scholarly journals Optimizing Unanesthetized Cerebral Oxygen Consumption Measures: Comparison of NIRS and MRI Approaches in Neonates with Congenital Heart Disease

2016 ◽  
Author(s):  
Silvina L. Ferradal ◽  
Jeffrey N. Stout ◽  
Borjan Gagoski ◽  
Rutvi Vyas ◽  
Christopher Ha ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Oxygen Consumption ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cerebral Oxygen ◽  
Cerebral Oxygen Consumption

scholarly journals Reduced Fetal Cerebral Oxygen Consumption Is Associated With Smaller Brain Size in Fetuses With Congenital Heart Disease

Circulation ◽  
2015 ◽  
Vol 131 (15) ◽  
pp. 1313-1323 ◽  
Author(s):  
Liqun Sun ◽  
Christopher K. Macgowan ◽  
John G. Sled ◽  
Shi-Joon Yoo ◽  
Cedric Manlhiot ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Oxygen Consumption ◽  
Heart Disease ◽  
Congenital Heart ◽  
Brain Size ◽  
Cerebral Oxygen ◽  
Cerebral Oxygen Consumption

Abstract 17303: Longitudinal Cerebral Oxygen Metabolism in Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jessie Mei Lim ◽  
Davide Marini ◽  
Amandeep Saini ◽  
Stephanie Au-Young ◽  
Steven Fan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Oxygen Consumption ◽  
Congenital Heart ◽  
Oxygen Metabolism ◽  
Cerebral Oxygen ◽  
Brain Growth ◽  
Cerebral Oxygen Metabolism ◽  
Cerebral Oxygen Consumption

Background: Brain growth differences are apparent between different types of cyanotic congenital heart disease, but the underlying mechanism remains unclear. Here, we explored and characterized longitudinal cerebral hemodynamic and oxygen metabolism profiles and their relationships to brain growth patterns in infants with single ventricle physiologies (SV) and transposition of the great arteries (TGA). We hypothesized that there are marked differences in cerebral oxygen metabolism in those with SV compared with TGA. Methods: Cerebral blood flow (CBF), oxygen delivery (CDO2) and consumption (CVO2) and brain growth were measured in 103 term newborns with SV and TGA using MRI at pre- and post-surgery and at follow-up. We measured whole brain size by segmenting a 3D steady state free precession acquisition. Cerebral blood flow was measured using phase contrast imaging of the neck vessels and cerebral venous blood oxygen saturation was derived from T2 oximetry of the superior sagittal sinus. TGAs were divided into those with and without ventricular septums. Results: CBF profiles were similar between the 3 lesion groups. Cerebral oxygen delivery trends increased but were not significantly different between cardiac groups. We observed that this may be mediated by different mechanisms: an increase in arterial saturation in TGAs, and an increase in hemoglobin concentration in SVs. Cerebral oxygen consumption in SV infants remained low (p = 0.54) while that of TGA increased over time (TGA IVS p < 0.001; TGA VSD p <0.001) (Fig. 1), mediated by an unchanging oxygen extraction fraction in SVs (p = 0.59). The SV cerebral oxygen consumption profile aligned with their declining brain weight z-score trajectory. Conclusions: In conclusion, there are characteristic differences in hemodynamic adaptations between SVs and TGAs. Changes in oxygen metabolism may be facilitating brain growth trajectories. This informs us of possible mechanisms involved during a time of critical brain development.

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