Background: The focus of clinical care after treating congenital heart disease (CHD) has shifted from saving patients’ lives to improving their quality of life. This study aimed to examine the influence of minimally invasive and traditional surgeries on the quality of life of children with CHD. Methods: This was a retrospective cross-sectional study. A total of 459 children aged 2–18 years with CHD treated at Second Xiangya Hospital of Central South University from July 2016 to June 2017 were enrolled, among whom 219 underwent minimally invasive surgery and 240 traditional surgery. The quality of life of children with CHD after surgery was reported by the patients’ parents. We applied propensity score matching to correct for confounding factors and conducted multiple linear regression analysis to examine the related effects of minimally invasive and traditional surgeries on the quality of life of children with CHD. Results: The scores of problems related to perceived physical appearance in children undergoing minimally invasive surgery was higher than those in those undergoing traditional surgery (p = 0.004). Different treatment modes were independent influencing factors for problems related to perceived physical appearance in children with CHD. There was no significant difference in average treatment effect scores of children undergoing different surgical procedures in other quality of life dimensions (problems related to cardiac symptoms and their treatment, drug treatment, anxiety regarding treatment, cognitive psychology, and communication), suggesting that different operation modes were not independent influencing factors for these related problems. Conclusion: Compared with traditional surgery, minimally invasive surgery can significantly improve the physical appearance perception scores of children with CHD after surgery. Therefore, minimally invasive surgery can improve the quality of life of children with CHD.

Key Clinical message: Eculizumab in pregnancy has been reported to be effective in improving outcomes in patients with paroxysmal nocturnal hemoglobinuria. However, a cesarean section may result in surgery‐triggered hemolysis. An additional dose of eculizumab just prior to delivery is an appropriate choice to prevent postoperative hemolysis.

Congenital heart disease (CHD) survivors often suffer from impaired health-related quality of life (HRQoL), requiring cardiac rehabilitation (CR) as an additional intervention. CR involves various modalities and has been demonstrated to reduce mortality and improve HRQoL in cardiovascular diseases. However, there is a lack of systematic analysis and summary of the accumulated literature on cardiac rehabilitation for congenital heart disease (CRfCHD). This study aimed to provide a comprehensive overview of the literature on cardiac rehabilitation for congenital heart disease. By analyzing research trends and hotspots, it also sought to highlight key developments and suggest future directions in this growing field. A systematic search of the Web of Science Core Collection was performed to identify publications related to CRfCHD. Bibliometric tools, including CiteSpace and VOSviewer, were used to visualize co-authorship networks, keyword clusters, and citation patterns. A total of 218 articles were included in the analysis. The number of research papers on CRfCHD has shown an increasing trend over time, with a significant rise in publications since 2019. The United States has the highest number of publications, while the most cited paper focuses on the effects of physical exercise training in CHD patients. Keyword analysis reveals hotspots in the field such as congenital heart disease, physical activity, children, and adolescents. This bibliometric study analyzed the development of CRfCHD from 2003 to 2022, and overviewed the evolution and frontiers in this promising field. Future research should focus on developing comprehensive and effective CRfCHD programs. Home-based cardiac rehabilitation and mental health research in CHD patients require more attention.

Objectives: To summarise current evidence on the use of pentoxifylline (PTX) to prevent contrast-induced nephropathy (CIN). Methods: The PubMed, Embase and CENTRAL databases were searched for randomised controlled trials including patients with and without PTX undergoing contrast media exposure. We analysed the incidence of CIN and serum creatinine changes before and after contrast media exposure. All statistical analyses were conducted with Review Manager V.5.3. Results: We finally enrolled in seven randomised controlled trials with a total of 1484 patients in this analysis. All of seven included studies were performed in patients undergoing angioplasty or stenting. The overall rates of CIN were 8.8% and 10.4% in the PTX groups and control groups, respectively. However, no significant reduction in the CIN rate was observed in the patients treated with PTX compared with the control groups (OR 0.81, 95% CI 0.57 to 1.13, I ² =0, p=0.21). All studies reported no hospital mortality and the new requirement for dialysis during the trials. Conclusion: Perioperative administration of PTX to patients undergoing angioplasty did not significantly reduce the development of CIN but showed some weak tendency of lower serum creatinine increase. Based on the available trials, the evidence does not support the administration of PTX for the prevention of CIN. More trials with larger sample sizes are needed to evaluate the role of PTX in CIN prevention.

Mitral valve prolapse (MVP), defined as toward displacement of one or both mitral valve leaflets into the left atrium in systole, is a common valve disease that affects nearly 2–3% of the population. ¹ Studies have found that about 35–50% of MVP cases have a positive family history, and the strong familial aggregation of MVP suggests a clear heritable component. ² However, the genetic etiology for most non-syndromic MVP remains poorly characterized. Recently, Durst et al. ² identified two heterozygosis missense variants in the DCHS1 gene, segregated fully with MVP in 3 unrelated families. In vitro and in vivo experiments found that DCHS1 has a critical role in the valve’s morphogenesis and confirmed that loss of function of this gene results in MVP.

Iron overload has been associated with sepsis, but the role of iron deficiency and its molecular links remain unclear. We investigated the association between iron deficiency and sepsis and identified candidate genes potentially linking these conditions. MIMIC-IV data were used to assess the association between serum iron and sepsis status. Transcriptomic datasets from dietary iron-deficient mice (GSE10421), LPS-induced septic mice (GSE267388), and a human blood sepsis cohort (GSE137340) were sequentially analyzed to identify and externally evaluate candidate genes. IEU Open GWAS summary statistics were used for exploratory Mendelian randomization (MR). Exploratory drug prediction was performed using L1000FWD, followed by molecular docking analysis. Patients with sepsis had significantly lower serum iron levels, and restricted cubic spline analysis showed a nonlinear association between serum iron and the odds of sepsis. Cross-tissue transcriptomic analysis identified Sqle , Lss , and Rdh11 as candidate genes. In the human blood cohort, SQLE and RDH11 were significantly increased, whereas LSS was not significantly altered. Exploratory MR showed that genetically proxied SQLE expression was associated with higher odds of sepsis (odds ratio [OR] = 1.23, P = 1.67 × 10 ⁻³ ), whereas LSS expression was associated with lower odds (OR = 0.97, P = 8.90 × 10 ⁻⁴ ); RDH11 showed no significant association (OR = 1.01, P = .90). Drug prediction identified ML106 as the top-ranked candidate drug, and molecular docking predicted potential binding poses with SQLE and LSS. Serum iron showed a nonlinear association with sepsis status. SQLE, LSS, and RDH11 emerged as candidate genes, with concordant expression changes of SQLE and RDH11 observed in human blood. MR findings for SQLE and LSS were exploratory and require further validation. ML106 was identified through exploratory drug prediction and requires experimental validation before its therapeutic relevance can be established.