Single-ventricle anatomy predicts delayed microstructural brain development
Open accessAbstract
Background Term newborns with congenital heart disease (CHD) show delayed brain development as early as the third trimester, especially in single-ventricle physiology (SVP). Mechanisms causing delayed brain development in CHD are uncertain but may include impaired fetal brain blood flow. Our objective was to determine if cardiac anatomy associated with obstruction to antegrade flow in the ascending aorta is predictive of delayed brain development as measured by diffusion tensor imaging and magnetic resonance spectroscopic (MRS) imaging.Methods Echocardiograms from 36 term newborns with SVP were reviewed for the presence of aortic atresia and the diameter of the ascending aorta. Quantitative magnetic resonance imaging parameters measuring brain microstructural (fractional anisotropy (FA) and average diffusivity (Dav)) or metabolic development (N-acetylaspartate (NAA) and lactate/choline (Lac/Cho)) were recorded.Results Increasing NAA/Cho and white matter (WM) FA, and decreasing Dav and Lac/Cho characterize normal brain development. Consistent with the hypothesis that delayed brain development is related to impaired brain perfusion, smaller ascending aortic diameter and aortic atresia were associated with higher Dav and lower WM FA. Echocardiogram variables were not associated with brain metabolic measures.Conclusions These observations support the hypothesis that obstruction to fetal cerebral blood flow impairs brain microstructural development.
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Altered white matter microstructure before surgery appears to be influenced by smaller aortic diameter in the presence of aortic atresia in single ventricle pathology.
“Altered white matter microstructure before surgery appears to be influenced by smaller aortic diameter in the presence of aortic atresia in SVP.58”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [58]
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Fetal neuroimaging: an update on technical advances and clinical findings
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Epidemiology and etiology of strokes in babies
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Long-Term Neurologic Outcomes in Children With Congenital Heart Disease
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TWIN REVERSED ARTERIAL PERFUSION CAUSES DECREASED FETAL CEREBRAL VASCULAR IMPEDANCE
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- Authors
- Sethi, V., Tabbutt, S., Dimitropoulos, A., Harris, K. C., Chau, V., Poskitt, K., Campbell, A., Azakie, A., Xu, D., Barkovich, A. J., Miller, S. P., & McQuillen, P. S.
- Affiliations
- University of California, San Francisco (US)
- University of British Columbia (CA)
- Corresponding author
- McQuillen, Patrick S.
- ORCID
- Venue
- Pediatric Research
- Published
- 2013-02-13
- Volume
- 73
- Issue
- 5
- Pages
- 661-667
- ISSN
- 0031-3998 (ISSN-L)
- 1530-0447
- PMC
- PMC3631295
- OpenAlex
- W1973142402
- Cited by
- 64
- References
- 44
- Citations by year
- 2026: 1 · 2025: 6 · 2023: 6 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 7 · 2018: 5 · 2017: 10 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 2
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- National Institute of Neurological Disorders and Stroke (R01NS063876)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- single ventricle physiology, congenital heart disease, fetal brain development, aortic atresia, ascending aortic diameter, fetal cerebral blood flow, brain microstructure, fractional anisotropy, diffusion tensor imaging, magnetic resonance spectroscopy, N-acetylaspartate, white matter development, term infants
- MeSH terms
- Brain, Cerebral Ventricles, Echocardiography, Female, Humans, Infant, Newborn, Male
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