Abstract：
:Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy and randomised into a crossover study comparing the model with conventional maintenance dosing, over a 12-month period. Five patients enrolled in Group 1. Compared to the control group, the median time to achieve the first therapeutic INR was longer (5 vs. 2 days), to stable anticoagulation was shorter (29.0 vs. 96.5 days), to over-anticoagulation was longer (15.0 vs. 4.0 days). In addition, median percentage of INRs within the target range (%ITR) and percentage of time in therapeutic range (%TTR) was higher; 70% versus 47.4% and 83.4% versus 62.3%, respectively. Group 2 included 26 patients. No significant differences in INR control were found between model and conventional dosing phases; mean %ITR was 68.82% versus 67.9% (p = 0.84) and mean %TTR was 85.47% versus 80.2% (p = 0.09), respectively. The results suggest model-based dosing can improve anticoagulation control, particularly when initiating and stabilising warfarin dosing. Larger studies are needed to confirm these findings.
journal_name
Pediatr Cardioljournal_title
Pediatric cardiologyauthors
Al-Metwali BZ,Rivers P,Goodyer L,O'Hare L,Young S,Mulla Hdoi
10.1007/s00246-019-02215-ysubject
Has Abstractpub_date
2019-12-01 00:00:00pages
1735-1744issue
8eissn
0172-0643issn
1432-1971pii
10.1007/s00246-019-02215-yjournal_volume
40pub_type
杂志文章,随机对照试验abstract：:The hypothesis that mild recurrent aortic obstruction produces subtle changes in ambulatory blood pressure was investigated by performing 24-hour monitoring on 11 postoperative coarctation patients. Patients (age 16.1 +/- 2.7 years) were compared with normal controls (age 15.7 +/- 2.5 years, n = 15). Surgery (end-to-e...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF00794187
更新日期：1995-07-01 00:00:00
abstract：:A methodology that would allow for comparison of charges across institutions has not been developed for catheterization in congenital heart disease. A single institution catheterization database with prospectively collected case characteristics was linked to hospital charges related and limited to an episode of care i...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-014-0994-3
更新日期：2015-02-01 00:00:00
abstract：:This report describes a rare case of complete transposition of the great arteries (TGA) with an intramural right coronary artery arising well above the sinotubular junction. Additionally in this case, the left circumflex artery arose anomalously as a branch from the right coronary. Identification of this anatomic anom...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-011-0108-4
更新日期：2012-01-01 00:00:00
abstract：:At the University of California Davis Medical Center, a screening fetal ultrasound examination (level I or II) incorporates a comprehensive segmental evaluation of the fetal heart. This study evaluated the reliability of the fetal ultrasound exam in the detection of abnormal heart anatomy. Our retrospective study revi...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-001-0073-4
更新日期：2002-11-01 00:00:00
abstract：:The aim of this study was to clarify the association of clinical characteristics of unexplained syncope with the outcome of the head-up tilt test (HUT) in children. A total of 47 patients with unexplained syncope were classified into two groups according to their outcomes of HUT: the positive response group and the ne...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-003-0513-4
更新日期：2004-07-01 00:00:00
abstract：:The longer survival of patients with Duchenne muscular dystrophy due to advances in clinical care has increased the incidence of Duchenne muscular dystrophy-associated cardiomyopathy, a nearly consistent feature in the third decade of life. A 26-year-old patient with Duchenne muscular dystrophy experienced severe acut...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-019-02072-9
更新日期：2019-03-01 00:00:00
abstract：:Left ventricular hypertrophy is an adaptive mechanism in children undergoing chronic dialysis to improve contractility at rest. The aim of this study was to determine the left ventricular performance and contractility reserve by "dobutamine stress echocardiography" in children undergoing chronic dialysis. Thirty-five ...
journal_title：Pediatric cardiology
pub_type： 临床试验,杂志文章
doi：10.1007/s00246-010-9721-x
更新日期：2010-10-01 00:00:00
abstract：:Quantification of pulmonary regurgitation (PR), pulmonary flow distribution, and ventricular function is important for clinical surveillance in repaired Tetralogy of Fallot (TOF). Cardiovascular magnetic resonance (CMR) is the established reference, but cost, test duration, and patient discomfort are potential limitat...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-018-2035-0
更新日期：2019-03-01 00:00:00
abstract：:The occurrence of familial heart disease in association with tricuspid atresia is rare. The first reported instance of tricuspid atresia and Ebstein's anomaly in siblings is presented. The presence of these two distinct pathologic variants of tricuspid valve malformations in siblings suggests that these malformations ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s002469900072
更新日期：1996-09-01 00:00:00
abstract：:Heart failure (HF) has high morbidity and mortality in children. This study aimed to investigate the value of cardiac myosin binding protein-C (cMyBP-C) as a diagnostic and prognostic biomarker in children with heart failure. This study was a prospective case-control study that involved 50 children with acute HF and 2...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-016-1532-2
更新日期：2017-02-01 00:00:00
abstract：:Novel COstatus system (Transonic Systems, Inc., NY), based on ultrasound dilution (UD), works off in situ arterial and central venous catheters in pediatric patients to measure cardiac output (CO). The purpose of the present study was to validate CO measurement by UD (COUD) with pulmonary artery (PA) thermodilution (C...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-011-9915-x
更新日期：2011-06-01 00:00:00
abstract：:Magnetic resonance imaging (MRI) is a powerful tool which enables the visualization of anatomy and the assessment of many physiological aspects of organ function. MRI and magnetic resonance angiography and magnetic resonance spectroscopy will play critical roles in cardiac applications during the next millennium. Thus...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s002469910003
更新日期：2000-01-01 00:00:00
abstract：:We report a rare case of tetralogy of Fallot with total anomalous pulmonary venous return, left heart hypoplasia, right lung hypoplasia, and left ocular-mandibular synchinesia (Marcus-Gunn phenomenon), correctly diagnosed by cardiovascular magnetic resonance imaging and successfully operated by modified Glenn anastomo...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-004-0769-3
更新日期：2005-07-01 00:00:00
abstract：:During the development of so-called aneurysmal transformation of perimembranous ventricular septal defects (pmVSD), tricuspid valve (TV) morphology and function may be altered resulting in left ventricular (LV) to right atrial (RA) shunting. The feasibility and outcome of interventional closure of these pmVSD has not ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-015-1170-0
更新日期：2015-10-01 00:00:00
abstract：:The aim of this study was to evaluate by Doppler echocardiography whether administration of transdermal nitroglycerin (NTG) to children with congestive heart failure could modify mitral flow velocity profile with redistribution of left ventricular filling to late diastole, suggesting preload reduction of the left vent...
journal_title：Pediatric cardiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s002460010144
更新日期：2001-01-01 00:00:00
abstract：:We report a 4-month-old infant with torsade de pointes secondary to procainamide treatment. The infant presented with atrial flutter and converted to normal sinus rhythm with intravenous procainamide. Oral procainamide therapy was initiated as the infusion was tapered, and the patient subsequently developed incessant ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF00796823
更新日期：1995-03-01 00:00:00
abstract：:Fifty infants with interrupted aortic arch (IAA), admitted between 1979 and 1988, were reviewed. They usually presented early in severe cardiac failure or shock. In the initial 5-year period, 17 of the 21 infants underwent diagnostic or confirmatory cardiac catheterization, in contrast with the latter 5 years when onl...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF00838779
更新日期：1992-10-01 00:00:00
abstract：:Apelin is an endogenous inotrope that decreased in heart failure (HF). We aimed to evaluate the prognostic value of its level in children with HF due to congenital heart disease (CHD). Sixty children with HF due to CHD were included as a patient group. Sixty healthy children matched for age, sex, and weight served as ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-018-1879-7
更新日期：2018-08-01 00:00:00
abstract：:Mammalian cardiomyocytes withdraw from the cell cycle soon after birth. This process is called terminal differentiation. The c-kit, a receptor tyrosine kinase, is expressed on cardiomyocytes immediately after birth but for only a few days. In mice with genetic c-kit dysfunction, adult cardiomyocytes are phenotypically...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-008-9366-1
更新日期：2009-07-01 00:00:00
abstract：:An atrial septal aneurysm (ASA) is an increasingly recognized entity that involves septal tissue significantly bulging into either atria instead of remaining in a relatively neutral position. ASAs may be described based on the length of the segment of atrial septal tissue involved as well as the distance and direction...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-018-2017-2
更新日期：2019-01-01 00:00:00
abstract：:This study was undertaken to examine the impact that prenatal diagnosis of congenital heart disease (CHD) has on birth and early neonatal outcomes. The prevalence of prenatally diagnosed CHD has risen over the past decade, but the effect that prenatal diagnosis of CHD has on peripartum decisions remains unclear. No co...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-012-0504-4
更新日期：2013-03-01 00:00:00
abstract：:Ventriculo-coronary arterial connections are frequently observed in pulmonary atresia with intact interventricular septum. Sustained right ventricular hypertension during cardiac morphogenesis is thought to be responsible for persistence of myocardial sinusoidal-coronary artery connections. Considering an unusual obse...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s002469900305
更新日期：1998-05-01 00:00:00
abstract：:Extracardiac valved conduits are routinely employed in the correction of complex congenital heart lesions. Compression of a conduit and/or of the heart may present serious operative and postoperative complications. We believe its occurrence can be minimized and hemodynamic results improved by adhering to simple surgic...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF02242263
更新日期：1983-07-01 00:00:00
abstract：:The aim of this study is to evaluate the relationship between maternal single nucleotide polymorphisms (SNPs) of methylenetetrahydrofolate reductase (MTHFR) gene with plasma homocysteine (HCY) level and offspring congenital heart diseases (CHDs). 338 mothers with offspring CHDs as case group and 306 mothers of normal ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-020-02449-1
更新日期：2020-11-21 00:00:00
abstract：:Kearns-Sayre syndrome (KSS) is a rare mitochondrial disorder characterized by large-scale deletions of mitochondrial DNA. Neuromuscular and cardiac conduction systems are most commonly involved in these patients. Here, we discuss a 10-year-old patient with diabetes mellitus who presented in complete heart block leadin...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-007-9040-z
更新日期：2008-05-01 00:00:00
abstract：:Acute myopericarditis is a major cause of acquired heart disease worldwide in pediatric patients. Various viruses have been reported as the etiology, of which varicella zoster virus was first reported in 1953. However, since nationwide administration of the varicella vaccine, reports of varicella-associated myopericar...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-009-9637-5
更新日期：2010-07-01 00:00:00
abstract：:Children with congenital heart defects often demonstrate a reduced capacity for exercise, even after surgical intervention. Forty subjects, with various heart defects, completed a 5-year study to evaluate the impact of a postoperative training program on their physical exercise capacity. All of the patients were signi...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF02238841
更新日期：1990-07-01 00:00:00
abstract：:We herein describe, for the first time, the fetal presentation of a case of ventricular inversion, restrictive ventricular septal defect, pulmonary stenosis, hypertensive left ventricle and double outlet right ventricle at 34 weeks of gestational age. Postnatal echocardiography confirmed the prenatal diagnosis. The pa...
journal_title：Pediatric cardiology
pub_type： 杂志文章,评审
doi：10.1007/s00246-018-2048-8
更新日期：2019-01-01 00:00:00
abstract：:In 810 schoolchildren (aged 5-14 years) the prevalence of a grade 1-3/6 vibratory innocent heart murmur (VIHM) is 41%. Restricted to a grade 2 or 3 VIHM, the prevalence is 14%, decreasing from 21% in the age-class 5-6 years to 8% for children 13-14 years of age. The prevalence of a grade 3 VIHM is 1%. Together with a ...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/BF00798120
更新日期：1994-11-01 00:00:00
abstract：:Debilitating cardiomyocyte loss underlies the progression to heart failure. Although there have been significant advances in treatment, current therapies are intended to improve or preserve heart function rather than regenerate lost myocardium. A major hurdle in implementing a cell-based regenerative therapy is the in...
journal_title：Pediatric cardiology
pub_type： 杂志文章
doi：10.1007/s00246-009-9409-2
更新日期：2009-07-01 00:00:00
