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A Pipeline to Characterize Structural Heart Defects in the Fetal Mouse

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Single-ventricle anatomy predicts delayed microstructural brain development.

Viyeka Sethi¹, Sarah Tabbutt, Anastasia Dimitropoulos

¹Department of Pediatrics and Neurology, University of California, San Francisco Benioff Children's Hospital, San Francisco, California, USA.

Pediatric Research

|February 15, 2013

Summary

This summary is machine-generated.

Congenital heart disease (CHD) in newborns can cause delayed brain development. Obstructions in the ascending aorta, like aortic atresia, are linked to impaired brain microstructural development in infants with single-ventricle physiology (SVP).

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Area of Science:

Neonatal Neurology
Pediatric Cardiology
Neuroimaging

Background:

Term newborns with congenital heart disease (CHD) exhibit delayed brain development, particularly those with single-ventricle physiology (SVP).
Impaired fetal brain blood flow is a potential mechanism contributing to this developmental delay.
The study investigates cardiac anatomy's role in predicting brain development issues in CHD.

Purpose of the Study:

To determine if cardiac anatomy, specifically obstruction to antegrade flow in the ascending aorta, predicts delayed brain development in newborns with SVP.
To correlate echocardiographic findings with neuroimaging parameters of brain development.

Main Methods:

Review of echocardiograms from 36 term newborns with SVP, assessing aortic atresia and ascending aorta diameter.
Quantitative magnetic resonance imaging (MRI) parameters, including diffusion tensor imaging (DTI) for microstructural development (fractional anisotropy (FA), average diffusivity (Dav)) and magnetic resonance spectroscopic (MRS) imaging for metabolic development (N-acetylaspartate (NAA), lactate/choline (Lac/Cho)).

Main Results:

Smaller ascending aorta diameter and aortic atresia were associated with higher average diffusivity (Dav) and lower white matter (WM) fractional anisotropy (FA).
These findings align with the hypothesis that impaired brain perfusion negatively impacts brain microstructural development.
Echocardiographic variables did not correlate with brain metabolic measures.

Conclusions:

Obstruction to fetal cerebral blood flow, indicated by specific cardiac anatomy, supports the hypothesis of impaired brain microstructural development in newborns with CHD.
Cardiac anatomy assessment may aid in identifying infants at risk for neurodevelopmental deficits.