Neurocognition in Adult Congenital Heart Disease: How to Monitor and Prevent Progressive Decline

Keir, Michelle; Ebert, Patricia; Kovacs, Adrienne H.; Smith, Jonathan; Kwan, Emily; Field, Thalia S.; Brossard‐Racine, Marie; Marelli, Ariane J.

doi:10.1016/j.cjca.2019.06.020

Cited by 24 publications

(31 citation statements)

References 83 publications

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“…Some syndromes may have systemic and neurocognitive consequences having impact on physical functioning, mental health, and QoL. 33 Health behaviours, such as smoking, drug use, and consumption of alcohol, also may have a differential impact on outcomes in different heart defects. 34,35 These are avenues for future research.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Physical Functioning, Mental Health, and Quality of Life in Different Congenital Heart Defects: Comparative Analysis in 3538 Patients From 15 Countries

Moons

Luyckx

Thomet

et al. 2021

Canadian Journal of Cardiology

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Background: We compared physical functioning, mental health, and quality of life (QoL) of patients with different subtypes of congenital heart disease (CHD) in a large international sample and investigated the role of functional class in explaining the variance in outcomes across heart defects. Methods: In the cross-sectional Assessment of Patterns of Patient-Reported Outcome in Adults with Congenital Heart Disease-International Study (APPROACH-IS), we enrolled 4028 adult patients with CHD from 15 countries. Diagnostic groups with at least 50 patients were included in these analyses, yielding a sample of 3538 patients (median age: 32 years; 52% women). Physical functioning, mental health, and QoL were measured with the SF-12 health status survey, Hospital Anxiety and Depression Scale (HADS), linear analog scale (LAS) and Satisfaction with Life Scale, respectively. Functional class was assessed using the patient-reported New York Heart Association (NYHA) class. Multivariable general linear mixed models were applied to assess the relationship between the type of CHD and patientreported outcomes, adjusted for patient characteristics, and with country as random effect. Results: Patients with coarctation of the aorta and those with isolated aortic valve disease reported the best physical functioning, mental health, and QoL. Patients with cyanotic heart disease or Eisenmenger syndrome had worst outcomes. The differences were statistically significant, above and beyond other patient characteristics. However, the explained variances were small (0.6% to 4.1%) and decreased further when functional status was added to the models (0.4% to 0.9%). Conclusions: Some types of CHD predict worse patient-reported outcomes. However, it appears that it is the functional status associated with the heart defect rather than the heart defect itself that shapes the outcomes.

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Section: Methodological Considerationsmentioning

confidence: 99%

Physical Functioning, Mental Health, and Quality of Life in Different Congenital Heart Defects: Comparative Analysis in 3538 Patients From 15 Countries

Moons

Luyckx

Thomet

et al. 2021

Canadian Journal of Cardiology

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“…29 These findings are relevant because recent studies have reported a higher risk for cognitive decline in adults with CHD; however, this phenomenon is currently understudied. 30 We detected a smaller surface area and inward displacement on the surface of the globus pallidus, which was concentrated anteriorly mainly on the lateral surfaces in the CHD group when compared to controls. Last, we found no differences in striatal morphometry between youth with CHD and healthy peers.…”

Section: Discussionmentioning

confidence: 59%

Characterizing the Subcortical Structures in Youth with Congenital Heart Disease

Fontes

Courtin

Rohlicek³

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Congenital heart disease is a leading cause of neurocognitive impairment. Many subcortical structures are known to play a crucial role in higher-order cognitive processing. However, comprehensive anatomic characterization of these structures is currently lacking in the congenital heart disease population. Therefore, this study aimed to compare the morphometry and volume of the globus pallidus, striatum, and thalamus between youth born with congenital heart disease and healthy peers. MATERIALS AND METHODS:We recruited youth between 16 and 24 years of age born with congenital heart disease who underwent cardiopulmonary bypass surgery before 2 years of age (n ¼ 48) and healthy controls of the same age (n ¼ 48). All participants underwent a brain MR imaging to acquire high-resolution 3D T1-weighted images.RESULTS: Smaller surface area and inward bilateral displacement across the lateral surfaces of the globus pallidus were concentrated anteriorly in the congenital heart disease group compared with controls (q , 0.15). On the lateral surfaces of bilateral thalami, we found regions of both larger and smaller surface areas, as well as inward and outward displacement in the congenital heart disease group compared with controls (q , 0.15). We did not find any morphometric differences between groups for the striatum. For the volumetric analyses, only the right globus pallidus showed a significant volume reduction (q , 0.05) in the congenital heart disease group compared with controls. CONCLUSIONS:This study reports morphometric alterations in youth with congenital heart disease in the absence of volume reductions, suggesting that volume alone is not sufficient to detect and explain subtle neuroanatomic differences in this clinical population.ABBREVIATION: CHD ¼ congenital heart disease C ongenital heart disease (CHD) is a leading cause of neurodevelopmental impairment. 1 A variety of motor delays, language disorders, behavioral problems, and learning difficulties have been described in children and adolescents with CHD. 2,3 Adults and senior citizens with CHD are also at a greater risk for neurocognitive challenges and early cognitive decline. 4 Brain

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“…Moreover, mild ischemic lesions shown on MRI in the neonatal periods completely disappeared 4 to 6 months after surgery [16]. However, more and more studies confirm that the adolescents and adults suffer from frequent neurodevelopmental challenges, including cognitive, motor, language, psychosocial, social, and communication impairments [13,23,39,40]. Experts interrogate the association between brain abnormalities and function, such 3 Computational and Mathematical Methods in Medicine as brain volume [41,42], hemispheric sulcal patterns [43][44][45], and white matter microstructure.…”

Section: Discussionmentioning

confidence: 99%

Brain MRI Radiomics Analysis of School-Aged Children with Tetralogy of Fallot

Song-mei

et al. 2021

Computational and Mathematical Methods in Medicine

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Introduction. Radiomics could be potential imaging biomarkers by capturing and analyzing the features. Children and adolescents with CHD have worse neurodevelopmental and functional outcomes compared with their peers. Early diagnosis and intervention are the necessity to improve neurological outcomes in CHD patients. Methods. School-aged TOF patients and their healthy peers were recruited for MRI and neurodevelopmental assessment. LASSO regression was used for dimension reduction. ROC curve graph showed the performance of the model. Results. Six related features were finally selected for modeling. The final model AUC was 0.750. The radiomics features can be potential significant predictors for neurodevelopmental diagnoses. Conclusion. The radiomics on the conventional MRI can help predict the neurodevelopment of school-aged children and provide parents with rehabilitation advice as early as possible.

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Neurocognition in Adult Congenital Heart Disease: How to Monitor and Prevent Progressive Decline

Cited by 24 publications

References 83 publications

Physical Functioning, Mental Health, and Quality of Life in Different Congenital Heart Defects: Comparative Analysis in 3538 Patients From 15 Countries

Physical Functioning, Mental Health, and Quality of Life in Different Congenital Heart Defects: Comparative Analysis in 3538 Patients From 15 Countries

Characterizing the Subcortical Structures in Youth with Congenital Heart Disease

Brain MRI Radiomics Analysis of School-Aged Children with Tetralogy of Fallot

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