Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome

Steger, Céline; Feldmann, Maria; Borns, Julia; Hagmann, Cornelia; Latal, Beatrice; Held, Ulrike; Jakab, András; Tuura, Ruth; Knirsch, Walter

doi:10.1038/s41390-022-02253-y

Cited by 2 publications

(1 citation statement)

References 48 publications

(49 reference statements)

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“…Congenital heart disease (CHD) is the most common congenital birth defect in infants and young children, and children with CHD can experience different degrees of neurodevelopmental disorders. Early detection and scientific evaluation are conducive to timely clinical intervention, which is crucial for improving neurological function, development, and the quality of life of children with CHD [ 1 , 2 ]. The early clinical manifestations of nervous system dysplasia are not obvious, which complicates the diagnosis and treatment of this disease.…”

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of preoperative brain development in pediatric congenital heart disease patients by synthetic MRI

Xu,

Ma,

Zhang

et al. 2024

Insights Imaging

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Objectives This study investigated the quantitative assessment and application of Synthetic MRI (SyMRI) for preoperative brain development in children with congenital heart disease (CHD). Methods Forty-three CHD patients aged 2–24 months were prospectively included in the observation group, and 43 healthy infants were included in the control group. The SyMRI scans were processed by postprocessing software to obtain T1, T2, and PD maps. The values of T1, T2, and PD in different brain regions were compared with the scores of the five ability areas of the Gesell Development Scale by Pearson correlation analysis. Results In the observation group, the T1 values of the posterior limb of the internal capsule (PLIC), Optic radiation (PTR), cerebral peduncle, centrum semiovale, occipital white matter, temporal white matter, and dentate nucleus were greater than those in the control group. In the observation group, the T2 values of the PLIC, PTR, frontal white matter, occipital white matter, temporal white matter, and dentate nucleus were greater than those in the control group. Pearson correlation analysis revealed that the observation group had significantly lower Development Scale scores. In the observation group, the T2 value of the splenium of the corpus callosum was significantly positively correlated with the personal social behavior score. The AUCs for diagnosing preoperative brain developmental abnormalities in children with CHD using T1 values of the temporal white matter and dentate nucleus were both greater than 0.60. Conclusions Quantitative assessment using SyMRI can aid in the early detection of preoperative brain development abnormalities in children with CHD. Critical relevance statement T1 and T2 relaxation values from SyMRI can be considered as a quantitative imaging marker to detect abnormalities, allowing for early clinical evaluation and timely intervention, thereby reducing neurodevelopmental disorders in these children. Key Points T1 and T2 relaxation values by SyMRI are related to myelin development. Evaluated development quotient markers were lower in the observation compared to the control group. SyMRI can act as a reference indicator for brain development in CHD children. Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Quantitative assessment of preoperative brain development in pediatric congenital heart disease patients by synthetic MRI

Xu,

Ma,

Zhang

et al. 2024

Insights Imaging

View full text Add to dashboard Cite

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Effects of hemodynamic alterations and oxygen saturation on cerebral perfusion in congenital heart disease

De Silvestro,

Natalucci,

Feldmann

et al. 2024

Pediatr Res

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Background Patients with severe congenital heart disease (CHD) are at risk for neurodevelopmental impairment. An abnormal cerebral blood supply caused by the altered cardiac physiology may limit optimal brain development. The aim of this study was to evaluate the effect of a systemic-to-pulmonary shunt, aortic arch obstruction and arterial oxygen saturation on cerebral perfusion in patients with severe CHD. Methods Patients with severe CHD requiring cardiac surgery within the first six weeks of life, who underwent pre- and/or postoperative brain magnetic resonance imaging (MRI), and healthy controls with one postnatal scan were included. Cerebral perfusion in deep and cortical gray matter was assessed by pseudocontinuous arterial spin labeling MRI. Results We included 59 CHD and 23 healthy control scans. The presence of a systemic-to-pulmonary shunt was associated with decreased perfusion in cortical (p = 0.003), but not in deep gray matter (p = 0.031). No evidence for an effect of aortic arch obstruction and arterial oxygen saturation on cerebral perfusion was found. After adjusting for hemodynamic and oxygen saturation parameters, deep (p = 0.018) and cortical (p = 0.012) gray matter perfusion was increased in patients with CHD compared to controls. Conclusion We detected regional differences in compensation to the cerebral steal effect in patients with severe CHD. Impact Patients with severe congenital heart disease (CHD) have altered postnatal brain hemodynamics. A systemic-to-pulmonary shunt was associated with decreased perfusion in cortical gray matter but preserved perfusion in deep gray matter, pointing towards regional differences in compensation to the cerebral steal effect. No effects of aortic arch obstruction and arterial oxygenation on cerebral perfusion were seen. Cerebral perfusion was increased in patients with CHD compared to healthy controls after adjusting for hemodynamic alterations and oxygen saturation. To improve neuroprotection and neurodevelopmental outcomes, it is important to increase our understanding of the factors influencing cerebral perfusion in neonates with severe CHD.

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Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome

Cited by 2 publications

References 48 publications

Quantitative assessment of preoperative brain development in pediatric congenital heart disease patients by synthetic MRI

Quantitative assessment of preoperative brain development in pediatric congenital heart disease patients by synthetic MRI

Effects of hemodynamic alterations and oxygen saturation on cerebral perfusion in congenital heart disease

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