Abstract 17204: Asymmetric Patterns of Cerebral Cortical Development in Fetuses With Complex Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuanchiao Lu ◽  
Kushal Kapse ◽  
Nicole Andersen ◽  
Catherine Lopez ◽  
Jessica Quistorff ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Brain ◽  
Fetal Mri ◽  
Complex Congenital Heart Disease ◽  
Single Shot ◽  
Healthy Controls ◽  
Hemispheric Asymmetries ◽  
The Right

Introduction: Neurodevelopmental disabilities are common among infants with complex congenital heart disease (CHD). While hemispheric asymmetries in normal fetal brain size and shape have been reported, the effect of CHD on hemispheric development of the developing fetal brain remains unknown. Hypothesis: We hypothesized that emerging cerebral hemispheric asymmetries of the fetal CHD brain would differ compared to healthy controls using in vivo MRI tools. Methods: A total of 252 pregnant women were recruited (164 controls; 88 CHD fetuses), in which 328 fetal MRI scans were performed. Single shot fast spin echo T2-weighted images were acquired on a 1.5T GE MRI scanner. High-resolution 3D models of the fetal brain were reconstructed using slice-to-volume registration method for motion correction and Draw-EM algorithm for automatic segmentation. Volumetric analysis of brain tissues was conducted, and cortical folding measures of brain lobes were evaluated. Mixed effects regression was utilized to compare the brain features between right and left hemispheres for healthy controls and CHD fetuses. Results: The mean gestational age of all fetal MRI studies was 32.1±3.7 weeks (range: 24.0-39.4). For healthy fetuses, the volume of cortical gray matter was higher in the left hemisphere; however, this pattern was diminished in CHD fetuses. Gyrification indices were higher in the parietal and occipital lobes of the right hemisphere for controls, but not for CHD fetuses. Similarly, Gaussian curvature was higher in the right frontal lobe for controls only. Conversely, the surface area of the left occipital lobe was lower in CHD fetuses, but not in healthy fetuses. Conclusions: We report for the first time early disturbances in emerging hemispheric asymmetric patterns of the fetal brain in CHD compared to controls. The extent to which these lateralization differences reflect genetic, epigenetic and/or hemodynamic disturbances in CHD fetuses is under investigation.

Case 5.20

2014 ◽  
pp. 280-281
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
History Of ◽  
The Right ◽  
Accessory Spleens

55-year-old woman with a history of complex congenital heart disease Axial postgadolinium 3D SPGR images (Figure 5.20.1) show a left-sided liver, right-sided stomach, and multiple small accessory spleens in the right upper quadrant. The IVC is absent, and the azygos and hemiazygos veins are prominent. Coronal postgadolinium 3D SPGR images (...

Right ventricular noncompaction in a neonate with complex congenital heart disease

2005 ◽  
Vol 15 (4) ◽  
pp. 434-436 ◽  
Author(s):  
Dursun Alehan ◽  
Omer Faruk Dogan
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Ventricular Myocardium ◽  
Complex Congenital Heart Disease ◽  
Limited Data ◽  
Ventricular Noncompaction ◽  
The Right

Ventricular noncompaction is a rare unclassified cardiomyopathy occurring because of arrest of the normal intrauterine compaction of the loose luminal component of the ventricular myocardium. There is limited data regarding its diagnosis and outcome in children. It is recognised, however, that right ventricular involvement is extremely rare. We report a case in which only the right ventricular myocardium was noncompacted, a situation which led to heart failure soon after birth.

scholarly journals Determinants of soluble angiotensin-converting enzyme 2 concentrations in adult patients with complex congenital heart disease

2020 ◽  
Author(s):  
Tanja Raedle-Hurst ◽  
Sarah Wissing ◽  
Nils Mackenstein ◽  
Rima Obeid ◽  
Juergen Geisel ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Congenital Heart ◽  
Nyha Class ◽  
Complex Congenital Heart Disease ◽  
Healthy Controls ◽  
Converting Enzyme ◽  
Class Iii

Abstract Background Angiotensin-converting enzyme (ACE) 2 is known to be a functional receptor for SARS-CoV-2 in the current pandemic. Soluble ACE2 (sACE2) concentrations are elevated in patients with various cardiovascular disorders including heart failure. Methods In a total of 182 consecutive adult patients with complex congenital heart disease (CHD) and 63 healthy controls, sACE2 concentrations were measured in serum using the Human ACE2® assay by Cloud-Clone Corporation and associated with clinical, laboratory and echocardiographic parameters. Results Median sACE2 levels were increased in patients with complex CHD as compared to healthy controls (761.9 pg/ml vs 365.2 pg/ml, p < 0.001). Moreover, sACE2 concentrations were significantly elevated in patients with a higher NYHA class ≥ III (1856.2 pg/ml vs 714.5 pg/ml in patients with NYHA class I/II, p < 0.001). Using linear regression analysis, higher sACE2 levels were associated with a higher NYHA class ≥ III, more severe CHD, a morphological left systemic ventricle, higher creatinine and the use of mineralocorticoid receptor antagonists (MRA) in the univariable model. The use of ACE inhibitors or angiotensin receptor blockers (ARB) was associated with lower sACE2 levels. In the multivariable model, higher sACE2 levels were independently associated with a higher NYHA class ≥ III (p = 0.002) and lower sACE2 levels with the use of ACE inhibitors or ARB (p = 0.001). Conclusion Soluble ACE2 concentrations were significantly increased in all types of complex CHD with highest levels found in patients with NYHA class ≥ III. Moreover, a higher NYHA class ≥ III was the most significant determinant that was independently associated with elevated sACE2 concentrations. Graphic abstract

Severity of Fetal Brain Abnormalities in Congenital Heart Disease in Relation to the Main Expected Pattern of in utero Brain Blood Supply

2015 ◽  
Vol 39 (4) ◽  
pp. 269-278 ◽  
Author(s):  
Narcís Masoller ◽  
Magda Sanz-Cortés ◽  
Fàtima Crispi ◽  
Olga Gómez ◽  
Mar Bennasar ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Blood Supply ◽  
Congenital Heart ◽  
Cortical Development ◽  
Fetal Brain ◽  
Fetal Mri ◽  
In Utero ◽  
Class A ◽  
Severe Reduction

Objectives: We evaluated the hypothesis that in fetuses with congenital heart disease (CHD) there is a correlation between the expected pattern of in utero brain blood supply and the severity of neurodevelopmental impairment. Methods: A total of 58 fetuses with CHD and 58 controls underwent a Doppler ultrasound and fetal MRI at 36-38 weeks. Fetuses with CHD were divided into two functional classes: class A with an expected severe reduction in oxygenated brain blood supply (left outflow tract obstruction and transposition of great vessels) and class B with theoretically near-normal or mildly impaired oxygenated brain blood supply (other CHD). Head biometry and cerebroplacental Doppler were assessed by ultrasound, and brain volumetry, cortical development and metabolism by MRI. Results: Both class A and B CHD fetuses had significant differences in head biometry, brain perfusion, cortical development and brain metabolism compared with controls. However, there was a significant linear tendency for head biometry, cerebral Doppler, volumes, cortical sulcation and metabolic ratios across the three clinical groups, with signs of more severe brain alterations in type A CHD fetuses. Conclusions: All fetuses with CHD showed significant brain developmental changes, but differences were more pronounced in CHD associated with an expected severe reduction in oxygenated blood supply to the brain.

Double-chambered left ventricle with complex congenital heart disease in an infant: an extremely rare pathology

2019 ◽  
Vol 16 (3) ◽  
pp. 187-191
Author(s):  
T.V. Rogova ◽  
A.I. Kim ◽  
A.V. Sobolev ◽  
S.A. Aleksandrova ◽  
E.V. Kholmanskaya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Left Ventricle ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease
Sign in / Sign up

Export Citation Format

Share Document