Association of Cerebrovascular Stability Index and Head Circumference Between Infants With and Without Congenital Heart Disease

Congenital heart disease (CHD) is a common birth defect in the United States. CHD infants are more likely to have smaller head circumference and neurodevelopmental delays; however, the cause is unknown. Altered cerebrovascular hemodynamics may contribute to neurologic abnormalities, such as smaller...

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Bibliographic Details
Published inPediatric cardiology Vol. 43; no. 7; pp. 1624 - 1630
Main Authors Tran, Nhu N., Tran, Michelle, Panigrahy, Ashok, Brady, Ken M., Votava-Smith, Jodie K.
Format Journal Article
LanguageEnglish
Published New York Springer US 01.10.2022
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Summary:Congenital heart disease (CHD) is a common birth defect in the United States. CHD infants are more likely to have smaller head circumference and neurodevelopmental delays; however, the cause is unknown. Altered cerebrovascular hemodynamics may contribute to neurologic abnormalities, such as smaller head circumference, thus we created a novel Cerebrovascular Stability Index (CSI), as a surrogate for cerebral autoregulation. We hypothesized that CHD infants would have an association between CSI and head circumference. We performed a prospective, longitudinal study in CHD infants and healthy controls. We measured CSI and head circumference at 4 time points (newborn, 3, 6, 9 months). We calculated CSI by subtracting the average 2-min sitting from supine cerebral oxygenation (rcSO 2 ) over three consecutive tilts (0–90°), then averaged the change score for each age. Linear regressions quantified the relationship between CSI and head circumference. We performed 177 assessments in total (80 healthy controls, 97 CHD infants). The average head circumference was smaller in CHD infants (39.2 cm) compared to healthy controls (41.6 cm) ( p  < 0.001) and head circumference increased by 0.27 cm as CSI improved in the sample ( p  = 0.04) overall when combining all time points. Similarly, head circumference increased by 0.32 cm as CSI improved among CHD infants ( p  = 0.04). We found CSI significantly associated with head circumference in our sample overall and CHD infants alone, which suggests that impaired CSI may affect brain size in CHD infants. Future studies are needed to better understand the mechanism of interaction between CSI and brain growth.
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Author Contributions NT conceived the study question and study design. NT performed assessments and collected data. MT performed the data analyses. NT and MT wrote the first draft of the manuscript and all authors provided revisions on the draft. NT verified the analytical methods and oversaw all manuscript revisions. JV, AP, and KB reviewed and edited all versions. All authors contributed to and approved the final manuscript.
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-022-02891-3