Effects of steady state free precession parameters on cardiac mass, function, and volumes

G0400444/Medical Research Council/United Kingdom Wellcome Trust/United Kingdo

Maternal mental health:a key area for future research among women with congenital heart disease

In this viewpoint, we respond to the recently published national priorities for research in congenital heart disease (CHD) among adults, established through the James Lind Alliance Priority Setting Partnership, with specific attention to priority 3 (mental health) and priority 5 (maternal health). Our recent policy impact project explored how maternal mental health is currently addressed in adult congenital heart disease (ACHD) services in the National Health Service, identified gaps and discussed possible ways forward. Our multidisciplinary discussion groups, which included women with lived experience of CHD and pregnancy, cardiology and obstetrics clinicians and medical anthropologists, found that while pregnancy and the postnatal period increase the mental health challenges faced by women with CHD, current services are not yet equipped to address them. Based on this work, we welcome the prioritisation of both mental health and maternal health in ACHD, and suggest that future research should focus on the overlaps between these two priority areas

Operator induced variability in left ventricular measurements with cardiovascular magnetic resonance is improved after training

Background: Accurate and reproducible measurement of left ventricular (LV) mass and function is a significant strength of Cardiovascular Magnetic Resonance (CMR). Reproducibility and accuracy of these measurements is usually reported between experienced operators. However, an increasing number of inexperienced operators are now training in CMR and are involved in post-processing analysis. The aim of the study was to assess the interobserver variability of the manual planimetry of LV contours amongst two experienced and six inexperienced operators before and after a two months training period. Methods: Ten healthy normal volunteers (5 men, mean age 34 ± 14 years) comprised the study population. LV volumes, mass, and ejection fraction were manually evaluated using Argus software (Siemens Medical Solutions, Erlangen, Germany) for each subject, once by the two experienced and twice by the six inexperienced operators.The mean values of experienced operators were considered the reference values. The agreement between operators was evaluated by means of Bland-Altman analysis. Training involved standardized data acquisition, simulated off-line analysis and mentoring. Results: The trainee operators demonstrated improvement in the measurement of all the parameters compare

Echocardiographic Findings in Covid-19 Pneumonia.

The aim of this study was to characterize the echocardiographic phenotype of patients with Covid-19 pneumonia and its relation to biomarkers. Seventy-four patients (59±13 years, 78% male) admitted with Covid-19 were included after referral for transthoracic echocardiography (TTE) as part of routine care. A level 1 British Society of Echocardiography TTE assessed chamber size and function, valvular disease and likelihood of pulmonary hypertension. The chief abnormalities were right ventricular (RV) dilatation (41%) and RV dysfunction (27%). RV impairment was associated with increased D-dimer and CRP levels. In contrast, left ventricular (LV) function was hyper-dynamic or normal in most (89%) patients

The impact of the COVID-19 pandemic on application of European Society of Cardiology (ESC) guidelines for exercise in adults with congenital heart disease: a data-based questionnaire.

INTRODUCTION Regular physical activity is safe and effective therapy for adults with congenital heart disease (ACHD) and is recommended by European Society of Cardiology (ESC) guidelines. The COVID-19 pandemic poses enormous challenges to healthcare teams and patients when ensuring guideline compliance. We explored the implications of COVID-19 on physical activity levels in ACHD patients. MATERIALS AND METHODS A data-based questionnaire was distributed to ACHD patients at a regional tertiary centre from October to November 2020. RESULTS Prior to the COVID-19 pandemic, 96 (79.3%) of 125 respondents reported participating in regular physical activity, with 66 (52.8%) meeting target levels (moderate physical activity for at least 150 minutes per week). Commonest motivations for physical activity were general fitness (53.6%), weight loss (36.0%) and mental health benefits (30.4%). During the pandemic, the proportion that met target levels significantly decreased from 52.8% to 40.8% (p=0.03). The commonest reason was fear of COVID-19 (28.0%), followed by loss of motivation (23.2%) and gym/fitness centre closure (15.2%). DISCUSSION The COVID-19 pandemic has negatively impacted exercise levels of ACHD patients. Most do not meet recommended physical activity levels, mainly attributable to fear of COVID-19. Even before the pandemic, only half of respondents met physical activity guidelines. Availability of online classes can positively impact exercise levels so could enhance guideline compliance. This insight into health perceptions and behaviors of ACHD patients may help develop quality improvement initiatives to improve physical activity levels in this population