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Review Article
Cardiology
Lifelong impact of elevated blood pressure from childhood to adulthood
Junhyun Kwon, Eunji Kim
Clin Exp Pediatr. 2025;68(4):278-286.   Published online November 28, 2024
· Childhood blood pressure (BP) is significantly associated with adult hypertension and cardiovascular disease.
· Despite ongoing debate regarding the need for regular BP screening and early pharmacotherapy in children, the benefits of optimizing BP throughout childhood are clear.
· Childhood presents a critical window for normalizing BP through lifestyle modifications such as reducing sodium intake and increasing physical activity to promote lifelong cardiovascular health and prevent longterm complications.
Original Article
Cardiology
Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study
Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah
Clin Exp Pediatr. 2024;67(12):694-703.   Published online September 12, 2024
Question: What is the prevalence of HTN among adolescents enrolled in the TLGS according to 3 different accepted definitions (4th report, ESH, and AAP-CPG). Also, what is the ability of each of these definitions in predicting early adulthood CIMT, as a surrogate for cardiovascular disease events?
Finding: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. The highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively.
Meaning: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG.
Effect of face mask on pulmonary artery pressure during echocardiography in children and adolescents
Alireza Ahmadi, Mohammad Reza Sabri, Zohreh Sadat Navabi
Clin Exp Pediatr. 2024;67(3):161-167.   Published online January 23, 2024
Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease?
Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure.
Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents.
Review Article
Nephrology (Genitourinary)
Neonatal hypertension: concerns within and beyond the neonatal intensive care unit
Kathleen Altemose, Janis M. Dionne
Clin Exp Pediatr. 2022;65(8):367-376.   Published online May 30, 2022
Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course.
Original Article
Gastroenterology
Noninvasive markers for esophageal varices in children with cirrhosis
Parisa Rahmani, Fatemeh Farahmand, Ghobad Heidari, Azadeh Sayarifard
Clin Exp Pediatr. 2021;64(1):31-36.   Published online July 21, 2020
Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis?
Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices.
Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.
Cardiology
Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran
Nastaran ahmadi, Seyedeh Mahdieh Namayandeh, Seyed Mahmood Sadr Bafghi, Mohammad Reza Mohammadi, Masoud Mirzaei, Mohammadtaghi Sarebanhassanabadi, Amir Houshang Mehrparvar, Reza Faraji, Neda Nilforoshan, Ahmad Karimi
Clin Exp Pediatr. 2020;63(8):321-328.   Published online July 21, 2020
Question: What is the 90th, 95th, 99th percentile of blood pressure based on height as the cut point for diagnosis of hypertension in children of our province?
Finding: We used blood pressure of 456 males and 579 females in 6–18 years old in “Iranian Children and Adolescents' Psychiatric Disorders survey.
Meaning: The 90th, 95th, 99th percentiles of systolic and diastolic blood pressure in both sex based on age and 10-cm height intervals were developed in Yazd.
Neonatology (Perinatology)
Placental histopathology in late preterm infants: clinical implications
Kristina Ericksen, Joshua Fogel, Rita P. Verma
Clin Exp Pediatr. 2020;63(2):48-51.   Published online August 19, 2019
Question: Placental histopathology and its clinical implications in late preterm infants.
Finding: Placental vascular anomalies are more, and placental inflammation less common in late preterm infants compared to term. Higher maternal age, magnesium sulfate therapy and hypertension are clinical risk factors associated with late preterm delivery.
Meaning: Prevention and aggressive management of hypertension, and conception before 30 years of age might be effective in preventing late preterm births.
Case Report
Reninoma: a rare cause of curable hypertension
Ji Hye Kim, Ji Hyun Kim, Myung Hyun Cho, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Kyung Chul Moon, Il-Soo Ha, Hae Il Cheong
Clin Exp Pediatr. 2019;62(4):144-147.   Published online October 29, 2018
The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma...
Original Article
Cardiology
Change of voltage-gated potassium channel 1.7 expressions in monocrotaline-induced pulmonary arterial hypertension rat model
Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2018;61(9):271-278.   Published online September 15, 2018

Purpose: Abnormal potassium channels expression affects vessel function, including vascular tone and proliferation rate. Diverse potassium channels, including voltage-gated potassium (Kv) channels, are involved in pathological changes of pulmonary arterial hypertension (PAH). Since the role of the Kv1.7 channel in PAH has not been previously studied, we investigated whether Kv1.7 channel expression changes in the lung tissue of a monocrotaline...
Case Report
Gastroenterology
Intestinal duplication revealed by posterior reversible encephalopathy syndrome
Yosra Kerkeni, Hela Louati, Mourad Hamzaoui
Clin Exp Pediatr. 2018;61(4):132-134.   Published online April 23, 2018

We report a unique case of intestinal duplication detected on posterior reversible encephalopathy syndrome (PRES) in a 13-year-old girl. She was admitted to the pediatric Emergency Department because of generalized seizures. Radiological assessment revealed a large, well-defined, thick-walled cystic lesion in the mid abdomen, suggestive of duplication cyst associated to a PRES. Exploration confirmed the diagnosis of ileal duplication cyst,...

Original Article
Neurology
Clinical characteristics of hypertensive encephalopathy in pediatric patients
Chang Hoon Ahn, Seung-A Han, Young Hwa Kong, Sun Jun Kim
Clin Exp Pediatr. 2017;60(8):266-271.   Published online August 14, 2017
Purpose

The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children.

Methods

We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children's Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally,...

Case Report
Cardiology
Idiopathic midaortic syndrome with malignant hypertension in 3-year-old boy
Kyung Jin Ahn, Ja Kyoung Yoon, Gi Beom Kim, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
Clin Exp Pediatr. 2016;59(Suppl 1):S84-S87.   Published online November 30, 2016

Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit....

Original Article
Cardiology
The effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline-induced right ventricular failure
Hyun Kyung Bae, Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2016;59(6):262-270.   Published online June 30, 2016
Purpose

Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF.

Methods

The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the...

Correlation between the morning hypertension on ambulatory blood pressure monitoring and the left ventricular mass in children
Hyun Jung Kim, Kyung Hee Kim, Hong Ryang Kil
Clin Exp Pediatr. 2014;57(9):403-409.   Published online September 30, 2014
Purpose

Although high morning blood pressure (BP) is known to be associated with the onset of cardiovascular events in adults, data on its effects in children with hypertension are limited. Our retrospective study aimed to define the clinical characteristics of children with morning hypertension (MH) and to determine its associated factors.

Methods

We reviewed 31 consecutive patients with hypertension, confirmed by the ambulatory...

An inhibitory effect of tumor necrosis factor-alpha antagonist to gene expression in monocrotaline-induced pulmonary hypertensive rats model
Jung Hyun Kwon, Kwan Chang Kim, Min-Sun Cho, Hae Soon Kim, Sejung Sohn, Young Mi Hong
Clin Exp Pediatr. 2013;56(3):116-124.   Published online March 18, 2013
Purpose

Tumor necrosis factor (TNF)-α is thought to contribute to pulmonary hypertension. We aimed to investigate the effect of infliximab (TNF-α antagonist) treatment on pathologic findings and gene expression in a monocrotaline-induced pulmonary hypertension rat model.

Methods

Six-week-old male Sprague-Dawley rats were allocated to 3 groups: control (C), single subcutaneous injection of normal saline (0.1 mL/kg); monocrotaline (M), single subcutaneous injection of monocrotaline...

Effect of early postnatal neutropenia in very low birth weight infants born to mothers with pregnancy-induced hypertension
Yang Hee Park, Gyung Min Lee, Jung Min Yoon, Enn Jung Cheon, Kyung Ok Ko, Yung Hyuk Lee, Jae Woo Lim
Clin Exp Pediatr. 2012;55(12):462-469.   Published online December 20, 2012
Purpose

In this study, we aimed to investigate the perinatal clinical conditions of very low birth weight (VLBW) infants born to mothers with pregnancy-induced hypertension (PIH) focusing on the effects of early postnatal neutropenia.

Methods

We reviewed the medical records of 191 VLBW infants who were born at Konyang University Hospital, between March 2003 and May 2011. We retrospectively analyzed the clinical characteristics...

Case Report
Bronchial compression in an infant with isolated secundum atrial septal defect associated with severe pulmonary arterial hypertension
Sung-Hee Park, So Young Park, Nam Kyun Kim, Su-Jin Park, Han Ki Park, Young Hwan Park, Jae Young Choi
Clin Exp Pediatr. 2012;55(8):297-300.   Published online August 23, 2012

Symptomatic pulmonary arterial hypertension (PAH) in patients with isolated atrial septal defect (ASD) is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on...

Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome
Hyung Soon Choi, Jeong Jin Yu, Young-Hwue Kim, Jae-Kon Ko, In-Sook Park
Clin Exp Pediatr. 2012;55(6):212-214.   Published online June 21, 2012

Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our...

Review Article
Pulmonary hypertension in infants with bronchopulmonary dysplasia
Gi Beom Kim
Clin Exp Pediatr. 2010;53(6):688-693.   Published online June 23, 2010

An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type...

Original Article
Surgical outcome of severe pulmonary arterial hypertension secondary to left-to-right shunt lesions
Cha Gon Lee, Su In Jeong, June Huh, I-Seok Kang, Heung Jae Lee, Ji-Hyuk Yang, Tae Gook Jun
Clin Exp Pediatr. 2010;53(2):195-202.   Published online February 15, 2010
Purpose : Despite recent advances in pulmonary hypertension management and surgery, appropriate guidelines remain to be developed for operability in congenital heart disease with pulmonary artery hypertension (PAH). Our aim was to evaluate clinical outcomes of patients with severe PAH who underwent surgical closure of left-to-right shunt lesions (LRSL) on the basis of pulmonary reactivity. Methods : We retrospectively reviewed 21...
Case Report
The effect of perioperative inhaled iloprost on congenital heart disease with severe pulmonary arterial hypertension
Su Nam Kim, Deok Young Choi
Clin Exp Pediatr. 2010;53(1):93-96.   Published online January 15, 2010
A 47-year-old male patient in whom atrial septal defect (ASD) had been diagnosed 15 years previously was admitted for cardiac catheterization. He had definite cyanotic lips and nail beds and severe pulmonary arterial hypertension (PAH). He had received medical treatment only for the last few years after being diagnosed with Eisenmenger syndrome. After cardiac catheterization, he received iloprost inhalation therapy...
Original Article
Left ventricular dysfunction measured by tissue Doppler imaging and strain rate imaging in hypertensive adolescents
Hye Mi Ahn, Sun Ok Jung, Jung Hyun Kwon, Young Mi Hong
Clin Exp Pediatr. 2010;53(1):72-79.   Published online January 15, 2010
Purpose : Left ventricular (LV) hypertrophy and impaired diastolic function may occur early in systemic hypertension. Diastolic dysfunction is associated with increased cardiovascular risk. Tissue Doppler imaging (TDI)-derived tissue velocity and strain rate are new parameters for assessing diastolic dysfunction. The aim of this study is to determine whether TDI and strain rate imaging (SRI) would improve the ability to...
Review Article
Neonatal respiratory distress: recent progress in understanding pathogenesis and treatment outcomes
So Young Kim
Clin Exp Pediatr. 2010;53(1):1-6.   Published online January 15, 2010
Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal...
Treatment of chronic kidney disease in children
Joo Hoon Lee
Clin Exp Pediatr. 2009;52(10):1061-1068.   Published online October 15, 2009
The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth...
Hypertension in children and adolescents
Jo Won Jung
Clin Exp Pediatr. 2009;52(7):745-751.   Published online July 15, 2009
Hypertension is a major risk factor for myocardial infarction, stroke, and cardiovascular mortality in adults; its treatment reduces the risk of cardiovascular events. In recent times, attention is being paid to monitoring of blood pressure from childhood to adulthood. Childhood hypertension is associated with hypertension in later life, and early intervention is important. In the Korean socioeconomic background, a rapid...
Original Article
Effect of endothelin receptor blockade on monocrotaline-induced pulmonary hypertension in rats
Kyoung Ah Lim, Jung Yun Shim, Sang Ho Cho, Kwan Chang Kim, Jae Jin Han, Young Mi Hong
Clin Exp Pediatr. 2009;52(6):689-695.   Published online June 15, 2009
Purpose : To examine the effect of bosentan, a dual endothelin receptor (ER) antagonist, on the development of monocrotaline (MCT)-induced pulmonary hypertension in rats by especially focusing on the pulmonary vascular morphology changes. Methods : Sprague-Dawley rats were treated as follows: controls received a subcutaneous saline injection, MCT-treated rats received a subcutaneous MCT injection, and bosentan-treated rats received a MCT...
A study of the development of macrovascular complications and factors related to these complications in young adults with childhood/adolescence-onset type 1 diabetes mellitus
Min Jae Kang, Joo Hwa Kim, Hye Rim Chung, Young Ah Lee, Choong Ho Shin, Sei Won Yang, You Yeh Kim, Seon Mi Jin, Chung Il Noh
Clin Exp Pediatr. 2009;52(2):220-226.   Published online February 15, 2009
Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients (23.9¡¾2.4 years) with T1DM diagnosed before 18 years...
Serum level of the adiponectin and adiponectin I164T polymorphism in hypertensive adolescents
Jung Ah Lee, Joo Hyun Gil, Young Mi Hong
Clin Exp Pediatr. 2009;52(2):187-193.   Published online February 15, 2009
Purpose : Adiponectin is a molecule that plays an important role in the metabolic syndrome. In addition, its concentration is known to be decreased in obesity, type 2 diabetes, and coronary artery disease. Although a relationship between hypertension and serum adiponectin concentrations has been reported by several authors, such findings continue to be debated. We investigated whether hypoadiponectinemia is related...
Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents
Joo Hyun Gil, Jung Ah Lee, Eun Young Park, Young Mi Hong
Clin Exp Pediatr. 2009;52(1):36-43.   Published online January 15, 2009
Purpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential...
Prevalence of obesity, hypertension, and hyperlipidemia in Gunpo children of low economic status
Kyung Hee Yi
Clin Exp Pediatr. 2008;51(12):1310-1314.   Published online December 15, 2008
Purpose : This study aimed to assess the prevalence of obesity, hypertension, and hyperlipidemia in children from low-income families in Gunpo and to evaluate whether economic status affects the prevalence of obesity. Methods : Between October 2007 and March 2008, 341 children (167 girls and 174 boys; age, 6 to 13 years) were enrolled in this study. All these children came...
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