As a pediatric cardiologist with a specialist interest in heart function and transplant medicine I am interested in disease processes and management of children with end stage heart failure and pediatric heart transplantation. Specifically I am interested in the long term follow up of these children. I have a long standing interest in exercise physiology and quality of life especially in children following heart transplant. I am also interested in the autonomic nervous system and the benefit of exercise in children with dysautonomia.


An 8-Week Virtual Exercise Training Program for Pediatric Solid Organ Transplant Recipients
Pediatric Exercise Science
Nikol K. Grishin and Astrid M. De Souza and Julie Fairbairn and A. William Sheel and E. Puterman and Tom Blydt-Hansen and James E. Potts and Kathryn R. Armstrong
DOI: 10.1123/pes.2023-0066

Self-reported physical activity and lack of association with health-related quality of life in a pediatric solid-organ transplant population.
Pediatric transplantation
Lui S and Hind T and Moon E and de Souza A and Broad K and Fairbairn J and Schreiber R and Armstrong K and Blydt-Hansen TD
DOI: 10.1111/petr.14093
PubMed: 34296505

Post-traumatic stress as a determinant of quality of life in pediatric solid-organ transplant recipients.
Pediatric transplantation
Hind T and Lui S and Moon E and Broad K and Lang S and Schreiber RA and Armstrong K and Blydt-Hansen TD
DOI: 10.1111/petr.14005
PubMed: 33769652

Response by Mital et al to Letter Regarding Article, "A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy".
Mital S and Armstrong KR and Butts RJ and Conway J and Fan S and Gardin L and Kantor PF and Kaufman B and Lafreniere-Roula M and Miron A and Richmond ME and Rossano JW and Russell MW and PRIMaCY Investigators
DOI: 10.1161/circulationaha.120.051632
PubMed: 33720772

Adolescents with solid organ transplant: Using the BRIEF2 parent-report and self-report to measure parent-child agreement and everyday executive function.
Applied neuropsychology. Child
Hutchison SM and Rathgeber SL and De Souza AM and Blydt-Hansen T and Mâsse LC and Armstrong KR and Oberlander TF
DOI: 10.1080/21622965.2020.1800468
PubMed: 32758025

Physical activity and its correlates in a pediatric solid-organ transplant population
Pediatric Transplantation
Samantha Lui and Astrid de Souza and Atul Sharma and Julie Fairbairn and Richard Schreiber and Kathryn Armstrong and Tom Blydt-Hansen
DOI: 10.1111/petr.13745

A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy.
Miron A and Lafreniere-Roula M and Steve Fan CP and Armstrong KR and Dragulescu A and Papaz T and Manlhiot C and Kaufman B and Butts RJ and Gardin L and Stephenson EA and Howard TS and Mital S
DOI: 10.1161/circulationaha.120.047235
PubMed: 32418493

Pubertal Hormonal Changes and the Autonomic Nervous System: Potential Role in Pediatric Orthostatic Intolerance.
Frontiers in neuroscience
Coupal KE and Heeney ND and Hockin BCD and Ronsley R and Armstrong K and Sanatani S and Claydon VE
DOI: 10.3389/fnins.2019.01197
PubMed: 31798399

Physiological Responses to Exercise in Pediatric Heart Transplant Recipients.
Medicine and science in sports and exercise
Bovard JM and DE Souza AM and Harris KC and Human DG and Hosking MCK and Potts JE and Armstrong K and Sandor GGS and Cote AT
DOI: 10.1249/mss.0000000000001889
PubMed: 30629048

Response Letter to 'Optimising physiology for adolescents with dysautonomia'.
Acta paediatrica (Oslo, Norway : 1992)
Armstrong KR and De Souza AM and Sneddon PL and Potts JE and Claydon VE and Sanatani S
DOI: 10.1111/apa.14058
PubMed: 28906019

Exercise and the multidisciplinary holistic approach to adolescent dysautonomia.
Armstrong KR and De Souza AM and Sneddon PL and Potts JE and Claydon VE and Sanatani S
DOI: 10.1111/apa.13750
PubMed: 28112424

The role of the autonomic nervous system in arrhythmias and sudden cardiac death.
Autonomic neuroscience : basic & clinical
Franciosi S and Perry FKG and Roston TM and Armstrong KR and Claydon VE and Sanatani S
DOI: 10.1016/j.autneu.2017.03.005
PubMed: 28392310

Peritoneal-pericardial communication in an adolescent on peritoneal dialysis.
Teoh CW and Nadel H and Armstrong K and Harris KC and White CT
DOI: 10.1007/s00467-015-3206-3
PubMed: 26386589

Childhood obesity, arterial stiffness, and prevalence and treatment of hypertension.
Armstrong KR and Cote AT and Devlin AM and Harris KC
DOI: 10.1007/s11936-014-0339-9
PubMed: 25248796

New-onset migraine following closure of atrial septal defects in children.
Armstrong K and O'Mahony O and Farah L and Webb D
DOI: 10.1177/0333102414523341
PubMed: 24554622

Cardiovascular dysfunction in infants with neonatal encephalopathy.
Armstrong K and Franklin O and Sweetman D and Molloy EJ
DOI: 10.1136/adc.2011.214205
PubMed: 21798875

Cardiac biomarkers in neonatal hypoxic ischaemia.
Sweetman D and Armstrong K and Murphy JF and Molloy EJ
DOI: 10.1111/j.1651-2227.2011.02539.x
PubMed: 22118561

Life and death decisions for incompetent patients: determining best interests--the Irish perspective.
Armstrong K and Ryan CA and Hawkes CP and Janvier A and Dempsey EM
DOI: 10.1111/j.1651-2227.2010.02084.x
PubMed: 21070357

Benchmarking care for very low birthweight infants in Ireland and Northern Ireland.
Murphy BP and Armstrong K and Ryan CA and Jenkins JG
DOI: 10.1136/adc.2009.160002
PubMed: 19723619

Fetal antecedents of male factor sub-fertility: how important is birthweight?
Ozturk O and Armstrong K and Bhattacharya S and Templeton A
DOI: 10.1093/humrep/16.10.2238
PubMed: 11574523


Current Projects
As part of my Heart Function research to date I sought to determine whether the existing Adult Hypertrophic Cardiomyopathy (HCM) Calculator to Predict Risk of Sudden cardiac death could be applied directly to the HCM Pediatric population at the Hospital for Sick Children in Toronto. Results showed that this calculator allowed us to risk stratify these patients, which we presented at AHA in November 2016. Our current project is to participate in a multi centre retrospective study across North America to explore this further with the hope of being able to risk stratify and predict which of our patients with Hypertophic cardiomyopathy are at risk of having a sudden cardiac event, and in whom would benefit from early intervention such as implantable cardioverter defibrillator (ICD) insertion.

We recently completed a study on the effect of an 8-week body weight exercise program on the quality of life in adolescents with dysautonomia. We showed a dramatic effect of exercise on the quality of life of these children and this research will be ongoing through the newly established Dysautonomia Clinic.

Our transplant team is involved in multiple studies on the physical health, exercise capacity, quality of life, and overall long-term health in pediatric transplant recipients. Coronary Allograft Vasculopathy (CAV) is one of the leading causes of death in pediatric transplant patients. To date, there is no clear way to detect CAV in these patients. One of my research focuses will be to look at the early detection of CAV in pediatric transplant patients.


iACT Clinical Investigator Trainee Synergy Grant

Honours & Awards

Laura McRae Award

Department of Pediatrics, BC Children’s Hospital Subspecialty Resident/Fellow Award for Excellence in Pediatric Medicine 2015

1st prize

Irish Pediatric Association Gold Medal, Belfast April 2012. National award for research at annual IPA meeting

1st prize

National Children’s Research Centre Open Day, May 2012. National award for Trainees involved in clinical research

Child &Family Research Institute Outstanding Achievement by a Clinical Sub-specialty Resident or Fellow 2015

ITCC award for Cardiovascular Research Excellence in Pediatric Cardiology 2015

Research Group Members

Jennifer Chuon
Claire Galvin, Masters Student
Cindy Sha, Masters Student