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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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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Abstract 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.
AbstractList 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.
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 ) 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.
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.
Author Panigrahy, Ashok
Tran, Michelle
Brady, Ken M.
Tran, Nhu N.
Votava-Smith, Jodie K.
AuthorAffiliation 2 Department of Pediatrics, Keck School of Medicine, University of Southern California (KSOM USC), Los Angeles, CA, USA
3 Department of Population and Public Health Sciences, KSOM USC, Los Angeles, CA, USA
7 Lurie Children’s Hospital of Chicago, Anesthesiology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
6 University of Pittsburgh Medical Center, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
8 Division of Cardiology, Department of Pediatrics, CHLA and KSOM USC, Los Angeles, CA, USA
1 Division of Neonatology, Children’s Hospital Los Angeles (CHLA), Fetal and Neonatal Institute, 4650 Sunset Blvd., MS#137, Los Angeles, CA 90027, USA
4 Division of Research on Children, Youth, and Families, The Saban Research Institute, CHLA, Los Angeles, CA, USA
5 Department of Pediatric Radiology, CHLA, Los Angeles, CA, USA
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CitedBy_id crossref_primary_10_1017_cts_2023_581
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crossref_primary_10_1177_08830738221115982
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Keywords Near infrared spectroscopy
Congenital heart disease
Infants
Cerebrovascular Stability Index
Head circumference
Language English
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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.
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Snippet Congenital heart disease (CHD) is a common birth defect in the United States. CHD infants are more likely to have smaller head circumference and...
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pubmed
springer
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StartPage 1624
SubjectTerms Cardiac Surgery
Cardiology
Head
Heart Defects, Congenital - complications
Hemodynamics
Humans
Infant
Infant, Newborn
Longitudinal Studies
Medicine
Medicine & Public Health
Original Article
Prospective Studies
Vascular Surgery
Title Association of Cerebrovascular Stability Index and Head Circumference Between Infants With and Without Congenital Heart Disease
URI https://link.springer.com/article/10.1007/s00246-022-02891-3
https://www.ncbi.nlm.nih.gov/pubmed/35426499
https://search.proquest.com/docview/2651693324
https://pubmed.ncbi.nlm.nih.gov/PMC10230613
Volume 43
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