大脑血流,大脑损伤,在Fontan手术后的大动脉-肺部附带流
Mark A Fogel1, Elizabeth Donnelly2, Ian Crandell3
1Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia/The Perelman School of Medicine, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Radiology, The Children's Hospital of Philadelphia/The Perelman School of Medicine, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
The American journal of cardiology
|October 16, 2023
概括
在Fontan患者中,随着时间的推移,大脑血流 (CBF) 和肺上腺附带血流 (APC) 的流量会减少. 这种反向关系可能会影响神经发育,APC可能是一个可修改的风险因素.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 神经发育结果的结果
- 医疗成像医学成像
背景情况:
- 患有单心室生理学的患者通常会发展出甲肺肺附带病 (APC).
- APC流与大脑血流 (CBF) 相反,这可能会影响神经发育.
- 缺少在Fontan患者中CBF和APC流量的纵向数据,考虑到脑损伤 (BI).
研究的目的:
- 为了纵向评估CBF和APC流量的变化之间的关系,在Fontan生理病患者.
- 评估大脑损伤 (BI) 对这种关系的影响.
- 确定APC流是否是神经发育结果的可修改风险因素.
主要方法:
- 未来27名Fontan患者 (10±1.9岁) 的纵向队列接受了连续的心脏和大脑MRI.
- 测量包括CBF (通过关静脉流) 和APC流 (大动脉流减去马匹返回) 在两个时间点,约6年间隔.
- 使用多变量建模分析了APC流量,CBF和BI变化之间的关系.
主要成果:
- 在CBF和APC流量变化之间观察到显著的反向关系 (R2 = 0.70-0.72,p < 0.02).
- 在6年内,CBF减少了9±11%,APC流量减少了0.73±0.67L/分钟/m2.
- 每个单元增加的APC流变化与CBF变化下降8%相关,独立于时间,性别和BI.
结论:
- 随着时间的推移,在Fontan患者中,CBF和APC流量变化是反向相关的,即使在调整BI后也是如此.
- 观察到CBF和APC流量的减少可能会对神经发育产生负面影响.
- 针对APC,可能通过栓塞,可能是改善神经发育结果的可修改风险因素.
相关概念视频
The Arch of Aorta
700
The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
Encircling the heart, the coronary arteries form a ring-like structure before...
700
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Arteries of the Head and Neck
1.3K
The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
1.3K
Blood Flow
69.9K
Blood is pumped by the heart into the aorta, the largest artery in the body, and then into increasingly smaller arteries, arterioles, and capillaries. The velocity of blood flow decreases with increased cross-sectional blood vessel area. As blood returns to the heart through venules and veins, its velocity increases. The movement of blood is encouraged by smooth muscle in the vessel walls, the movement of skeletal muscle surrounding the vessels, and one-way valves that prevent backflow.
69.9K


