the normal range in all cases [median (interquartile range), 9.0/10.0 (9.0-10.0/9.3-10.0)]. CONCLUSIONS Zero-fluoroscopic catheter ablation was an effective and safe treatment option for our 13 pregnant patients. Catheter ablation may have less side effects on fetal development than the use of AADs during pregnancy.
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Affiliation(s)
- Sára Mladoniczky
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - Zsófia Nagy
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - Csaba Földesi
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - Zoltán Som
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - Hajnalka O. Bálint
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - László Környei
- Pediatric Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
| | - Diána Ruzsa
- University of Pécs Medical SchoolHeart InstitutePécsHungary
| | - Eszter Fődi
- University of Pécs Medical SchoolHeart InstitutePécsHungary
| | - Tamás Simor
- University of Pécs Medical SchoolHeart InstitutePécsHungary
| | - Attila Kardos
- Adult Cardiology DepartmentGottsegen National Cardiovascular CenterBudapestHungary
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Kuti R, Zólyomi G, László G, Hajdu C, Környei L, Hajdu F. Examination of effects of indoor fires on building structures and people. Heliyon 2022; 9:e12720. [PMID: 36632104 PMCID: PMC9826857 DOI: 10.1016/j.heliyon.2022.e12720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/05/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022] Open
Abstract
The scientific study of the harmful effects of indoor fires on building structures and on the environment is a top issue today. Indoor fires frequently occur all over the world. The goal of our research is to examine the effects of an average room fire on the survival possibility of a trapped person and on the building structure, taking into account features of the Eastern European architecture. First, a computational fluid dynamics (CFD) simulation was performed to examine the change of temperature, oxygen, and carbon monoxide concentration in a selected room in a vacant building used for military training. Based on the results, a 1:1 scale fire experiment was carried out with the parameters used in the simulation. The experiment was repeated once with the same settings. It was observed that without the intervention of firefighters, the temperature in the experiment could have rapidly reached 400 °C, as suggested by the simulation, which could have caused structural damage to the building. Furthermore, after 3 min the carbon monoxide concentration reached 400 ppm in both experiments and the simulation, which is a harmful level to people trapped inside the room. Also, in the experiment there was sufficient oxygen at the ground level with what people can survive 3 min.
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Affiliation(s)
- Rajmund Kuti
- Department of Automation and Mechatronics, Faculty of Mechanical Engineering, Informatics and Electrical Engineering, Széchenyi István University, Győr, Hungary
| | - Géza Zólyomi
- Directorate for Disaster Management of Heves County, Gyöngyös Disaster Department, Hungary
| | - Gabriella László
- Doctoral School of Multidisciplinary Engineering Sciences, Széchenyi István University, Győr, Hungary
| | - Csaba Hajdu
- Doctoral School of Multidisciplinary Engineering Sciences, Széchenyi István University, Győr, Hungary
| | - László Környei
- Department of Mathematics, Faculty of Mechanical Engineering, Informatics and Electrical Engineering, Széchenyi István University, Győr, Hungary
| | - Flóra Hajdu
- Department of Machine Design, Faculty of Mechanical Engineering, Informatics and Electrical Engineering, Széchenyi István University, Győr, Hungary,Corresponding author.
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7
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Silvetti MS, Bruyndonckx L, Maltret A, Gebauer R, Kwiatkowska J, Környei L, Albanese S, Raimondo C, Paech C, Kempa M, Fésüs G, Knops RE, Blom NA, Drago F. The SIDECAR project: S-IcD registry in European paediatriC and young Adult patients with congenital heaRt defects. Europace 2022; 25:460-468. [PMID: 36107451 PMCID: PMC9935000 DOI: 10.1093/europace/euac162] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Subcutaneous-implantable cardiac defibrillators (S-ICDs) are used increasingly to prevent sudden cardiac death in young patients. This study was set up to gain insight in the indications for S-ICD, possible complications, and their predictors and follow-up results. METHODS AND RESULTS A multicentre, observational, retrospective, non-randomized, standard-of-care registry on S-ICD outcome in young patients with congenital heart diseases (CHDs), inherited arrhythmias (IAs), idiopathic ventricular fibrillation (IVF), and cardiomyopathies (CMPs). Anthropometry was registered as well as implantation technique, mid-term device-related complications, and incidence of appropriate/inappropriate shocks (IASs). Data are reported as median (interquartile range) or mean ± standard deviation. Eighty-one patients (47% CMPs, 20% CHD, 21% IVF, and 12% IA), aged 15 (14-17) years, with body mass index (BMI) 21.8 ± 3.8 kg/m2, underwent S-ICD implantation (primary prevention in 59%). This was performed with two-incision technique in 81% and with a subcutaneous pocket in 59%. Shock and conditional zones were programmed at 250 (200-250) and 210 (180-240) b.p.m., respectively. No intraoperative complications occurred. Follow up was 19 (6-35) months: no defibrillation failure occurred, 17% of patients received appropriate shocks, 13% of patients received IAS (supraventricular tachycardias 40%, T-wave oversensing 40%, and non-cardiac oversensing 20%). Reprogramming, proper drug therapy, and surgical revision avoided further IAS. Complications requiring surgical revision occurred in 9% of patients, with higher risks in patients with three-incision procedures [hazard ratio (HR) 4.3, 95% confidence interval (95% CI) 0.5-34, P = 0.038] and BMI < 20 (HR 5.1, 95% CI 1-24, P = 0.031). CONCLUSION This multicentre European paediatric registry showed good S-ICD efficacy and safety in young patients. Newer implantation techniques and BMI > 20 showed better outcome.
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Affiliation(s)
| | - Luc Bruyndonckx
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium
| | - Alice Maltret
- Department of Paediatric Cardiology Hopital Necker-Enfants Malades, Paris, France,Hopital Marie Lannelongue-M3C, GHPSJ, Université Paris Descartes, Paris, France
| | - Roman Gebauer
- Department of Paediatric Cardiology, Heart Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Joanna Kwiatkowska
- Department of Paediatric Cardiology and Congenital Heart Defects, Medical University of Gdansk, Gdansk, Poland
| | - László Környei
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - Sonia Albanese
- Heart Surgery Team, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Cristina Raimondo
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy,Department of Paediatric Cardiology Hopital Necker-Enfants Malades, Paris, France
| | - Christian Paech
- Department of Paediatric Cardiology, Heart Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Gábor Fésüs
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - Reinoud E Knops
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Nico Andreas Blom
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
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8
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Környei L, Szabó A, Tooth F, Krivácsy P. Gyermekkori, kórházon kívüli hirtelen szívmegállás és öröklődő arrhythmiaszindrómák Magyarországon. Orv Hetil 2022; 163:473-477. [DOI: 10.1556/650.2022.32404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló.
Bevezetés: A gyermekkori hirtelen szívmegállás ritka, de egy
részük megelőzhető lehetne. Célkitűzés: Vizsgálatunk célja az
volt, hogy a Magyarországon előforduló, kórházon kívüli gyermekkori szívmegállás
gyakoriságát és hátterében az öröklődő arrhythmiaszindrómák jelentőségét
megbecsüljük. Módszer: Három megközelítést alkalmaztunk.
Elemeztük 1) az Országos Mentőszolgálat 2012. január 1. és 2015. június 30.
közötti eseteinek Utstein-adatlapjait, 2) az Országos Gyermekszív Központba
hirtelen szívmegállás miatt 2000. január 1. és 2021. augusztus 11. között
felvett, valamint 3) az öröklött arrhythmiaszindróma gyanúja miatt 2015. október
1. és 2021. augusztus 11. között gondozásba vett gyermekek adatait.
Eredmények: 1) A vizsgált 3,5 év alatt 373 gyermekkori
keringésmegálláshoz riasztották a mentőket. Az Utstein-adatlapok alapján
vélhetően 84 esetben (≈24/év) állhatott cardialis ok a háttérben. A reanimáció
az esetek 20%-ában volt sikeres. 2) A vizsgált közel 21 évben 24 gyermek (≈1/év)
került felvételre előzmény nélküli hirtelen szívmegállást követően a tercier
országos központba. Hátterükben 11/24 (46%) esetben öröklött
arrhythmiaszindróma, 4/24 (16%) esetben strukturális szívbetegség igazolódott.
9/24 (38%) esetben az ok nem volt tisztázható. 3) A vizsgált közel 6 évben 73
gyermeknél (≈12/év) történt genetikai vizsgálat öröklődő arrhythmiaszindróma
gyanúja miatt: tünetek nélküli kóros EKG: n = 23, családszűrés: n = 21, syncope:
n = 15, sikeres újraélesztést követően: n = 14. Egyértelmű patológiás mutáció 29
(≈5/év), ismeretlen jelentőségű variáns 15 esetben igazolódott.
Következtetés: Az Országos Mentőszolgálat adatai alapján
Magyarországon évente kb. 20–25 gyermeknél következik be kórházon kívüli
hirtelen szívmegállás. Ezen esetek körülbelül egyötödében sikeres az
újraélesztés, és a túlélő betegek egyötöde gyógyul súlyos szövődmények,
neurológiai károsodás nélkül és kerül az Országos Gyermekszív Központba további
ellátásra (a gyermekkori szívmegállások 5%-a). Ezen betegek közel felénél utólag
öröklött arrhythmiaszindróma igazolható. Öröklődő arrhythmiaszindróma miatt az
országos központban gondozásba kerülő gyermekek egyötödét ismerik fel hirtelen
szívmegállást követően. Orv Hetil. 2022; 163(12): 473–477.
Summary.
Introduction: The incidence of pediatric out-of-hospital sudden
cardiac arrest is low, but a part of them could be preventable.
Objective: Aim of our study was to assess the pediatric
cardiac arrest in Hungary and the magnitude of inherited cardiac arrhythmias in
the background. Method: Three methods were used. 1) Utstein
data sheets of the National Ambulance Service between 01. 01. 2012 and 30. 06.
2015. 2) Records of admissions to the national tertiary pediatric heart centre,
due to out-of-hospital pediatric sudden cardiac arrest between 01. 01. 2000 –
11. 08. 2021. and 3) Results of genetic testing in patients with suspicion of
inherited arrhythmia syndromes between 01. 10. 2015 – 11. 08. 2021 were analysed
retrospectively. Results: 1) Ambulance was called to 373
paediatric cardiac arrests during the study period of 3.5 years. Primary cardiac
origin was presumed in 84 cases (≈24/year) on the basis of Utstein data sheets.
Reanimation was successful in 20%. 2) 24 children (≈1/year) were admitted to the
national pediatric heart centre after out-of-hospital sudden cardiac arrest
during the study period of 21 years. Inherited arrhythmia syndromes in 11/24
(46%), structural heart disease in 4/24 (16%) cases could be identified, but
etiology remained unclear in the rest 9/24 (38%). 3) Suspicion of inherited
arrhythmia syndrome emerged in 73 children in 6 years of the study (≈12/year)
and it was based on pathological ECG: n = 23, family screening: n = 21, syncope:
n = 15, successful reanimation: n = 14. Genetic testing revealed pathological
variation in 29 cases (≈5/year), variant of unknown significance in 15 cases.
Conclusion: 20–25 children have out-of-hospital cardiac
arrest annually in Hungary based on data from the National Ambulance Service.
Reanimation is successful in one fifth of the cases. One fifth of these
surviving children had no severe complications and neurological deficit and they
were admitted to the national pediatric heart centre for further diagnosis and
treatment (5% of pediatric cardiac arrest). Inherited arrhythmia syndrome could
be identified in the background in half of these admissions. One fifth of
children checked up and followed for inherited arrhythmia syndrome in the
national centre were diagnosed after sudden cardiac arrest. Orv Hetil. 2022;
163(12): 473–477.
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Affiliation(s)
- László Környei
- Gottsegen György Országos Kardiovaszkuláris Intézet, Gyermekszív Központ Budapest, Haller u. 29., 1096 Magyarország
| | - Andrea Szabó
- Gottsegen György Országos Kardiovaszkuláris Intézet, Gyermekszív Központ Budapest, Haller u. 29., 1096 Magyarország
| | - Franciska Tooth
- Bajcsy-Zsilinszky Kórház és Rendelőintézet Budapest Magyarország
| | - Péter Krivácsy
- Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika Budapest Magyarország
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9
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Környei L, Szabó A, Róth G, Ferenci T, Kardos A. Supraventricular tachycardias in neonates and infants: factors associated with fatal or near-fatal outcome. Eur J Pediatr 2021; 180:2669-2676. [PMID: 34184119 DOI: 10.1007/s00431-021-04159-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/13/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022]
Abstract
Prognosis of supraventricular tachycardias in neonates and infants is thought to be excellent with rare fatal outcomes. Nevertheless, initial management can be challenging. The aim of this study was to perform a retrospective analysis in neonates/infants with non-pos-toperative supraventricular tachycardias regarding risk factors for clinical outcome and type of antiarrhythmic drug therapy. The data of 157 patients aged < 1 year who presented between 2000 and 2015 with symptomatic tachycardias were retrospectively reviewed. Pharmacological therapy was successful in 151 patients (96%); 1 patient (1%) required catheter ablation and 5 patients (3%) died (1 death linked to hemodynamical reasons after effective arrhythmia control). Serious complications following acute medical therapy occurred in 4 patients of survivors. Patients with complications or death had a lower bodyweight, more frequent intrauterine tachycardia, transplacental therapy, urgent caesarian section, higher PRISM II score, longer period to control tachycardia, more frequent proarrhythmia, and major adverse event-defined as life-threatening event without a documented new arrhythmia-compared to the group without complications. There was no significant difference between the groups regarding prematurity, structural heart disease, and type of tachycardia. Proarrhythmia occurred in 6 cases and was related to intravenous drug use with class IC antiarrhythmics in 3/6 cases, digoxin in 2/6 cases, and amiodarone in 1/6 cases. ECG signs of impending proarrhythmia without new-onset arrhythmia requiring cessation of therapy were detected in 6 patients.Conclusion: Although rare, non-post-operative supraventricular tachycardia in neonates and infants might be a serious disease. Acute intravenous pharmacological treatment to control tachycardia might pose a risk for fatal or near-fatal outcome. Detection of proarrhythmia related to class IC antiarrhythmics in neonates might be especially difficult and requires alertness. What is Known • Prognosis of supraventricular tachycardias in children are thought to be excellent with fatal outcomes being rare. • Mortality is increased in the very young and in those with structural heart disease. What is New • Complicated outcome of non-post-operative supraventricular tachycardias in neonates is associated with lower bodyweight, age, prenatal tachycardia, higher PRISM II score, longer period to control tachycardia, and proarrhythmia. • Detection of class IC proarrhythmic effect is especially difficult in neonates because of their narrow QRS and warrants alertness.
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Affiliation(s)
- László Környei
- Hungarian Pediatric Heart Center, Gottsegen György Hungarian Institute of Cardiology, Haller u. 29, Budapest, 1096, Hungary.
| | - Andrea Szabó
- Hungarian Pediatric Heart Center, Gottsegen György Hungarian Institute of Cardiology, Haller u. 29, Budapest, 1096, Hungary
| | - György Róth
- Hungarian Pediatric Heart Center, Gottsegen György Hungarian Institute of Cardiology, Haller u. 29, Budapest, 1096, Hungary
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University, Budapest, Hungary.,Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - Attila Kardos
- Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary
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10
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Déri S, Borbás J, Hartai T, Hategan L, Csányi B, Visnyovszki Á, Madácsy T, Maléth J, Hegedűs Z, Nagy I, Arora R, Labro AJ, Környei L, Varró A, Sepp R, Ördög B. Impaired cytoplasmic domain interactions cause co-assembly defect and loss of function in the p.Glu293Lys KNCJ2 variant isolated from an Andersen-Tawil syndrome patient. Cardiovasc Res 2021; 117:1923-1934. [PMID: 32810216 DOI: 10.1093/cvr/cvaa249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/16/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
AIMS Subunit interactions at the cytoplasmic domain interface (CD-I) have recently been shown to control gating in inward rectifier potassium channels. Here we report the novel KCNJ2 variant p.Glu293Lys that has been found in a patient with Andersen-Tawil syndrome type 1 (ATS1), causing amino acid substitution at the CD-I of the inward rectifier potassium channel subunit Kir2.1. Neither has the role of Glu293 in gating control been investigated nor has a pathogenic variant been described at this position. This study aimed to assess the involvement of Glu293 in CD-I subunit interactions and to establish the pathogenic role of the p.Glu293Lys variant in ATS1. METHODS AND RESULTS The p.Glu293Lys variant produced no current in homomeric form and showed dominant-negative effect over wild-type (WT) subunits. Immunocytochemical labelling showed the p.Glu293Lys subunits to distribute in the subsarcolemmal space. Salt bridge prediction indicated the presence of an intersubunit salt bridge network at the CD-I of Kir2.1, with the involvement of Glu293. Subunit interactions were studied by the NanoLuc® Binary Technology (NanoBiT) split reporter assay. Reporter constructs carrying NanoBiT tags on the intracellular termini produced no bioluminescent signal above background with the p.Glu293Lys variant in homomeric configuration and significantly reduced signals in cells co-expressing WT and p.Glu293Lys subunits simultaneously. Extracellularly presented reporter tags, however, generated comparable bioluminescent signals with heteromeric WT and p.Glu293Lys subunits and with homomeric WT channels. CONCLUSIONS Loss of function and dominant-negative effect confirm the causative role of p.Glu293Lys in ATS1. Co-assembly of Kir2.1 subunits is impaired in homomeric channels consisting of p.Glu293Lys subunits and is partially rescued in heteromeric complexes of WT and p.Glu293Lys Kir2.1 variants. These data point to an important role of Glu293 in mediating subunit assembly, as well as in gating of Kir2.1 channels.
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Affiliation(s)
- Szilvia Déri
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Dóm tér 12, PO Box 427, Szeged 6720, Hungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Dóm tér 12, 6720 Szeged, Hungary
| | - János Borbás
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | - Teodóra Hartai
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Dóm tér 12, PO Box 427, Szeged 6720, Hungary
| | - Lidia Hategan
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | - Beáta Csányi
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | - Ádám Visnyovszki
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Dóm tér 12, PO Box 427, Szeged 6720, Hungary
| | - Tamara Madácsy
- 1st Department of Internal Medicine, University of Szeged, Korányi fasor 8-10, 6720 Szeged, Hungary, Hungary
| | - József Maléth
- 1st Department of Internal Medicine, University of Szeged, Korányi fasor 8-10, 6720 Szeged, Hungary, Hungary
| | - Zoltán Hegedűs
- Institute of Biophysics, Biological Research Centre of the Hungarian Academy of Sciences, Temesvári krt. 62, 6726 Szeged, Hungary
- Department of Biochemistry and Medical Chemistry, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - István Nagy
- Institute of Biochemistry, Biological Research Centre the Hungarian Academy of Sciences, Temesvári krt. 62, 6726 Szeged, Hungary
- Seqomics Biotechnology Ltd, Vállalkozók útja 7, 6782 Mórahalom, Hungary
| | - Rohit Arora
- Department of Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Alain J Labro
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
- Department of Basic Medical Sciences, University of Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - László Környei
- Gottsegen György National Institute of Cardiology, Haller u. 9, 1096 Budapest, Hungary
| | - András Varró
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Dóm tér 12, PO Box 427, Szeged 6720, Hungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Dóm tér 12, 6720 Szeged, Hungary
- MTA-SZTE Research Group for Cardiovascular Pharmacology, Hungarian Academy of Sciences, Dóm tér 12, 6720 Szeged, Hungary
| | - Róbert Sepp
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | - Balázs Ördög
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Dóm tér 12, PO Box 427, Szeged 6720, Hungary
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11
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Környei L, Szabó A, Róth G, Kardos A, Fogarasi A. Frequency of syncope as a presenting symptom in channelopathies diagnosed in childhood. Can the multivariable EGSYS score unmask these children? Eur J Pediatr 2021; 180:1553-1559. [PMID: 33447893 DOI: 10.1007/s00431-020-03913-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Abstract
Pediatric syncope raises cardiac etiology concern as it might be the first sign of life-threatening arrhythmia syndromes. Our aim was to study the incidence of syncope as the presenting symptom in children with arrhythmia syndromes, and if known, warning signs are helpful to reveal the arrhythmic origin. All data on children with channelopathy was followed by a tertiary pediatric cardiac center between 2000 and 2018 and data were reviewed retrospectively. Forty-eight patients were enrolled, representing long QT syndrome (n = 39), catecholaminergic polymorphic ventricular tachycardia (n = 5), and Brugada syndrome (n = 4). Presenting symptoms were syncope in 13 cases [27%] (including 7 initially mislabeled as epilepsy) and sudden cardiac arrest (SCA) in 9 cases [19%]. In the rest of the group, the concern for arrhythmic etiology was raised by either an abnormal ECG during sports medicine screening (n = 13) [27%] or a positive family history of channelopathy (n = 13) [27%]. None of the patients presenting with SCA had a prior syncopal history. Six patients presenting with syncope and afterward treated with ICD had an appropriate shock. Description of witnessed syncope was available in eight out of thirteen children presenting with syncope. Multivariable EGSYS score suggested cardiac origin (≥ 3 points) in 7 out of 8 (88%) patients.Conclusions: Syncope was a relatively uncommon presenting symptom of channelopathies in this sample and did not always precede sudden cardiac arrests. However, we found that multivariable EGSYS score can identify syncope of arrhythmic origin, raising suspicion for pediatric channelopathies even in patients previously misdiagnosed with epilepsy. What is known: • Cardiac syncope is rare in children but can be the first sign of a potentially fatal primary arrhythmia syndrome and is frequently misdiagnosed as atypical/therapy-resistant epilepsy. • Multivariate EGSYS score is effective to diagnose cardiac syncope in adults. What is new: • Cardiac syncope as a presenting symptom is not common in children with cardiac channelopathies and is not often present before sudden cardiac arrest. • Multivariable EGSYS score might identify cardiac syncope in children with a hereditary and secondary channelopathy.
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Affiliation(s)
- László Környei
- Gottsegen György Hungarian Institute of Cardiology, Pediatric Heart Center, Haller u. 29, Budapest, 1096, Hungary.
| | - Andrea Szabó
- Gottsegen György Hungarian Institute of Cardiology, Pediatric Heart Center, Haller u. 29, Budapest, 1096, Hungary
| | - György Róth
- Gottsegen György Hungarian Institute of Cardiology, Pediatric Heart Center, Haller u. 29, Budapest, 1096, Hungary
| | - Attila Kardos
- Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary
| | - András Fogarasi
- Department of Neurology, Bethesda Children's Hospital, Budapest, Hungary
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12
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Sepp R, Hategan L, Bácsi A, Cseklye J, Környei L, Borbás J, Széll M, Forster T, Nagy I, Hegedűs Z. Timothy syndrome 1 genotype without syndactyly and major extracardiac manifestations. Am J Med Genet A 2017; 173:784-789. [PMID: 28211989 DOI: 10.1002/ajmg.a.38084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/21/2016] [Indexed: 11/09/2022]
Abstract
Timothy syndrome 1 (TS1) is a rare genetic disorder characterized by multisystem abnormalities including QT prolongation, congenital heart defects, facial dysmorphism, episodic hypoglycemia, and neurological symptoms. A morphological hallmark of TS1 is syndactyly, present in all cases. TS1 is caused by the canonical p.Gly406Arg mutation in the alternatively spliced exon 8A in the CACNA1C gene, encoding for the main cardiac L-type calcium channel. A variant case of TS1 is reported. The proband had intermittent fetal bradycardia with heart rate of 72 bpm. On the first day of life bradycardia due to 2:1 atrioventricular (AV) block and marked QTc prolongation of 600 ms was noted. On medical therapy with propranolol and mexiletine 1:1 AV conduction returned with QTc prolongation of 470-580 ms. The patient lacked other extracardiac manifestations, most importantly syndactyly, neurological complications or autism. On genetic analysis, the canonical TS1 causing mutation, p.Gly406Arg in exon 8A of the CACNA1C gene was detected. The CACNA1C p.Gly406Arg variant was not present in the parents, but was detected in different DNA samples of the index patient. Our case highlight further phenotypic variability in TS. Most importantly, it underlines that the lack of syndactyly does not exclude the presence of a TS1 genotype. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Róbert Sepp
- Second Department of Internal Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - Lidia Hategan
- Second Department of Internal Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - Attila Bácsi
- Fejér County "Szent György" University Teaching Hospital, Székesfehérvár, Hungary
| | | | - László Környei
- "Gottsegen György" National Institute of Cardiology, Budapest, Hungary
| | - János Borbás
- Second Department of Internal Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - Márta Széll
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- Second Department of Internal Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - István Nagy
- Seqomics Biotechnology Ltd., Mórahalom, Hungary.,Institute of Biochemistry, Biological Research Centre, Szeged, Hungary
| | - Zoltán Hegedűs
- Institute of Biophysics, Biological Research Centre, Szeged, Hungary.,Department of Biochemistry and Medical Chemistry, University of Pécs, Pécs, Hungary
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13
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Tényi D, Gyimesi C, Kupó P, Horváth R, Bóné B, Barsi P, Kovács N, Simor T, Siegler Z, Környei L, Fogarasi A, Janszky J. Ictal asystole: A systematic review. Epilepsia 2016; 58:356-362. [DOI: 10.1111/epi.13644] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Dalma Tényi
- Department of Neurology; University of Pécs; Pécs Hungary
| | - Csilla Gyimesi
- Department of Neurology; University of Pécs; Pécs Hungary
| | - Péter Kupó
- Heart Institute; University of Pécs; Pécs Hungary
| | - Réka Horváth
- Department of Neurology; University of Pécs; Pécs Hungary
| | - Beáta Bóné
- Department of Neurology; University of Pécs; Pécs Hungary
| | - Péter Barsi
- MR Research Center; Semmelweis University; Budapest Hungary
| | - Norbert Kovács
- Department of Neurology; University of Pécs; Pécs Hungary
- PTE-MTA Clinical Neuroscience MR Research Group; Budapest Hungary
| | - Tamás Simor
- Heart Institute; University of Pécs; Pécs Hungary
| | - Zsuzsa Siegler
- Epilepsy Center; Bethesda Children's Hospital; Budapest Hungary
| | - László Környei
- Gottsegen György Hungarian Institute of Cardiology; Budapest Hungary
| | - András Fogarasi
- Epilepsy Center; Bethesda Children's Hospital; Budapest Hungary
| | - József Janszky
- Department of Neurology; University of Pécs; Pécs Hungary
- PTE-MTA Clinical Neuroscience MR Research Group; Budapest Hungary
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14
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Ördög B, Hategan L, Kovács M, Seprényi G, Kohajda Z, Nagy I, Hegedűs Z, Környei L, Jost N, Katona M, Szekeres M, Forster T, Papp JG, Varró A, Sepp R. Identification and functional characterisation of a novel KCNJ2 mutation, Val302del, causing Andersen–Tawil syndrome. Can J Physiol Pharmacol 2015; 93:569-75. [DOI: 10.1139/cjpp-2014-0527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Loss-of-function mutations of the KCNJ2 gene encoding for the inward rectifier potassium channel subunit Kir2.1 cause Andersen–Tawil Syndrome (ATS), a rare genetic disorder characterised by periodic paralysis, ventricular arrhythmias, and dysmorphic features. Clinical manifestations of the disease appear to vary greatly with the nature of mutation, therefore, functional characterisation of ATS-causing mutations is of clinical importance. In this study, we describe the identification and functional analysis of a novel KCNJ2 mutation, Val302del, identified in a patient with ATS. Heterologously expressed wild type (WT) and Val302del mutant alleles showed similar subcellular distribution of the Kir2.1 protein with high intensity labelling from the membrane region, demonstrating normal membrane trafficking of the Val302del Kir2.1 variant. Cells transfected with the WT allele displayed a robust current with strong inward rectification, while no current above background was detected in cells expressing the Val302del Kir2.1 subunit. Co-transfection of CHO cells with the WT and the Val302del Kir2.1 revealed a dose-dependent inhibitory effect of the Val302del Kir2.1 mutant subunit on WT Kir2.1 currents. These observations indicate that the WT and the Val302del mutant subunits co-assemble in the cell membrane and that the mutation affects potassium conductivity and (or) gating of the WT/Val302del heteromeric Kir2.1 channels.
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Affiliation(s)
- Balázs Ördög
- Department of Pharmacology and Pharmacotherapy, University of Szeged, H-6720, Szeged, Dóm tér 12, Hungary
| | - Lidia Hategan
- 2nd Department of Internal Medicine and Cardiology Center, University of Szeged, H-6720 Szeged, Korányi fasor 6, Hungary
| | - Mária Kovács
- Department of Pharmacology and Pharmacotherapy, University of Szeged, H-6720, Szeged, Dóm tér 12, Hungary
| | - György Seprényi
- Department of Medical Biology, Faculty of Medicine, University of Szeged, H-6720 Szeged, Somogyi Béla utca 4, Hungary
| | - Zsófia Kohajda
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, H-6720 Szeged, Dóm tér 12, Hungary
| | - István Nagy
- Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, H-6726, Szeged, Temesvári krt. 62, Hungary
| | - Zoltán Hegedűs
- Institute of Biophysics, Bioinformatics Group, Biological Research Centre of the Hungarian Academy of Sciences, H-6726, Szeged, Temesvári krt. 62, Hungary
| | - László Környei
- Division of Pediatric Cardiology, “Gottsegen György” National Institute of Cardiology, 1096 Budapest, Haller utca 29, Hungary
| | - Norbert Jost
- Department of Pharmacology and Pharmacotherapy, University of Szeged, H-6720, Szeged, Dóm tér 12, Hungary
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, H-6720 Szeged, Dóm tér 12, Hungary
| | - Márta Katona
- Department of Pediatrics, University of Szeged, H-6720 Szeged, Korányi fasor 14-15, Hungary
| | - Miklós Szekeres
- Institute of Plant Biology, Biological Research Centre of the Hungarian Academy of Sciences, H-6726, Szeged, Temesvári krt. 62, Hungary
| | - Tamás Forster
- 2nd Department of Internal Medicine and Cardiology Center, University of Szeged, H-6720 Szeged, Korányi fasor 6, Hungary
| | - Julius Gy. Papp
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, H-6720 Szeged, Dóm tér 12, Hungary
| | - András Varró
- Department of Pharmacology and Pharmacotherapy, University of Szeged, H-6720, Szeged, Dóm tér 12, Hungary
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, H-6720 Szeged, Dóm tér 12, Hungary
| | - Róbert Sepp
- 2nd Department of Internal Medicine and Cardiology Center, University of Szeged, H-6720 Szeged, Korányi fasor 6, Hungary
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15
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Affiliation(s)
- László Környei
- Department of Pediatric Cardiology, Gottsegen Gyorgy Hungarian Institute of Cardiology, Haller Street 29, 1096 Budapest, Hungary
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Szabó G, Környei L, Keller É, Lengyel G, Fehér J. Levels of carbohydrate-deficient transferrin according to gender and age in a small town in Hungary. ACTA ACUST UNITED AC 2009. [DOI: 10.1556/cemed.3.2009.28487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
A szénhidrátszegény transzferrin (CDT: carbohydrate deficient transferrin) meghatározása a napi 60 gr-nál több alkoholt fogyasztók körében volt eddig használatos, elsősorban biztosítás-orvostani szempontok miatt, mivel annak szintje 2–3 héttel a fogyasztás befejezése után is informatív értékű.
Célkitűzés:
A vegyszerek használata esetén a CDT-szintre vonatkozóan sok információ nincs a szakirodalomban, ezért eseteinket bemutatásra érdemesnek tartjuk.
Esetismertetés:
Az első esetben nitrobázisú lakk használata után egy hónappal történt a CDT-vizsgálat: a CDT értéke megemelkedett. A másik esetben mezőgazdasági (vegyszerező/permetező) növényvédelmi munkakörben dolgozónál történt a meghatározás 6 hónappal a munka befejezése után. A CDT értéke szintén nagyon emelkedett volt.
Következtetés:
Mivel mindkét dolgozó dokumentáltan alkoholos italfogyasztásra absztinens volt, így valószínűsíthető a CDT kórjelző/problémajelző értéke a vegyszerfogyasztás hatására. A szerzők úgy látják, hogy a CDT magas értéke vegyszeres expozíciók esetén utalhat a vegyszer okozta károsodás következményére.
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Affiliation(s)
- György Szabó
- 1 Háziorvosi Szolgálat Enese Szabadság út 18. 9143
| | - Éva Keller
- 2 Kaposi Mór Megyei Kórház Központi Laboratórium Kaposvár
| | - László Környei
- 3 MTA Szilárdtestfizikai és Optikai Kutatóintézet Budapest
| | - Gabriella Lengyel
- 4 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest
| | - János Fehér
- 4 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest
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Szili-Török T, Szeghy S, Kardos A, Környei L, Paprika D, Szatmári A, Temesvári A. [Treatment of arrhythmias associated with congenital heart disease using transcatheter ablation]. Orv Hetil 2008; 149:115-9. [PMID: 18194919 DOI: 10.1556/oh.2008.28180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED Rhythm disturbances are common long after surgical repair of congenital heart disease. These arrhythmias caused by the progression of the disease itself, however, a significant proportion is a result of the presence of surgical scar. Although interventional electrophysiology procedures are complex and encounter difficulties, pharmacological therapy is often very disappointing. AIM AND METHODS In the present study we aimed to describe our experience obtained between 2004 and 2006 in patients undergoing transcatheter ablation long after surgery for congenital heart disease. RESULTS During this period 26 patients underwent catheter ablation. The procedure was successful in 24 out of the 26 patients (92%). Three patients required redo ablations due to arrhythmia recurrences (11%). There were no major complications related to the intervention. In four patients minor complications occurred (small hematomas). CONCLUSIONS Our descriptive data indicate that transcatheter ablation for arrhythmias after surgery for congenital heart disease is a effective safe and more importantly curative procedure. It is associated with reasonable success rate, low complication rate, but slightly higher recurrence rate as compared to the classical electrophysiological interventions.
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Környei L, Pleimling M, Iglói F. Nonequilibrium critical dynamics of the two-dimensional Ising model quenched from a correlated initial state. Phys Rev E Stat Nonlin Soft Matter Phys 2008; 77:011127. [PMID: 18351838 DOI: 10.1103/physreve.77.011127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Indexed: 05/26/2023]
Abstract
The universality class, even the order of the transition, of the two-dimensional Ising model depends on the range and the symmetry of the interactions (Onsager model, Baxter-Wu model, Turban model, etc.), but the critical temperature is generally the same due to self-duality. Here we consider a sudden change in the form of the interaction and study the nonequilibrium critical dynamical properties of the nearest-neighbor model. The relaxation of the magnetization and the decay of the autocorrelation function are found to display a power law behavior with characteristic exponents that depend on the universality class of the initial state.
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Affiliation(s)
- László Környei
- Institute of Theoretical Physics, Szeged University, H-6720 Szeged, Hungary
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Abstract
A rendszeres alkoholfogyasztás mennyiségének a megítélése a beteg anamnézisfelvételekor a beteg elmondása alapján rögzíthető adat. Sok esetben azonban a betegek az alkoholfogyasztás mértékét érdemlegesen nem közlik orvosukkal, bizonyos esetekben egyszerűen eltitkolják. Ilyenkor a szénhidrátszegény transzferrin (CDT) mennyiségének meghatározása segíthet.
Célkitűzés:
A szénhidrátszegény transzferrin szintjének meghatározása egészséges populációban.
Módszerek:
A szerzők vizsgálataikat egy magyarországi település (Enese) lakosainak körében végezték. 409 beteg (átlagéletkor: 49,7 év) adatait dolgoztuk fel. Közülük 204 volt férfi (átlagéletkor: 49,3 év) és 205 nő (átlagéletkor: 50,3 év). A vizsgált egyéneket két csoportra osztottuk: 1. alkoholos italt nem vagy csak kismértékben (napi 40 g alatt) fogyasztók; illetve 2. napi 40–60 g-nak megfelelő, úgynevezett társasági ivók csoportjára. A szénhidrátszegény transzferrin mennyiségét immunturbidimetriás módszerrel, Roche/Hitachi Modular P 912 automata készülékkel (Roche, USA) mérték.
Eredmények:
A CDT értéke alkoholos italt nem vagy csak kis mennyiségben fogyasztók esetében a kor előrehaladtával fokozatosan nő. 45–65 éves korban szignifikánsan magasabb, mint a 25 év alattiak értéke. Nők esetén a fiatalabb, 45 év alatti korosztályban jelentősen nagyobb értéket találtak, mint férfiaknál. A társasági ivóknál (napi 40–60 g-nak megfelelő alkoholos italfogyasztás esetén) az értékek minden esetben magasabbak voltak, mint az alkoholt nem fogyasztók esetén, a 45–65 éves korcsoportban pedig szignifikánsan nagyobb szintet találtak, mint a fiatalabb korosztályban. Közöttük a férfiak esetén volt jelentősen magasabb az érték a nőkhöz viszonyítva.
Következtetés:
A CDT-szint a korral mérsékelten emelkedik, a társasági alkoholfogyasztás is növeli az értéket.
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21
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Környei L, Iglói F. Geometrical clusters in two-dimensional random-field Ising models. Phys Rev E Stat Nonlin Soft Matter Phys 2007; 75:011131. [PMID: 17358134 DOI: 10.1103/physreve.75.011131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Indexed: 05/14/2023]
Abstract
We consider geometrical or Ising clusters (i.e., domains of parallel spins) in the square lattice random-field Ising model by varying the strength of the Gaussian random field Delta . In agreement with the conclusion of a previous investigation [Phys. Rev. E 63, 066109 (2001)], the geometrical correlation length, i.e., the average size of the clusters xi is finite for Delta>Delta_{c} approximately 1.65 and divergent for DeltaDelta_{c} . The scaling function of the distribution of the mass of the clusters as well as the geometrical correlation function are found to involve the scaling exponents of critical percolation. On the other hand, the divergence of the correlation length, xi(Delta) approximately (Delta-Delta_{c});{-nu} , with nu approximately 2 , is related to that of tricritical percolation. It is verified numerically that critical geometrical correlations transform conformally.
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Affiliation(s)
- László Környei
- Institute of Theoretical Physics, Szeged University, H-6720 Szeged, Hungary
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Hartyánszky I, Bodor G, Tamás C, Héthársi B, Környei L. Double switch procedure, the anatomic correction of the congenitally corrected transposition of the great arteries. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hartyánszky I, Bodor G, Tamás C, Héthársi B, Környei L. [Anatomic correction of the congenitally corrected transposition of the great vessels by the first successful "double switch" operation in Hungary]. Orv Hetil 2006; 147:1321-4. [PMID: 16999018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Congenitally corrected transposition of the great arteries is a rare defect characterized by discordant atrioventricular and ventriculoarterial connections. Symptoms result from one or a combination of associated cardiovascular malformations, including ventricular septal defect, pulmonary stenosis or atresia, tricuspid valve dysfunction, dextrocardia, hypoplastic left or right ventricle. Correcting exclusively the associated defects, leaving the morphologic right ventricle in systemic position, will determine the patient's life-long prognosis. Anatomic repair by double switch technique may improve survival of patients with congenitally corrected transposition of the great arteries by establishing the morphologic left ventricle in the systemic circulation. A 3-year-old girl with congenitally corrected transposition of the great arteries, ventricular septal defect, hypoplastic right ventricle, and previous palliative procedure was corrected by double switch technique and patch closure of ventricular septal defect. The authors prefer the double switch procedure inspite of its many surgical challenges because it has very good long-term outcome. The more simple surgery namely the operation of only associated cardiac defects will involve the possibility of deterioration of right ventricular function.
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Affiliation(s)
- István Hartyánszky
- Gottsegen György Országos Kardiológiai Intézet, Gyermekszív Központ, Budapest.
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Szili-Török T, István O, Paprika D, Temesvári A, Környei L, Ofner P, Szatmári A. [Intracardiac echocardiography in clinical cardiac electrophysiology: review and first Hungarian experience]. Orv Hetil 2005; 146:1165-70. [PMID: 15991681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
During the last two decades revolutionary diagnostic and therapeutic changes were implemented in the management of patients with arrhythmias. Since the arrhythmia substrate is frequently associated with certain anatomical structures or morphological variants, improved imaging has increasing role in the improvement of these treatments. Furthermore, novel catheter ablation approaches require catheter placement to sites, which may be associated with increased complication risk. Therefore imaging has a crucial role both in guiding and improving safety of electrophysiology procedures. Recently, intracardiac echocardiography became available providing excellent accuracy in direct visualization of anatomical landmarks. Intracardiac echocardiography is therefore a potentially useful tool for guiding electrophysiology procedures. The first two Hungarian cases with intracardiac echocardiography are presented with a broad background in this comprehensive review.
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26
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Környei L, Király L, Szatmári A. [Berry syndrome: successful neonatal repair of a rare complex cardiac malformation]. Orv Hetil 2004; 145:963-6. [PMID: 15188643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Aortopulmonary septal defect, interrupted aortic arch, aortic origin of the right pulmonary artery, intact ventricular septum, and patent ductus arteriosus (Berry Syndrome) is a rarely reported malformation. A 6-day-old girl underwent successful one-stage complete repair of direct anastomosis between the ascending and descending aorta, reimplantation of the right pulmonary artery augmented with pericardium patch. Stenosis of the origin of the reimplanted right pulmonary artery was treated by balloon angioplasty at the age of 3 months. The authors emphasize the additive nature of surgical correction and interventional cardiology. Review of the literature reveals this patient to be the 25th reported case with Berry syndrome, and the first of that in Hungary.
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MESH Headings
- Angiography
- Angioplasty, Balloon
- Aorta, Thoracic/abnormalities
- Aorta, Thoracic/surgery
- Aortopulmonary Septal Defect/diagnosis
- Aortopulmonary Septal Defect/surgery
- Cardiac Surgical Procedures/methods
- Diagnosis, Differential
- Ductus Arteriosus, Patent/diagnosis
- Ductus Arteriosus, Patent/surgery
- Echocardiography, Doppler, Color
- Female
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/diagnostic imaging
- Heart Defects, Congenital/surgery
- Humans
- Infant
- Infant, Newborn
- Pulmonary Artery/abnormalities
- Pulmonary Artery/surgery
- Syndrome
- Treatment Outcome
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Affiliation(s)
- László Környei
- Gottsegen György Országos Kardiológiai Intézet, Gyermekszív Központ
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Kollár A, Hartyánszky I, Kàdár K, Oprea V, Környei L, Szatmári A. [Ross procedure instead of heart transplantation. Recovery potential of the dysfunctional myocardium in heart failure caused by congenital aortic valve insufficiency]. Orv Hetil 2002; 143:1779-81. [PMID: 12224454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
UNLABELLED The authors report a case of a child who presented in advanced valvular heart failure secondary to aortic regurgitation. Due to social circumstances heart transplantation was not a viable option, therefore a high risk pulmonary autograft aortic root replacement (Ross procedure) was performed. Following surgery a delayed but rather gratifying myocardial recovery was observed. CONCLUSION This case represents the preserved recovery potential of the pediatric myocardium in end stage heart failure.
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Affiliation(s)
- András Kollár
- Semmelweis Egyetem, Altalános Orvostudományi Kar, Er- és Szívsebészeti Klinika, Budapest.
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28
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Hartyánszky I, Kollár A, Szatmári A, Székely A, Kádár K, Oprea V, Székely E, Héthársi B, Környei L, Prodán Z, Sápi E. [Aortic root replacement with pulmonary allograft (Ross procedure) in children. Early results]. Orv Hetil 2002; 143:1745-8. [PMID: 12198922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
INTRODUCTION For infants and children with congenital aortic valve disease root replacement with pulmonary allograft (Ross procedure) is the preferred method of choice. PATIENTS/RESULTS The authors have successfully applied this operation in 12 children (age range from 2.5 to 17 years--mean 9 years, body weight from 12 to 58 kg--mean 46 kg), one of whom has also required a Konno extension for long segment left ventricular outflow tract obstruction. The operation was complicated by early postoperative endocarditis in one case, and the child required redo homograft root replacement on the ninth postoperative day. All patients, including this one survived, and are doing well at present. CONCLUSIONS In the Hungarian literature this is the first report on the Ross and Konno procedure in children. On the basis of our excellent early results, Ross procedure is the method of choice in aortic valve disease in children.
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Affiliation(s)
- István Hartyánszky
- Gottsegen György Országos Kardiológiai Intézet Gyermekszív Központ, Budapest.
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Szatmári A, Németh J, Környei L, Palik I, Hartyánszky I, Lozsádi K. [Closure of the patent ductus arteriosus by means of cardiac catheterization]. Orv Hetil 1998; 139:1283-6. [PMID: 9632922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Authors report their results with transcatheter closure of patent arterial duct during a period of 1 year. Thirty patients underwent the procedure at the mean age of 5.22 yrs (range 5 mos-22.3 yrs) and mean bodyweight of 19.1 kg (range 5.8-73 kg). There were 9 males and 21 females. The diagnosis of the patent arterial duct was established by physical examination and noninvasive techniques. The procedures were attempted in all patients above 5 kg bodyweight with patent arterial duct and normal pulmonary artery pressure, irrespective of the shunt-size. All procedures were performed under general anesthesia in one session with the diagnostic cardiac catheterisation. Transcatheter closure was successful in 29 patients. In one patient the device embolized into the left pulmonary artery, snaring was unsuccessful, surgical closure of the patent duct and removal of the device took place uneventfully. Control aortography 15 minutes after the coil placement showed insignificant residual shunt through the patent duct in 8 patients (27%), while echocardiography at 1 month proved complete closure in all. The patients were followed by noninvasive methods. No mortality was observed. Authors emphasize the low risk and cost-effectiveness of the procedure. They stress the importance of the patients selection. Authors applied the technique for the first time and introduced it to the regular patient-care practice in Hungary.
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