TAILIEUCHUNG - Abnormal Brain Development in Newborns with Congenital Heart Disease

Congenital heart disease in newborns is associated with global impairment in development. We characterized brain metabolism and microstructure, as measures of brain maturation, in newborns with congenital heart disease before they underwent heart surgery. Methods We studied 41 term newborns with congenital heart disease — 29 who had transposition of the great arteries and 12 who had single-ventricle physiology — with the use of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and diffusion tensor imaging (DTI) before cardiac surgery | Abnormal Brain Development in Newborns with Congenital Heart Disease Abnormal Brain Development in Newborns with Congenital Heart Disease Steven P. Miller . . Patrick S. McQuillen . Shannon Hamrick . Duan Xu . David V. Glidden . Natalie Charlton . Tom Karl . Anthony Azakie . Donna M. Ferriero . A. James Barkovich . and Daniel B. Vigneron . abstract From the Departments of Neurology . . . Pediatrics . . . Radiology . . . . Epidemiology and Biostatistics . and Surgery . . University of California at San Francisco San Francisco the Department of Pediatrics University of British Columbia Vancouver Canada . and the Department of Pediatrics Emory University Atlanta . . Address reprint requests to Dr. Miller at the Division of Neurology BC Children s Hospital K3-180 4480 Oak St. Vancouver BC V6H 3V4 Canada or at smiller6@. N Engl J Med 2007 357 1928-38. Copyright 2007 Massachusetts Medical Society. background Congenital heart disease in newborns is associated with global impairment in development. We characterized brain metabolism and microstructure as measures of brain maturation in newborns with congenital heart disease before they underwent heart surgery. methods We studied 41 term newborns with congenital heart disease 29 who had transposition of the great arteries and 12 who had single-ventricle physiology with the use of magnetic resonance imaging MRI magnetic resonance spectroscopy MRS and diffusion tensor imaging DTI before cardiac surgery. We calculated the ratio of N-acetylaspartate to choline which increases with brain maturation the ratio of lactate to choline which decreases with maturation average diffusivity which decreases with maturation and fractional anisotropy of white-matter tracts which increases with maturation . We compared these findings with those in 16 control newborns of a similar gestational age. results As compared with control .

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