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  • Ovid Technologies (Wolters Kluwer Health)  (4)
  • 1
    Online Resource
    Online Resource
    Abstract 14771: Obstructive Sleep Apnea is Associated With Cardiac Dysfunction in Children With Congenital Heart Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Obstructive sleep apnea (OSA) is associated with cardiac dysfunction in children without congenital heart disease (CHD). Children with CHD are at increased risk for OSA and may be susceptible to further cardiovascular consequences due to OSA but the extent and nature of such cardiovascular effects of OSA are unknown. Methods: Children (6-17 years old) with corrected CHD without current cyanosis or Down syndrome were recruited from pediatric cardiology clinic. Home sleep tests were done to determine the presence and severity of OSA. OSA was defined as an obstructive apnea hypopnea index (oAHI) ≥1. Mild OSA was defined as an oAHI of ≥1 to 〈 5 and moderate OSA was defined as an oAHI of ≥5 to 〈 10. Standard clinically indicated echocardiograms were performed in clinic. Echocardiographic findings were compared between children with CHD with and without comorbid OSA using t-tests, Wilcoxon-sign rank tests as well as linear or logistic regression as appropriate. Results: Thirty-two children had sleep study and echocardiographic data available. OSA was present in 18 children (56%). OSA was mild in 89% and moderate in 11% of cases. There were no significant differences in age, body mass index, CHD severity, gender or ethnicity between children with and without OSA. Children with OSA had larger height-indexed right ventricular end-diastolic diameter (RVDi) compared to those without OSA (median 1.35, 95% CI 1.09, 1.56 vs. 1.21, 95% CI 1.01, 1.57; p=0.04). Children with moderate OSA had a reduced left ventricular shortening fraction compared to both those with mild OSA and no OSA (30.0 ± 6.1% vs. 38.7 ± 4.4%; p=0.009 and 39.2 ± 3.6%; p=0.007, respectively). Children with moderate OSA had increased left ventricular end-systolic diameter compared to those with mild OSA and no OSA (3.4 ± 0.4 cm vs. 2.5 ± 0.4; p=0.007 and 2.4 ± 0.5; p=0.001, respectively). Children with an RVDi above the median were seven times more likely to have OSA than those with an RVDi below the median (odds ratio 6.9.; 95% CI 1.3, 35; p=0.02). Conclusions: OSA is associated with changes in cardiac morphology and reduced contractility in children with CHD. Additionally, the presence of right ventricular dilation may suggest the need for OSA evaluation in children with CHD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.14771
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Abstract 16748: Application and Utility of iPads in Pediatric Tele-Echocardiography
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: The remote acquisition and interpretation of medical information (telemedicine) is an integral part of health care. Radiologic images (eg CT scans) can be accurately interpreted on tablet devices with high display resolution. To date, there have been no published studies on the use of iPads for interpretation of pediatric echocardiograms (echo). OBJECTIVES: We evaluated and compared the quality of echo images, diagnostic accuracy, and review time for pediatric echos using 3 different modalities: remote access on an iPad Air (iPad), remote access via computer (Remote), and direct access on computer Ethernet linked to the server (Direct). METHODS: Fifty archived pediatric echos were re-interpreted using the 3 modalities. Studies were analyzed blindly and independently by two pediatric cardiologists. Outcome measures included: time to review, diagnoses and discrepancies, image quality, sharpness, and jitter. Diagnostic accuracy was assessed by comparing the study diagnoses with the original interpretation in patient’s chart. Discrepancies were rated as none, minor (one grade difference in severity of lesion, patient management not affected), or major ( 〉 one grade difference in severity of lesion, management affected). Remote desktop, Wi-Fi, Verizon, and Ethernet were used. RESULTS: Combining data from both reviewers, there were no major discrepancies, and 9.77% minor discrepancies. There were no significant differences in discrepancies as a function of device (iPad, Remote, Direct). Remote yielded significantly (p 〈 0.001) worse ratings for image quality, sharpness and jitter with iPad next and Direct yielding the best ratings (Table). Overall interpretation times were different (p 〈 0.0001) between viewing modes, (iPad longer vs remote vs direct). CONCLUSIONS: Remote echo review on iPads is possible, yields very good-to-excellent image quality, and allows for convenient, and reliable interpretation of pediatric echos.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.16748
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 3
    Online Resource
    Online Resource
    Transesophageal Echocardiography for the Intraoperative Evaluation and Management of a Left Ventricular Vegetation
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Anesthesia & Analgesia Vol. 106, No. 6 ( 2008-06), p. 1636-1638
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 106, No. 6 ( 2008-06), p. 1636-1638
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/ane.0b013e31817320d2
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 2018275-2
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  • 4
    Online Resource
    Online Resource
    Transesophageal Echocardiography for the Intraoperative Evaluation of a Large Anterior Mediastinal Mass
    Ovid Technologies (Wolters Kluwer Health) ; 2006
    In:  Anesthesia & Analgesia Vol. 103, No. 3 ( 2006-09), p. 578-579
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 103, No. 3 ( 2006-09), p. 578-579
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/01.ane.0000226095.59926.94
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2006
    detail.hit.zdb_id: 2018275-2
    Location Call Number Limitation Availability
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