Abstract 13794: Serial Brain Metabolism in Term Neonates With Congenital Heart Disease: Association With Clinical Factors and Neurodevelopmental Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anna L Harbison ◽  
Jodie K Votava-Smith ◽  
Sylvia Del Castillo ◽  
S Ram Kumar ◽  
Vincent K Lee ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Brain Metabolism ◽  
Clinical Factors ◽  
Neurodevelopmental Outcomes ◽  
Term Neonates ◽  
Significant Difference ◽  
Serial Brain

Objectives: Term congenital heart disease (CHD) neonates demonstrate pre-operative (op) abnormal brain metabolism (reduced N-acetylaspartate (NAA), elevated lactate) on long echo MR spectroscopy (MRS). We sought to delineate associations between serial brain metabolism and patient and perioperative clinical factors in term neonates with CHD using short echo MRS. We measured NAA and lactate as well as other metabolites important for brain connectivity such as neurotransmitters glutamate/glutamine and GABA. Methods: Subjects were prospectively enrolled to undergo pre and post-op 3T short echo single voxel MRS of parietal white matter with absolute quantitation of 15 metabolites using LCModel. Neurodevelopment (ND) was assessed via 18 month Battelle Developmental Inventory. Linear and logistic regression with false discovery rate correction was used for statistical analysis. Results: Eighty subjects were enrolled 2009-2015 and 21 term CHD infants underwent both pre and post-op MRS. Eight infants had at least one MRS and ND. NAA and glutamate were significantly decreased post-op compared to pre-op (p<0.0001), with no significant difference in other metabolites. Pre-op factors including lower Apgar score, birth weight, head circumference and PaO2 and higher arterial pH and serum lactate were associated with lower NAA (p<0.002). Single ventricle anatomy was associated with low NAA, high myo-inositol and low glutamine/glutamate compared to two ventricles (p<0.01). Longer cardipulmonary bypass time, but not deep hypothermic circulatory arrest, was associated with reduced NAA (p<0.001). Post-op, global alteration in multiple serial brain metabolites (NAA, lactate, glutamate/glutamine, GABA, myo-inostol) were associated with longer ICU and hospital stay (p<0.03). In those with ND testing, high GABA correlated with low cognitive domain score, while high glutamine correlated with low motor score (p<0.03). Conclusion: In term CHD neonates, serial brain metabolism by MRS demonstrates alterations beyond NAA, including neurotransmitters GABA and glutamate/glutamine. These abnormalities are associated with multiple clinical pre and post-op factors and also predict prolonged hospital stay and 18 month ND.

scholarly journals Clinical Factors Associated with Cerebral Metabolism in Term Neonates with Congenital Heart Disease

2017 ◽  
Vol 183 ◽  
pp. 67-73.e1 ◽  
Author(s):  
Anna Lonyai Harbison ◽  
Jodie K. Votava-Smith ◽  
Sylvia del Castillo ◽  
S. Ram Kumar ◽  
Vince Lee ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cerebral Metabolism ◽  
Clinical Factors ◽  
Term Neonates ◽  
Factors Associated

scholarly journals Factors Associated with Severe Lower Respiratory Tract Infection from Respiratory Syncytial Virus (RSV) in Thai Children

2021 ◽  
Vol 73 (12) ◽  
pp. 808-814
Author(s):  
Atipotsawee Tungsupreechameth ◽  
Klaita Srisingh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Logistic Model ◽  
Congenital Heart ◽  
Clinical Manifestations ◽  
Factors Associated ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Syncytial Virus

Objective: To determine the factors associated with severe ALRTI from RSV in children.Materials and Methods: A retrospective study of children aged 1-60 months were conducted from 2014 to 2018. Out of 269 patients diagnosed with RSV ALRTI, 100 children were enrolled in the study, 20 had severe RSV ALRTI, while 80 had non-severe RSV ALRTI as identified by the ReSVinet scale. A multivariable logistic model was conducted to select significant variables.Results: During the study period, 269 patients were diagnosed with RSV ALRTI. Mean age was 10.45 ± 3.53 months. Clinical manifestations of severe RSV ALRTI group had significant difference in abnormal general condition (P < 0.001), tachypnea (P < 0.001), SpO2 < 85% (P < 0.001), poor air entry in lungs (P < 0.001), and retraction (P < 0.001). The factors associated with severe RSV ALRTI group, were underlying congenital heart disease [aOR32.45; 95% CI 3.38-311.87, P = 0.003] and duration of hospital stay >5 days [aOR 19.56; 95% CI 1.81-212.05, P = 0.014].Conclusion: Factors associated with severe RSV ALRTI in children were underlying congenital heart disease andduration of hospital stay >5 days.

scholarly journals Cerebral Autoregulation in Neonates With and Without Congenital Heart Disease

2018 ◽  
Vol 27 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Nhu N. Tran ◽  
S. Ram Kumar ◽  
Felicia S. Hodge ◽  
Paul M. Macey
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cerebral Autoregulation ◽  
Congenital Heart ◽  
Cerebral Oxygenation ◽  
The United States ◽  
Neurological Deficits ◽  
Neurodevelopmental Outcomes ◽  
Significant Difference ◽  
Auditory Functions

Background Congenital heart disease (CHD) is a leading birth defect in the United States, affecting about 40 000 neonates each year. Despite efforts to prevent developmental delays, many children with CHD have neurological deficits that last into adulthood, influencing employability, self-care, and quality of life. Objective To determine if neonates with CHD have impaired cerebral autoregulation and poorer neurodevelopmental outcomes compared with healthy controls. Methods A total of 44 full-term neonates, 28 with CHD and 16 without, were enrolled in the study. Inclusion criteria included confirmed diagnosis of CHD, stable hemodynamic status, and being no more than 12 days old. Exclusion criteria included intraventricular hemorrhage and intubation. Cerebral autoregulation was determined by measuring regional cerebral oxygenation during a postural change. The Einstein Neonatal Neurobehavioral Assessment Scale was used to measure overall neurodevelopmental outcomes (motor, visual, and auditory functions). Results Of the 28 neonates with CHD, 8 had single-ventricle physiology. A χ2 analysis indicated no significant difference in impaired cerebral autoregulation between neonates with CHD and controls (P = .38). Neonates with CHD had lower regional cerebral oxygenation than did neonates without CHD (P &lt; .001). Regression analyses with adjustments for cerebral autoregulation indicated that neonates with CHD had poorer total neurodevelopmental outcomes scores (β = 9.3; P = .02) and motor scores (β = 7.6; P = .04). Conclusion Preoperative neonates with CHD have poorer developmental outcomes and more hypoxemia than do controls.

scholarly journals Pattern and Clinical Profile of Congenital Heart Disease in A Teaching Hospital

1970 ◽  
Vol 21 (1) ◽  
pp. 58-62 ◽  
Author(s):  
L Shamima Sharmin ◽  
M Azizul Haque ◽  
M Iqbal Bari ◽  
M Ayub Ali
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Growth Failure ◽  
Female Child ◽  
Feeding Problems ◽  
Medical College ◽  
One Year ◽  
A Prospective Study

Objectives: To see the (a) type of congenital heart disease, (b) Clinical presentation of the cases, (c) association with extra-cardiac anomalies and disease, (d) complications of different CHD, (e) outcome of patients during hospital stay. Methodology: it was a prospective study conducted in the department of pediatrics of Rajshahi Medical College & Hospital over a period of one year.115 children from birth to 12 years of age who had congenital heart disease confirmed by echocardiography were included. All patients were treated conservatively and observed for immediate out come during the hospital stay. Result: major types of CHD were VSD (42.6%), TOF (18.3%), ASD (14.8%), PDA (7.8%). Male outnumbers female child. Common symptoms were breathlessness (60%), fatigue (54.8%), cough (43.5%), poor weight gain (41.7%), recurrent chest infection (34.8%), fever (28.7%), feeding problems (26.1%), palpitation (21.7%) and bluish discoloration of lips and fingertips (20%). Murmur with or without thrill and cardiomegaly was the most important cardiac finding. Frequently observed complications were heart failure, pulmonary hypertension and growth failure.   doi: 10.3329/taj.v21i1.3221 TAJ 2008; 21(1): 58-62

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

Abstract 240: Hypertension Prevalence and Management Among Adult Congenital Heart Disease Patients

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Joshua R Thomas ◽  
Ricky T Munoz ◽  
Mark D Fox ◽  
Angela T Yetman
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Hypertension Prevalence ◽  
Significant Difference ◽  
Adult Congenital ◽  
The Mean

Background: Cardiovascular risk factors (CRFs) are poorly defined among the population of adults with congenital heart disease. In particular, the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) are currently unknown. Objective: To determine the prevalence of pre-HTN and HTN among adults with congenital heart disease; and to assess HTN control rates among different clinic types. Methods: A retrospective analysis of a cohort of adults with congenital heart disease (CHD) was conducted. Data regarding CHD patients' blood pressure (BP), medications, and provider specialty were analyzed. Results: The cohort consisted of 971 patients. The mean age was 30.4 years (SD = 10.4), with 51% male. Thirty-two percent had HTN (n = 304). There was no statistically significant difference in the prevalence of Pre-HTN and HTN by clinic type (i.e. specialty vs. non-specialty)( p = .225, p= .633 respectively). However, a statistically significant association exists between clinic type and HTN control rates χ 2 (1) = 3.185, p = .07 (Table 1). Those receiving care from a specialty clinic are 1.6 times more likely to have controlled HTN. Conclusions: Pre-HTN and HTN are common among adults with congenital heart disease. These CRFs are better managed in specialty clinics devoted to this population.

scholarly journals COMPARISON OF SERUM VITAMIN A LEVELS BETWEEN NEONATES WITH CONGENITAL HEART DISEASE AND CONTROLS

2018 ◽  
Vol 11 (10) ◽  
pp. 130
Author(s):  
Saeed Abtahi ◽  
Zahra Mostafavian ◽  
Babak Behnam ◽  
Zahra Abbasi Shaye
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Vitamin A ◽  
Congenital Heart ◽  
Laboratory Data ◽  
Serum Vitamin ◽  
Analysis Of Covariance ◽  
Cyanotic Heart Disease ◽  
Significant Difference ◽  
The Mean

Objective: Prevention of congenital heart disease (CHD) has been hampered by a lack of information about the known modifiable risk factors for abnormalities in cardiac development. Vitamin A plays an important role in the periods of rapid cellular growth and differentiation, especially during pregnancy. Assuming a link between Vitamin A levels and congenital malformations, hypothetical different levels of Vitamin A were evaluated in neonates with and without CHD, in this study.Methods: In a case–control study that was conducted in 2015 in Mashhad/Iran, serum levels of Vitamin A in 30 neonates with CHD were compared to 30 healthy controls. The cases were diagnosed by echocardiography and recruited by convenience sampling. Demographic and laboratory data including age, sex, and serum Vitamin A level in each group were collected. Data analysis was done in SPSS V 20 software, and descriptive statistics, t-test, and analysis of covariance were used.Results: The mean age in cases was 11±3.4 days and in controls was 12.5±4.8 days. A total of 18 patients (60%) were male. In CHD patients, 10 cases (33.3%) had cyanotic heart disease, and 20 cases (66.7%) had non-cyanotic heart disease. The mean serum Vitamin A values in subjects (11.54±9.56 μg/dL) and controls (21.84±14.3 μg/dL) were significantly different, (p<0.05) and in case group was lower than the normal range.Conclusion: There was a significant difference in serum Vitamin A values in subjects and controls. Therefore, awareness of people about the importance of this vitamin in preventing CHD in children seems necessary.

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