Publications by authors named "Addison Gearhart"

Objective: For neonatal repair of coarctation of the aorta, patients may either undergo thoracotomy with extended end-to-end anastomosis or sternotomy for aortic arch reconstruction with cardiopulmonary bypass. The objective of this study was to evaluate the comparative effectiveness of the 2 approaches in patients with arch hypoplasia.

Methods: This is a single-center retrospective cohort study from July 2005 through May 2022 of patients who underwent neonatal repair for isolated coarctation of the aorta with additional arch hypoplasia.

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"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education.

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Background: Artificial intelligence-enhanced electrocardiogram (AI-ECG) analysis shows promise to detect biventricular pathophysiology. However, AI-ECG analysis remains underexplored in congenital heart disease (CHD).

Objectives: The purpose of this study was to develop and externally validate an AI-ECG model to predict cardiovascular magnetic resonance (CMR)-defined biventricular dysfunction/dilation in patients with CHD.

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The patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. While pharmacologic closure of the PDA is common and effective, it can be difficult to identify which patients will respond. As such, the objective of this study was to identify factors associated with successful pharmacologic closure of the PDA.

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Mean dP/dt is a quantitative measurement of ventricular function that can be obtained noninvasively by echocardiography. In adults with mitral regurgitation (MR), it has been shown to be a more sensitive predictor of postoperative left ventricular ejection fraction (EF). The utility of dP/dt in pediatric congenital heart diseases with MR has been underexplored.

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Article Synopsis
  • This study aimed to evaluate if unsupervised machine learning can differentiate patients with Fontan circulation from healthy individuals based on heart function metrics derived from cardiovascular magnetic resonance (CMR) imaging.
  • By analyzing 503 CMR studies from Fontan patients and 42 from controls, researchers identified four distinct patient clusters with different risks for adverse outcomes like heart failure or transplantation.
  • The highest-risk group, characterized by specific heart shapes and poor functioning, showed significantly greater health risks compared to the lowest-risk group, suggesting that machine learning can help target distinct patient subgroups for better clinical management.
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Background: Abnormal left ventricular (LV) rotational mechanics in biventricular hearts are associated with adverse outcomes; however, these are less well characterized for hearts with functionally single ventricles.

Objectives: The purpose of this study was to characterize ventricular rotational mechanics in the Fontan circulation and their relationship to outcomes.

Methods: Single-center, retrospective analysis of magnetic resonance examinations for 329 Fontan patients (15 [IQR: 10-21] years) and 42 controls.

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Background: Identification of risk factors for biventricular (BiV) repair in children with hypoplastic left ventricles (HLV) has been challenging. We sought to identify preoperative cardiovascular magnetic resonance (CMR) predictors of outcome in patients with HLVs who underwent BiV repair, with a focus on the mitral valve (MV).

Methods: Single-center retrospective analysis of preoperative CMRs on patients with HLV (≤50 mL/m) and no endocardial fibroelastosis who underwent BiV repair from 2005-2022.

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Article Synopsis
  • The study investigates how ventricular dyssynchrony affects clinical outcomes in patients who have undergone Fontan palliation compared to healthy individuals.
  • Using cardiac magnetic resonance imaging, the research analyzes various metrics of cardiac function, finding increased dyssynchrony, longer QRS durations, and worse systolic function in Fontan patients.
  • Key findings also show that certain factors like right ventricular morphology and ventricular dilation are linked to higher risks of death or heart transplantation, suggesting these metrics could help in assessing patient risk.
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  • Children with cardiac disease face a greater likelihood of cardiac arrest compared to healthy children, making effective CPR challenging due to their unique physiological characteristics.
  • The study aims to review resuscitation strategies for various cardiac conditions, update current recommendations, and identify research gaps to inform future efforts in this area.
  • Despite a small percentage encountering cardiac arrest in hospitals, mortality rates are high, and there's a pressing need for additional research and collaborative studies to improve treatment outcomes for these vulnerable patients.
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  • The study aimed to determine if nucleated red blood cells (NRBCs) in pediatric patients visiting the emergency department can predict outcomes like mortality and hospital complications.
  • Researchers analyzed data from patients under 19 years old, identifying a prevalence of NRBCs in 8.9% of ED encounters, which were linked to worse health outcomes, including increased in-hospital mortality and higher rates of serious conditions like sepsis and shock.
  • The findings indicate that the presence of NRBCs serves as a significant predictor for various negative outcomes, such as in-hospital mortality, ICU admissions, and the need for CPR in children presenting to the ED.
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  • Spontaneous coronary artery dissection in infants is a very uncommon occurrence.* -
  • The study discusses two neonates who experienced severe heart issues caused by this condition.* -
  • Both infants lacked other health problems or conditions that could clarify why they had coronary artery dissection.*
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The current era of big data offers a wealth of new opportunities for clinicians to leverage artificial intelligence to optimize care for pediatric and adult patients with a congenital heart disease. At present, there is a significant underutilization of artificial intelligence in the clinical setting for the diagnosis, prognosis, and management of congenital heart disease patients. This document is a call to action and will describe the current state of artificial intelligence in congenital heart disease, review challenges, discuss opportunities, and focus on the top priorities of artificial intelligence-based deployment in congenital heart disease.

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Background: View classification is a key step toward building a fully automated system for interpretation of echocardiograms. However, compared with adult echocardiograms, creating a view classification model for pediatric echocardiograms poses additional challenges, such as greater variation in anatomy, structure size, and views. The aim of this study was to develop a computer vision model to autonomously perform view classification on pediatric echocardiographic images.

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Cardiac infection with is rarely diagnosed, especially in children, and corresponding cardiac magnetic resonance imaging (CMR) has not been reported. We present a probable case, a 9-year-old girl with myopericarditis, eosinophilia, positive serology, and CMR findings consistent with myocardial edema.

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Artificial intelligence (AI) in the last decade centered primarily around digitizing and incorporating the large volumes of patient data from electronic health records. AI is now poised to make the next step in health care integration, with precision medicine, imaging support, and development of individual health trends with the popularization of wearable devices. Future clinical pediatric cardiologists will use AI as an adjunct in delivering optimum patient care, with the help of accurate predictive risk calculators, continual health monitoring from wearables, and precision medicine.

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The combination of pediatric cardiology being both a perceptual and a cognitive subspecialty demands a complex decision-making model which makes artificial intelligence a particularly attractive technology with great potential. The prototypical artificial intelligence system would autonomously impute patient data into a collaborative database that stores, syncs, interprets and ultimately classifies the patient's profile to specific disease phenotypes to compare against a large aggregate of shared peer health data and outcomes, the current medical body of literature and ongoing trials to offer morbidity and mortality prediction, drug therapy options targeted to each patient's genetic profile, tailored surgical plans and recommendations for timing of sequential imaging. The focus of this review paper is to offer a primer on artificial intelligence and paediatric cardiology by briefly discussing the history of artificial intelligence in medicine, modern and future applications in adult and paediatric cardiology across selected concentrations, and current barriers to implementation of these technologies.

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We present a pilot case using an innovative fusion of echocardiogram and MRI achieved with a MATLAB-based imaging programme to explore the feasibility of this imaging strategy in the functional and anatomic assessment of a patient with repaired tetralogy of Fallot requiring pulmonary valve intervention. Echocardiogram and MRI neutralises the disadvantages and limitations of each individual imaging modality and yields important anatomic and haemodynamic information crucial to the treatment decision-making process. Future image fusion strategies can apply to three-dimensional images and image-directed therapy for CHD.

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Objectives: Adolescents who seek care in emergency departments (EDs) are often at high risk for sexually transmitted infections (STIs). The objective of this study was to assess adolescent attitudes toward ED-based STI screening.

Methods: We conducted a secondary analysis of a cross-sectional study that evaluated STI screening acceptability and prevalence when STI testing was universally offered to asymptomatic adolescents presenting to the ED for care.

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