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Life
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Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment
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Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 26 February 2027 | Viewed by 9564

Editors

Prof. Dr. Eliza Elena Cintezǎ

E-Mail Website
Guest Editor
1. Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
2. Department of Pediatric Cardiology, “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania
Interests: congenital heart malformations; echocardiography; multimodal imaging; interventional cardiology; heart surgery; pediatric arrhythmia
Special Issues, Collections and Topics in MDPI journals
Dr. Ştefana Moisǎ

E-Mail Website
Guest Editor
1. Department of Pediatrics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
2. “Sfanta Maria” Clinical Emergency Hospital for Children, 700309 Iasi, Romania
Interests: pediatric cardiology; echocardiography; congenital heart diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of pediatric cardiology is advancing at an unprecedented pace, driven by groundbreaking innovations in the diagnosis and treatment of congenital and acquired heart diseases in children. This Special Issue, titled "Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment", aims to provide a comprehensive overview of the latest scientific and clinical advancements that are reshaping the care of pediatric patients with cardiovascular conditions. From cutting-edge imaging technologies, such as 3D echocardiography and fetal cardiac MRI, to the integration of artificial intelligence for risk stratification and early detection, this Special Issue explores how these tools are enabling more precise and personalized care. Minimally invasive interventions, including transcatheter procedures and robotic-assisted surgeries, are also transforming treatment paradigms, offering safer and more effective options for young patients. Additionally, this Special Issue delves into the growing role of genomics, molecular biology, and regenerative medicine in understanding and treating pediatric heart disease.

The scope of this Special Issue encompasses original research articles, reviews, and case studies that highlight emerging trends, challenges, and opportunities in pediatric cardiology. By fostering interdisciplinary collaboration and sharing innovative approaches, this Special Issue seeks to inspire further research, improve clinical practice, and ultimately enhance outcomes for children with cardiovascular conditions worldwide.

Prof. Dr. Eliza Elena Cintezǎ
Dr. Ştefana Moisǎ
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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. Life is an international peer-reviewed open access monthly 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

  • congenital heart disease
  • cardiovascular imaging
  • minimally invasive interventions
  • fetal cardiology
  • transcatheter therapies
  • artificial intelligence in cardiology
  • 3D echocardiography
  • cardiac MRI
  • personalized medicine
  • genetic heart disorders
  • heart failure in children
  • robotic-assisted surgery
  • cardiovascular biomarkers
  • electrophysiology in pediatrics
  • innovative surgical techniques
  • early diagnosis of heart disease
  • emerging therapies in cardiology

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Published Papers (7 papers)

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Research

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17 pages, 624 KB  
Article
Quality Assessment in Paediatric Cardiology: Experiences from Leveraging a Clinical Data Warehouse
by Wolfgang Wällisch, Sven Dittrich, Ariawan Purbojo, Isabelle Schöffl, Thomas Ganslandt, Hans-Ulrich Prokosch, Lorenz A. Kapsner and Jonathan M. Mang
Life 2026, 16(6), 941; https://doi.org/10.3390/life16060941 - 2 Jun 2026
Viewed by 184
Abstract
Background: The generation of quality metrics for paediatric heart centre programmes frequently relies on registry data, with all the known benefits and disadvantages. This retrospective monocentric study introduces an algorithm capable of processing unedited clinical data to identify mortality risk factors following paediatric [...] Read more.
Background: The generation of quality metrics for paediatric heart centre programmes frequently relies on registry data, with all the known benefits and disadvantages. This retrospective monocentric study introduces an algorithm capable of processing unedited clinical data to identify mortality risk factors following paediatric cardiac surgery. Methods: Patients who had undergone cardiac surgery in the department during the period from 2011 to 2020 were included when aged < 18 years. Congenital heart disease (CHD) was categorised into four diagnosis groups through hierarchical integration of the index surgery and CHD diagnosis. We evaluated preoperative, demographic, periprocedural, and postsurgical risk factors. Results: A total of 1700 patients with 2157 hospitalization encounters were included. The risk factors for elevated mortality with the highest degree of significance were extracorporeal membrane oxygenation (hazard ratio 13.97, p < 0.001), weight < 2500 g, patients in the univentricular heart group I, and the creatinine ratio. Conclusions: Beyond confirming established predictors such as ECMO and low body weight < 2500 g, the present analysis highlights the creatinine ratio as a strong laboratory-based predictor of mortality. The applied framework serves as a foundational step towards enabling the real-time utilisation of raw datasets across multiple centres, thereby supporting privacy-preserving and efficient quality metric assessment as well as enhanced risk stratification. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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28 pages, 1786 KB  
Article
Advanced Echocardiographic Characterization of Neonatal Ebstein’s Anomaly Using Myocardial Deformation Imaging: A Single-Center Study
by Carmen Corina Șuteu, Nicola Şuteu, Liliana Gozar, Oana Cristina Marginean, Andreea Cerghit-Paler, Maria Oana Săsăran, Camelia Râtea and Amalia Făgărăşan
Life 2026, 16(4), 670; https://doi.org/10.3390/life16040670 - 14 Apr 2026
Viewed by 593
Abstract
Background: Neonatal Ebstein’s anomaly (EA) is a severe condition with significant hemodynamic instability and early myocardial dysfunction, where abnormal right-heart geometry limits conventional echocardiography and highlights the value of myocardial deformation imaging. Methods: We conducted a single-center retrospective observational study including 16 neonates [...] Read more.
Background: Neonatal Ebstein’s anomaly (EA) is a severe condition with significant hemodynamic instability and early myocardial dysfunction, where abnormal right-heart geometry limits conventional echocardiography and highlights the value of myocardial deformation imaging. Methods: We conducted a single-center retrospective observational study including 16 neonates with EA and 26 healthy neonates. All subjects underwent comprehensive transthoracic echocardiography during the neonatal period. Conventional two-dimensional imaging and speckle-tracking echocardiography (STE) were used to assess biventricular and biatrial myocardial deformation. Deformation parameters were compared between groups, and receiver operating characteristic (ROC) curve analysis evaluated diagnostic performance. Results: Neonates with EA demonstrated significant structural remodeling and severe biventricular and biatrial dysfunction compared with controls. Speckle-tracking showed markedly reduced right ventricular longitudinal strain (LS) in all segments (all, p < 0.001), particularly in free-wall and four-chamber views. Left ventricular (LV) global LS (GLS) was significantly reduced in neonates with EA compared with controls (−14.53% vs. −22.32%, p < 0.001), indicating early involvement of LV myocardial function in the neonatal period. Atrial reservoir, conduit, and contractile strain were severely impaired in both atria (all, p < 0.001). ROC analysis revealed excellent diagnostic accuracy, especially for LVGLS (AUC 0.919) and right atrial contractile strain (AUC 0.958). Conclusions: STE enables the early detection of extensive biventricular and biatrial myocardial dysfunction in neonatal EA, including abnormalities not fully captured by conventional echocardiographic parameters, thereby providing significant incremental diagnostic value. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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19 pages, 3174 KB  
Article
Multichamber Strain Imaging and Biomarker Profiling for 1-Year Risk Stratification in Pediatric Dilated Cardiomyopathy
by Iolanda Muntean, Asmaa-Carla Hagau, Diana-Ramona Iurian, Beatrix Julia Hack, Diana Muntean and Horatiu Suciu
Life 2026, 16(3), 369; https://doi.org/10.3390/life16030369 - 24 Feb 2026
Viewed by 649
Abstract
Dilated cardiomyopathy (DCM) in children is rare, but carries a high risk of progression to advanced heart failure (HF) and heart transplant (HTx). Improved short-term risk stratification is essential; however, robust pediatric prognostic tools remain limited. We aimed to evaluate the 1-year prognostic [...] Read more.
Dilated cardiomyopathy (DCM) in children is rare, but carries a high risk of progression to advanced heart failure (HF) and heart transplant (HTx). Improved short-term risk stratification is essential; however, robust pediatric prognostic tools remain limited. We aimed to evaluate the 1-year prognostic value of multichamber speckle-tracking echocardiography (STE) and biomarkers, including age-adjusted N-terminal pro-B-type natriuretic peptide (NT-proBNP) and vitamin D, in children with DCM. In this single-centre prospective cohort study, 29 children with idiopathic DCM and 27 age- and sex-matched healthy controls underwent standardised clinical, laboratory, and echocardiographic assessment. The primary endpoint was a 12-month composite of implantation of an implantable cardioverter-defibrillator (ICD), left-ventricular assist device (LVAD), HTx, or all-cause mortality. During a 1-year follow-up, 9/29 (31%) DCM patients experienced major events. Compared with event-free patients and controls, children with events had more impaired LVGLS (−5.99 ± 2.45% vs. −13.44 ± 6.88% and −19.98 ± 3.25%), lower LASr (10.97 ± 7.67% vs. 25.36 ± 10.28% and 44.0 ± 11.43%), and reduced RVFWSL (−15.32 ± 5.24% vs. −23.13 ± 8.55% and −24.78 ± 4.45%; all p < 0.01). Zlog NT-proBNP was markedly higher in the event group (5.37 [5.00–6.08] vs. 2.28 [0.71–3.68] and 0.14 [−0.02–0.88]). LVGLS, Zlog NT-proBNP, and LASr showed excellent discrimination for 1-year events (AUC 0.91, 0.91, and 0.87, respectively), with clinically applicable cut-offs (LVGLS ≥ −8%, Zlog NT-proBNP ≥ 4.6, LASr ≤ 21%). In conclusion, multichamber strain imaging combined with age-adjusted NT-proBNP provides clinically relevant, exploratory markers for short-term risk stratification in pediatric DCM, supporting earlier intensification of follow-up and timely referral for advanced heart failure therapies. These findings warrant validation in larger multicenter cohorts. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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12 pages, 4125 KB  
Article
New Perspectives of Underlying Cardiomyopathy in Pediatric SMA Patients—An Age Matched Control Study
by Georgiana Nicolae, Andrei Capitanescu, Madalina Cristina Leanca, Elena Neagu, Daniela Vasile, Cristina Filip, Eliza Cinteza, Amelia Aria, Bianka Maria Pavlov, Gabriela Uscoiu, Cristiana Ioana Raita and Andrada Mirea
Life 2025, 15(7), 1091; https://doi.org/10.3390/life15071091 - 11 Jul 2025
Cited by 2 | Viewed by 1924
Abstract
Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder primarily affecting motor neurons. Emerging evidence suggests it also involves multiple organs, including potential cardiac manifestations. This study aimed to evaluate cardiac abnormalities in pediatric SMA patients compared to age-matched healthy controls, providing insight [...] Read more.
Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder primarily affecting motor neurons. Emerging evidence suggests it also involves multiple organs, including potential cardiac manifestations. This study aimed to evaluate cardiac abnormalities in pediatric SMA patients compared to age-matched healthy controls, providing insight into underlying cardiomyopathy in this population. A total of 126 children were included in the study, with 63 SMA patients and 63 age-matched controls. We conducted clinical examinations, standard electrocardiography (ECG), and cardiac ultrasound (CUS) in all patients. Electrocardiographic analysis revealed a higher prevalence of sinus tachycardia in the SMA group and significantly deeper Q waves, indicating possible myocardial involvement. Echocardiographic findings demonstrated a significant reduction in left ventricular mass and left ventricular mass index in SMA patients compared to controls, despite normal systolic function. Statistical analysis confirmed that SMA diagnosis was an independent predictor of reduced myocardial mass, suggesting a distinct cardiac phenotype in SMA patients. This study provides new evidence of subclinical cardiac involvement in SMA, characterized by reduced myocardial mass, altered electrocardiographic parameters, and increased sinus tachycardia. These findings suggest a previously unrecognized form of cardiomyopathy in SMA that differs from cardiac manifestations typically seen in other neuromuscular disorders. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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13 pages, 532 KB  
Article
Association of Plasma Renin Activity with Risk of Late Hypertension in Pediatric Patients with Early Aortic Coarctation Repair: A Retrospective Study
by Irina-Maria Margarint, Tammam Youssef, Iulian Rotaru, Alexandru Popescu, Olguta Untaru, Cristina Filip, Ovidiu Stiru, Ancuta-Alina Constantin, Vlad Anton Iliescu and Radu Vladareanu
Life 2025, 15(4), 656; https://doi.org/10.3390/life15040656 - 16 Apr 2025
Cited by 2 | Viewed by 1565
Abstract
Background: Coarctation of the aorta (CoA) represents 5% to 7% of all congenital heart diseases. Surgery and interventional methods offer great short-term results, but the occurrence of postoperative hypertension associated with cardiovascular and cerebral vascular disease increases mortality and morbidity in the long [...] Read more.
Background: Coarctation of the aorta (CoA) represents 5% to 7% of all congenital heart diseases. Surgery and interventional methods offer great short-term results, but the occurrence of postoperative hypertension associated with cardiovascular and cerebral vascular disease increases mortality and morbidity in the long term. This study aims to investigate risk factors associated with postoperative hypertension in pediatric patients with early repair of isolated aortic coarctation. Subjects and Methods: A total of 41 patients with isolated aortic coarctation were included. The mean age was 35.3 ± 46.34 days. Early repair under one month was performed in 65.9% of patients. In all except two patients, end-to-end anastomosis was used. A follow-up at two years revealed an incidence of 58.5% of hypertension. Using logistic regression, preoperative renin plasma concentration above the upper normal level (46.1 μUI/mL) was independently associated with the occurrence of hypertension (OR = 2.49, 95% CI = 2.001–5.03, p = 0.001). Conclusion: Coarctation of the aorta is not just a simple mechanical obstruction of the aorta and should be seen and managed as a systemic disease. Abnormal preoperative renin concentrations were independently associated with the occurrence of HT at follow-up, suggesting that vascular dysfunction could play a role in hypertension development after successful CoA repair, negatively influencing the long-term prognostic of these patients. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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Review

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21 pages, 6019 KB  
Review
Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review
by Carmina Nedelcu, Nicolae Sebastian Ionescu, Ana Mihaela Bizubac, Cristina Filip and Catalin Cirstoveanu
Life 2025, 15(10), 1621; https://doi.org/10.3390/life15101621 - 17 Oct 2025
Cited by 2 | Viewed by 2672
Abstract
Hemodynamic monitoring is essential in the postoperative management of neonates undergoing cardiac surgery, enabling early identification of circulatory failure and its underlying cause, optimization of oxygen delivery to tissues, and evaluation of treatment response. Despite its significant role, there is still no consensus [...] Read more.
Hemodynamic monitoring is essential in the postoperative management of neonates undergoing cardiac surgery, enabling early identification of circulatory failure and its underlying cause, optimization of oxygen delivery to tissues, and evaluation of treatment response. Despite its significant role, there is still no consensus and there remains substantial heterogeneity in bedside hemodynamic monitoring practices. Pediatric intensivists typically rely on macro- and microcirculatory indicators, including arterial blood pressure, urine output, capillary refill time, mixed venous oxygen saturation, lactate concentration, and serial echocardiographic evaluations. However, most of these are indirect hemodynamic indicators and provide only intermittent snapshots of the hemodynamic status, which can be very fluctuating following cardiac surgery. Technological advancements have driven a shift toward continuous, noninvasive monitoring techniques, such as near-infrared spectroscopy (NIRS), electrical biosensing technology, and microcirculatory assessment tools. Real-time, simultaneous tracking of multiple physiological variables through a multimodal hemodynamic monitoring protocol facilitates the understanding of systemic and regional perfusion and oxygenation. This narrative review aims to summarize current techniques and innovations in neonatal hemodynamic monitoring following cardiac surgery, combining clinical evaluation with both intermittent and continuous noninvasive techniques. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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Other

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9 pages, 6146 KB  
Case Report
Transcatheter Correction of Bilateral Partial Anomalous Pulmonary Venous Return with Intrapulmonary Dual Drainage: A Rare Entity
by Dusan Andric, Andrija Pavlovic, Igor Stefanovic, Marko Pavlovic, Maja Trkulja, Maja Bijelic, Milica Kuzmanovic, Jovan Petrovic, Mirko Topalovic, Vojislav Parezanovic and Milan Djukic
Life 2026, 16(2), 316; https://doi.org/10.3390/life16020316 - 12 Feb 2026
Viewed by 770
Abstract
Partial anomalous pulmonary venous return (PAPVR) with dual drainage is a very rare congenital heart anomaly. We report the case of a 6-year-old boy with PAPVR in whom both upper pulmonary veins (PVs) drain anomalously into the systemic venous circulation, while maintaining preserved [...] Read more.
Partial anomalous pulmonary venous return (PAPVR) with dual drainage is a very rare congenital heart anomaly. We report the case of a 6-year-old boy with PAPVR in whom both upper pulmonary veins (PVs) drain anomalously into the systemic venous circulation, while maintaining preserved intrapulmonary collateral venous connections with the remaining pulmonary veins draining into the left atrium. Careful balloon occlusion testing of the anomalous PVs was performed, simultaneously with measurements of pulmonary pressures and control angiography, proving the absence of venous congestion in the upper lung fields during the pulmonary venous phase. Transcatheter occlusion using vascular plugs was safely and successfully performed. Full article
(This article belongs to the Special Issue Pediatric Cardiology Frontiers: Innovations in Diagnosis and Treatment)
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