Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease

Background: Some infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation. Case presentation: We report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent. Conclusions: These two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease

The genetic landscape of cardiomyopathies

Insights into genetic causes of cardiomyopathies have tremendously contributed to the understanding of the molecular basis and pathophysiology of hypertrophic, dilated, arrhythmogenic, restrictive and left ventricular noncompaction cardiomyopathy. More than thousand mutations in approximately 100 genes encoding proteins involved in many different subcellular systems have been identified indicating the diversity of pathways contributing to pathological cardiac remodeling. Moreover, the classical view based on morphology and physiology has been shifted toward genetic and molecular patterns defining the etiology of cardiomyopathies. Today, novel high-throughput genetic technologies provide an opportunity to diagnose individuals based on their genetic findings, sometimes before clinical signs of the disease occur. However, the challenge remains that rapid research developments and the complexity of genetic information are getting introduced into the clinical practice, which requires dedicated guidance in genetic counselling and interpretation of genetic test results for the management of families with inherited cardiomyopathies