PhD defence
Advanced non-invasive diagnostics in congenital heart disease
- C. Terol Espinosa de los Monteros
- Date
- Thursday 16 April 2026
- Time
- Location
-
Academy Building
Rapenburg 73
2311 GJ Leiden
Supervisor(s)
- Prof.dr. N.A. Blom
Summary
Due to medical and surgical advances in recent decades, survival rates for children with congenital heart disease (CHD) have improved substantially, allowing most patients to reach adulthood. Consequently, the clinical focus has shifted from short-term survival to optimizing long-term outcomes and quality of life in a growing population of children and adolescents with CHD. This shift highlights the need for reliable diagnostic and prognostic tools capable of detecting early functional changes and guiding long-term clinical management.
This thesis evaluates the diagnostic and prognostic value of non-invasive tools in paediatric patients with CHD, with particular focus on patients after Fontan procedures, arterial switch operations (ASO), and Tetralogy of Fallot repair. Three complementary approaches were investigated: advanced echocardiographic parameters, including tissue Doppler imaging and speckle tracking echocardiography; cardiopulmonary exercise testing (CPET); and assessment of autonomic nervous system activity. Advanced echocardiography detected subtle ventricular dysfunction not identifiable with conventional methods. CPET analyses demonstrated reduced exercise capacity across CHD populations and highlighted the prognostic value of both maximal and submaximal parameters, particularly the oxygen uptake efficiency slope (OUES). Assessment of autonomic function suggested altered sympathetic responses following arterial switch operation, indicating potential physiological consequences of surgical correction. In addition, one study explored the application of machine learning to identify patterns of myocardial function from echocardiographic data.
Overall, this work supports the integration of advanced non-invasive diagnostic tools to enhance risk stratification and enable early diagnosis of long-term complications in paediatric patients following CHD correction, thereby contributing to more individualized follow-up and improved long-term outcomes and quality of life.
PhD dissertations
Approximately one week after the defence, PhD dissertations by Leiden PhD students are available digitally through the Leiden Repository, that offers free access to these PhD dissertations. Please note that in some cases a dissertation may be under embargo temporarily and access to its full-text version will only be granted later.
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General information
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