2024
Association Between High-Sensitivity Troponin (hs-cTnT) and Diagnosis of Myocarditis in Previously Healthy Pediatric Patients
Degen M, Leviter J, Bradley A, Karnik R, Ferdman D, McCollum S, Faherty E. Association Between High-Sensitivity Troponin (hs-cTnT) and Diagnosis of Myocarditis in Previously Healthy Pediatric Patients. Pediatric Cardiology 2024, 1-7. PMID: 39126513, DOI: 10.1007/s00246-024-03621-7.Peer-Reviewed Original ResearchDiagnosis of myocarditisPediatric patientsHs-cTnTTroponin levelsCardiac diagnosisHigh-sensitivity troponin THealthy pediatric patientsHigh-sensitivity troponinHs-cTnT groupMedian peak levelSensitivity troponin levelsElevated hs-cTnTCut-off valueInitial troponin levelMyocarditis diagnosisAcute myocarditisTroponin valuesCardiac troponinPediatric populationTroponin TMyocarditisPatientsPeak levelsDiagnosisMyocardial tissueImplementing Entrustable Professional Activities in Pediatric Fellowships: Facilitating the Process.
Langhan M, Boyer D, Hsu D, Moffatt M, Pitts S, Atlas M, Aye T, Chess P, Curran M, Czaja A, Dammann C, Fussell J, George R, Herman B, High P, James S, Kamin D, Karnik R, Kesselheim J, Lopez M, Mahan J, McFadden V, McGann K, Mehta J, Rama J, Robinson B, Sauer C, Stafford D, Turner D, Weiss P, Yussman S, Schwartz A, Mink R. Implementing Entrustable Professional Activities in Pediatric Fellowships: Facilitating the Process. Pediatrics 2024, 153 PMID: 38757175, DOI: 10.1542/peds.2023-065024.Peer-Reviewed Original ResearchEntrustable professional activitiesPediatric fellowshipImplementation of entrustable professional activitiesFellowship program directorsImplementing entrustable professional activitiesFacilitators to implementationFacilitators of implementationResponse rateOutcome dataMultiple organsEPA-based assessmentNonusersAmerican Board of PediatricsPediatric subspecialtiesPerceived barriersSubspecialty physiciansPotential facilitatorsProgram directorsPediatricAmerican BoardAssessment formAssessment toolPediatric fellowsFPDLEVEL OF SUPERVISION FOR THE EPAS COMMON TO GENERAL PEDIATRICS AND THE SUBSPECIALTIES DECREASES FROM RESIDENCY TO FELLOWSHIP.
Mink RB, Schwartz A, Mahan JD, Fussell JJ, George R, Schumacher DJ, McFadden V, Turner DA, Atlas MP. LEVEL OF SUPERVISION FOR THE EPAS COMMON TO GENERAL PEDIATRICS AND THE SUBSPECIALTIES DECREASES FROM RESIDENCY TO FELLOWSHIP. Acad Pediatr 2024 PMID: 38631477, DOI: 10.1016/j.acap.2024.04.004.Peer-Reviewed Educational Materials
2023
SMC5 Plays Independent Roles in Congenital Heart Disease and Neurodevelopmental Disability
O'Brien M, Pryzhkova M, Lake E, Mandino F, Shen X, Karnik R, Atkins A, Xu M, Ji W, Konstantino M, Brueckner M, Ment L, Khokha M, Jordan P. SMC5 Plays Independent Roles in Congenital Heart Disease and Neurodevelopmental Disability. International Journal Of Molecular Sciences 2023, 25: 430. PMID: 38203602, PMCID: PMC10779392, DOI: 10.3390/ijms25010430.Peer-Reviewed Original ResearchMinimum Supervision Levels Required for Pediatric Cardiology Fellowship Graduation by Pediatric Cardiology Fellowship Program Directors
Karnik R, Robinson B, Glickstein J, Schwartz A, Mink R, Neal A, Frank L, McMahon C, Kim M, Turner D, Srivastava S. Minimum Supervision Levels Required for Pediatric Cardiology Fellowship Graduation by Pediatric Cardiology Fellowship Program Directors. Pediatric Cardiology 2023, 1-8. PMID: 38117291, DOI: 10.1007/s00246-023-03371-y.Peer-Reviewed Original ResearchPediatric cardiologistsCardiac problemsPatient careMinimum LOSCardiac intensive careEntrustable professional activitiesSafe patient careEffective patient carePulmonary hypertensionSurvey response rateIntensive careArrhythmia managementFellowship program directorsResponse rateInterventional cardiologyFellowship graduationDelphi processSafe practiceInvestigator networksLOSCareCardiologistsEntrustment levelsFellowship programsUnsupervised practiceLongitudinal Assessment of Left Ventricular Function in Patients with Myopericarditis After mRNA COVID-19 Vaccination
NV B, McCollum S, Faherty E, Steele J, Karnik R. Longitudinal Assessment of Left Ventricular Function in Patients with Myopericarditis After mRNA COVID-19 Vaccination. Pediatric Cardiology 2023, 45: 1524-1532. PMID: 37294336, PMCID: PMC10251331, DOI: 10.1007/s00246-023-03200-2.Peer-Reviewed Original ResearchLeft ventricular longitudinal strainMRNA COVID-19 vaccinationCOVID-19 vaccinationSubclinical myocardial injuryEjection fractionFractional shorteningInitial presentationMyocardial injurySingle-center reviewMedian ejection fractionLeft ventricular functionVentricular longitudinal strainTime 0Area-length methodWilcoxon signed-rank testAcute illnessDiastolic functionVentricular functionDiastolic parametersLV functionRisk stratificationMyocardial recoveryTissue DopplerSigned-rank testMyopericarditisLeft ventricular strain in pediatric patients with bicuspid aortic valves and aortopathy
Frye R, Ittleman B, Shabanova V, Sugeng L, Steele J, Ferdman D, Karnik R. Left ventricular strain in pediatric patients with bicuspid aortic valves and aortopathy. Progress In Pediatric Cardiology 2023, 69: 101636. DOI: 10.1016/j.ppedcard.2023.101636.Peer-Reviewed Original ResearchBicuspid aortic valveLeft ventricular strainVentricular strainGlobal longitudinal strainGlobal circumferential strainAortic valvePediatric patientsEjection fractionLeft ventricle global longitudinal strainLeft ventricular global longitudinal strainBackground Bicuspid aortic valveVentricle global longitudinal strainSingle-center retrospective studyVentricular global longitudinal strainCommon congenital cardiac defectLongitudinal strainCircumferential strainAortic valve replacementNormal ejection fractionPrior cardiac interventionCongenital cardiac defectsYears of agePotential early markerLeft ventricular myocardiumSignificant differences
2022
New England Congenital Cardiology Association Bicuspid Aortopathy Registry (NECCA BAR): A regional preventive cardiovascular care collaboration
Flyer J, Goudie B, Greenstein E, Toro-Salazar O, Nikolli K, Sleeper L, Clarke C, Hidestrand P, Karnik R, O'Brien S, Zilberman M, Lacro R. New England Congenital Cardiology Association Bicuspid Aortopathy Registry (NECCA BAR): A regional preventive cardiovascular care collaboration. Progress In Pediatric Cardiology 2022, 66: 101543. DOI: 10.1016/j.ppedcard.2022.101543.Peer-Reviewed Original ResearchPatient care registriesBicuspid aortic valveMedical management guidelinesAortic rootCare registriesAortic valveBicuspid aortopathyPractice variationBackground Bicuspid aortic valveZ-scoreManagement guidelinesCommon congenital heart defectAortic growth rateProximal aortic dilationAdverse cardiovascular outcomesShort-term outcomesSingle-center dataRandomized clinical trialsClinical care guidelinesPreventive cardiovascular careAdverse drug eventsAorta z-scoreAortic valve disease progressionYears of ageCongenital heart defectsSystemic ventricular strain is abnormal with elevated BMI in adults with congenital heart disease
Adlakha H, Malik P, Donthula R, Rajagopal H, Kan A, Srivastava S, Karnik R, Shenoy R. Systemic ventricular strain is abnormal with elevated BMI in adults with congenital heart disease. Progress In Pediatric Cardiology 2022, 65: 101467. DOI: 10.1016/j.ppedcard.2021.101467.Peer-Reviewed Original ResearchElevated body mass indexBody mass indexCongenital heart diseaseType of CHDTransthoracic echocardiogramEjection fractionACHD patientsCardiac dysfunctionHeart diseaseCircumferential strainSignificant associationLV end-diastolic volumeSubclinical cardiac changesSubclinical myocardial dysfunctionSubset of patientsLeft ventricular hypertrophyMultivariate logistic regressionEnd-diastolic volumeResults Univariate analysisWilcoxon rank sum testRank sum testMedian GCSLifestyle modificationEchocardiographic markersBackground ObesityOpportunities to enhance parental well-being during prenatal counseling for congenital heart disease
Tacy TA, Kasparian NA, Karnik R, Geiger M, Sood E. Opportunities to enhance parental well-being during prenatal counseling for congenital heart disease. Seminars In Perinatology 2022, 46: 151587. PMID: 35461701, DOI: 10.1016/j.semperi.2022.151587.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsTraumatic stressTraumatic eventsComplex medical informationPsychological distressParental anxietyEarly parenthoodImportant skillExpectant parentsParentsCounselingAnxietyDistressSkillsParenthoodParticular diagnosisMedical decisionsUnborn childBeingDepressionTrainingChildrenElement of uncertaintyLongitudinal Assessment of Global and Regional Left Ventricular Strain in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C)
He M, Leone DM, Frye R, Ferdman DJ, Shabanova V, Kosiv KA, Sugeng L, Faherty E, Karnik R. Longitudinal Assessment of Global and Regional Left Ventricular Strain in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C). Pediatric Cardiology 2022, 43: 844-854. PMID: 34993558, PMCID: PMC8739007, DOI: 10.1007/s00246-021-02796-7.Peer-Reviewed Original ResearchConceptsMIS-C patientsAcute phaseChronic phaseInflammatory syndromeTwo-dimensional speckle tracking echocardiographySubclinical myocardial injuryCircumferential strainMultisystem inflammatory syndromeLeft ventricular dysfunctionSingle-institution reviewSpeckle tracking echocardiographyTwo-dimensional echocardiographyCoronavirus disease 2019Future adverse eventsVentricular function parametersBasal anterolateral segmentMean GCSVentricular dysfunctionAdverse eventsFractional shorteningSignificant sequelaeVentricular strainMyocardial dysfunctionGlobal longitudinalMyocardial injury
2021
Challenges of Diagnosing Viral Myocarditis in Adolescents in the Era of COVID-19 and MIS-C
Shah HP, Frye R, Chang S, Faherty E, Steele J, Karnik R. Challenges of Diagnosing Viral Myocarditis in Adolescents in the Era of COVID-19 and MIS-C. Case Reports In Pediatrics 2021, 2021: 4797498. PMID: 34616578, PMCID: PMC8490073, DOI: 10.1155/2021/4797498.Peer-Reviewed Case Reports and Technical NotesPediatric myocarditisElevated inflammatory markersMultisystem inflammatory syndromeShortness of breathDiagnosis of myocarditisSudden cardiac deathCOVID-19Electrocardiogram findingsInflammatory markersInflammatory syndromeChest tightnessCardiac deathMale presentingAnnual incidenceClinical presentationD-dimerViral myocarditisMyocardial injuryClinical conundrumSubclinical presentationMyocarditisRare diseaseClinical experienceTrue prevalenceCurrent Covid-19 pandemic eraA 13-Year-Old With Fever and Chest Pain
Soma G, Simmons MA, Canarie MF, Karnik R, Steele J, Tiyyagura G, Asnes J. A 13-Year-Old With Fever and Chest Pain. Pediatrics 2021, 148: e2021050960. PMID: 34344802, DOI: 10.1542/peds.2021-050960.Peer-Reviewed Case Reports and Technical Notes
2020
Resource Utilization in Implementation of a Point of Care Ultrasound Curriculum for Resident Training in Anesthesiology.
Deshpande R, Karnik R, Baer C, Kurup V. Resource Utilization in Implementation of a Point of Care Ultrasound Curriculum for Resident Training in Anesthesiology. The Yale Journal Of Biology And Medicine 2020, 93: 423-427. PMID: 32874148, PMCID: PMC7448394.Peer-Reviewed Original Research
2019
Cardiac Manifestations of Noonan Syndrome.
Karnik R, Geiger M. Cardiac Manifestations of Noonan Syndrome. Pediatric Endocrinology Reviews : PER 2019, 16: 471-476. PMID: 31115199, DOI: 10.17458/per.vol16.2019.kpg.manifestationsnoonan.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsLong-term prognosisDevelopment of cardiomyopathyCommon structural abnormalityPulmonary stenosisCardiac manifestationsMedical therapyTerm prognosisCardiovascular abnormalitiesHypertrophic cardiomyopathyCardiac diseaseCardiac pathologyStructural abnormalitiesRAF1 mutationsNoonan syndromePTPN11 mutationsInvolved pathwaysCardiomyopathyGenotype-phenotype associationsAbnormalitiesWide spectrumAssociationStenosisPrognosisSyndromeInfants
2018
Abnormalities in Left Ventricular Rotation Are Inherent in Young Children with Repaired Tetralogy of Fallot and Are Independent of Right Ventricular Dilation
Karnik R, Uppu SC, Tozzi M, Doucette J, Lytrivi ID, Geiger M, Klas B, Parness IA, Shenoy R, Rajagopal H, Srivastava S. Abnormalities in Left Ventricular Rotation Are Inherent in Young Children with Repaired Tetralogy of Fallot and Are Independent of Right Ventricular Dilation. Pediatric Cardiology 2018, 39: 1172-1180. PMID: 29644405, DOI: 10.1007/s00246-018-1877-9.Peer-Reviewed Original ResearchConceptsRight ventricular dilationRV dilationAbnormal ARLV systolicPulmonary regurgitationVentricular dilationRotational mechanicsApical rotationYoung childrenAge-matched normal controlsAsymptomatic young childrenLeft ventricular dysfunctionSingle-center studyLV myocardial mechanicsTetralogy of FallotLV rotational mechanicsTwo-dimensional echocardiographyFurther longitudinal studiesLeft ventricular rotationRTOF childrenLack of maturationVentricular dysfunctionDiastolic dysfunctionDiastolic functionClinical outcomesValidation of Right Atrial Area as a Measure of Right Atrial Size and Normal Values of in Healthy Pediatric Population by Two-Dimensional Echocardiography
Rajagopal H, Uppu SC, Weigand J, Lee S, Karnik R, Ko H, Bhatla P, Nielsen J, Doucette J, Parness I, Srivastava S. Validation of Right Atrial Area as a Measure of Right Atrial Size and Normal Values of in Healthy Pediatric Population by Two-Dimensional Echocardiography. Pediatric Cardiology 2018, 39: 892-901. PMID: 29523923, DOI: 10.1007/s00246-018-1838-3.Peer-Reviewed Original ResearchConceptsRight atrial sizeTransthoracic echocardiographyTwo-dimensional echocardiographyRA areaRA sizeZ-scoreAtrial sizeEntire cohortRight atrial areaHealthy pediatric populationNormal reference valuesCardiovascular deathHeart failureAtrial areaPediatric populationPrognostic indicatorHealthy childrenRA volumeNormal valuesEchocardiographyInverse correlationRegression analysisReference standardCohortScores
2016
Pediatric Pulmonary Hypertension
Rajagopal H, Karnik R, Sahulee R. Pediatric Pulmonary Hypertension. Pediatrics In Review 2016, 37: 129-131. PMID: 26933230, DOI: 10.1542/pir.2015-0067.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2014
Cardiotoxicity and Cardioprotection in Childhood Cancer
Lipshultz SE, Sambatakos P, Maguire M, Karnik R, Ross SW, Franco VI, Miller TL. Cardiotoxicity and Cardioprotection in Childhood Cancer. Acta Haematologica 2014, 132: 391-399. PMID: 25228565, DOI: 10.1159/000360238.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAnthracycline cumulative doseAdverse late effectsSignificant cardiovascular diseaseUse of dexrazoxaneLong-term cardioprotectionAnthracycline chemotherapyCardiovascular damageCardioprotective strategiesOncological efficacyCardiac damageBlack raceCumulative doseFemale sexRisk factorsChildhood cancerCardiotoxic effectsCardiovascular diseaseLate effectsHigh riskHigh doseGenetic predispositionCardiotoxicityYounger ageTrisomy 21Nutritional supplementsAnthracycline-related cardiotoxicity in childhood cancer survivors
Lipshultz SE, Karnik R, Sambatakos P, Franco VI, Ross SW, Miller TL. Anthracycline-related cardiotoxicity in childhood cancer survivors. Current Opinion In Cardiology 2014, 29: 103-112. PMID: 24284979, DOI: 10.1097/hco.0000000000000034.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAnthracycline-related cardiotoxicityCardiovascular complicationsAnthracycline treatmentRisk factorsCardioprotective agentGrowth hormone replacement therapyPrevention of cardiotoxicityHormone replacement therapySerious cardiovascular complicationsChildhood cancer survivorsLong-term outcomesUse of biomarkersDosage of anthracyclinesCardiac transplantationCardiac dysfunctionCancer survivorsCardiac injuryClinical manifestationsReplacement therapyEarly recognitionChildhood cancerCardiotoxic effectsΒ-blockersEnzyme inhibitorsCardiotoxicity