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Diagnostics
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Advances in Pediatric Cardiology: Diagnosis and Management
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Advances in Pediatric Cardiology: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 894

Special Issue Editor

Dr. Federico Gutiérrez-Larraya

E-Mail Website
Guest Editor
Department of Paediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain
Interests: pediatric cardiology; congenital heart disease; interventional cardiology

Special Issue Information

Dear Colleagues,

As a branch of cardiology, pediatric cardiology primarily focuses on heart diseases that emerge during childhood. These disorders, which may arise from various factors such as genetics, environment, and infections, pose a threat to children's lives and health. Pediatric heart diseases are diverse and often exhibit a degree of concealment, making them prone to being overlooked or misdiagnosed. Consequently, early and precise pediatric heart disease diagnosis is paramount. Echocardiography has emerged as the most commonly used diagnostic tool, capable of real-time visualization of cardiac structure, blood flow, and function, significantly enhancing diagnostic accuracy. Additionally, novel technologies like cardiac magnetic resonance imaging (MRI) and genetic diagnosis are gradually being integrated into clinical practice, providing robust support for diagnosing pediatric heart diseases.  This Special Issue focuses on the recent diagnostic and management advancements in pediatric cardiology. Original articles, reviews, and interesting images are welcome.

Dr. Federico Gutiérrez-Larraya
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric cardiology
  • pediatric heart diseases
  • congenital heart disease
  • echocardiography
  • MRI

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

10 pages, 719 KiB  
Article
New Systemic Inflammatory Indices as Predictors of Fulminant Myocarditis in Children
by Demet Kangel, İsa Ozyılmaz, Sercin Ozkok, Hatice Dilek Özcanoğlu, Ali Nazım Güzelbağ, Burcu Çevlik, İbrahim Cansaran Tanıdır, Ali Can Hatemi and Erkut Öztürk
Diagnostics 2025, 15(8), 961; https://doi.org/10.3390/diagnostics15080961 - 10 Apr 2025
Viewed by 215
Abstract
Background/Objectives: Myocarditis is a major cause of morbidity and mortality in children and can lead to long-term heart failure, dilated cardiomyopathy, the need for heart transplantation, or death. New systemic inflammatory indices that combine lymphocyte, neutrophil, and platelet counts have been recently used [...] Read more.
Background/Objectives: Myocarditis is a major cause of morbidity and mortality in children and can lead to long-term heart failure, dilated cardiomyopathy, the need for heart transplantation, or death. New systemic inflammatory indices that combine lymphocyte, neutrophil, and platelet counts have been recently used as strong prognostic markers of some inflammatory diseases and adverse outcomes of neoplasms. This study aimed to investigate the use of new systemic indices as early predictive markers for adverse outcomes in patients with pediatric myocarditis. Methods: This study retrospectively examined patients between the ages of >1 month and <18 years who were monitored in our clinic with a diagnosis of myocarditis between 1 January 2022 and 31 December 2024. The cases were divided into two groups: fulminant myocarditis (requiring the use of inotropes or extracorporeal membrane oxygenation due to hemodynamic disturbance) and non-fulminant myocarditis. The systemic inflammatory index values of these groups (calculated in the first 6 h) were compared, and the results were statistically analyzed. Results: The study included 122 pediatric myocarditis cases treated during the study period (80 boys; median age: 11 (IQR: 8–14) years). Twenty-six of these patients (21.3%) developed fulminant myocarditis. The median systemic immune-inflammation index (SII) value in the group with fulminant myocarditis was 1300 (IQR: 1000–1600), while this value was 500 (IQR: 350–650) for the non-fulminant group (p < 0.05). The median systemic inflammatory response index (SIRI) values were 2.9 (IQR: 2.5–3.2) in the fulminant myocarditis group and 1.5 (IQR: 1.2–1.8) in the non-fulminant group (p < 0.05). The cut-off values for fulminant myocarditis were found to be 1050 for the SII, with an AUC value of 0.76 (95% confidence interval: 0.80–0.96; p < 0.001), and 1.9 for the SIRI, with an AUC value of 0.64. Conclusions: The SII and SIRI may independently predict adverse myocarditis prognoses in children. These new biomarkers are easy to calculate using routine blood parameters. Full article
(This article belongs to the Special Issue Advances in Pediatric Cardiology: Diagnosis and Management)
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12 pages, 1040 KiB  
Article
Microcirculatory Dysfunction and Its Role in Diagnosing Acute Rejection in Pediatric Heart Transplantation: A Pilot Study
by Borja Rivero-Santana, Enrique Balbacid-Domingo, César Abelleira-Pardeiro, Carlos Labrandero de Lera, Viviana Arreo del Val, Santiago Jiménez-Valero, María Fernández-Velasco, Raúl Moreno and Federico Gutiérrez-Larraya
Diagnostics 2025, 15(5), 545; https://doi.org/10.3390/diagnostics15050545 - 24 Feb 2025
Viewed by 449
Abstract
Background/Objectives: Acute rejection remains a major challenge in pediatric heart transplantation (HT), with limited tools for early diagnosis. In adult HT recipients, microcirculatory dysfunction, as measured by the index of microcirculatory resistance (IMR), has been identified as a potential biomarker of rejection. [...] Read more.
Background/Objectives: Acute rejection remains a major challenge in pediatric heart transplantation (HT), with limited tools for early diagnosis. In adult HT recipients, microcirculatory dysfunction, as measured by the index of microcirculatory resistance (IMR), has been identified as a potential biomarker of rejection. However, its role in pediatric populations is largely unexplored. This pilot study aimed to evaluate the association between coronary microcirculatory dysfunction and acute rejection in pediatric heart transplant recipients, as well as its relationship with echocardiographic alterations. Methods: This prospective, single-center study included 10 pediatric HT recipients who underwent routine coronary angiography and endomyocardial biopsy. The IMR, coronary flow reserve (CFR), and fractional flow reserve (FFR) were assessed. Acute rejection was classified as either acute cellular rejection (ACR) or antibody-mediated rejection (AMR) based on ISHLT criteria. Echocardiographic parameters included left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), right ventricular (RV) dysfunction, and diastolic function. Patients were followed for a median of 9.7 months [IQR: 7.0–11.7]. Results: Patients with a history of acute rejection (40%, n = 4) were exclusively found in the IMR ≥ 15 group (66.7%), while no cases were observed in the IMR < 15 group (0%; p = 0.04). During follow-up, only one patient experienced acute rejection, occurring in the IMR ≥ 15 group, although the difference between groups was not statistically significant (p = 0.39). Both LVEF and GLS were worse in patients with IMR ≥ 15 compared to IMR < 15 (62.5% vs. 76.3% and −17.3% vs. −18.8%, respectively), although these differences did not reach statistical significance. No complications were reported during coronary physiology assessment. Conclusions: Microcirculatory dysfunction, as measured by IMR, was significantly associated with a history of acute cellular rejection in pediatric heart transplant recipients. While its predictive value for acute rejection during follow-up remains unclear due to the small sample size, this pilot study highlights the safety and feasibility of coronary physiology assessment in this population. Larger studies are needed to validate these findings and establish pediatric-specific diagnostic thresholds. Full article
(This article belongs to the Special Issue Advances in Pediatric Cardiology: Diagnosis and Management)
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