Newborns With Congenital Heart Disease Have Widespread Brain Abnormalities

Here's a 'information chicklet' for anyone interested.

Susan Jeffrey

November 15, 2007 — A new imaging study shows that term infants with congenital heart disease (CHD) undergoing imaging studies prior to corrective surgery have widespread brain abnormalities similar to those seen in premature infants.

"The key finding is that brain development is delayed in these term babies with congenital heart disease; the babies looked on imaging like preterm infants," first author Steven P. Miller, MD, from BC Children's Hospital in Vancouver, British Columbia, told Medscape Neurology & Neurosurgery. The hypothesis then, is that the abnormality may start in utero, he said.

Their report appears in the November 8 issue of the New England Journal of Medicine.

NEJM Abstract:

Background Congenital heart disease in newborns is associated with global impairment in development. We characterized brain metabolism and microstructure, as measures of brain maturation, in newborns with congenital heart disease before they underwent heart surgery.

Methods We studied 41 term newborns with congenital heart disease — 29 who had transposition of the great arteries and 12 who had single-ventricle physiology — with the use of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and diffusion tensor imaging (DTI) before cardiac surgery. We calculated the ratio of N-acetylaspartate to choline (which increases with brain maturation), the ratio of lactate to choline (which decreases with maturation), average diffusivity (which decreases with maturation), and fractional anisotropy of white-matter tracts (which increases with maturation). We compared these findings with those in 16 control newborns of a similar gestational age.

Results As compared with control newborns, those with congenital heart disease had a decrease of 10% in the ratio of N-acetylaspartate to choline (P=0.003), an increase of 28% in the ratio of lactate to choline (P=0.08), an increase of 4% in average diffusivity (P<0.001),> anisotropy (P<0.001).> on MRI, was not significantly associated with findings on MRS or DTI. White-matter injury was observed in 13 newborns with congenital heart disease (32%) and in no control newborns.

Conclusions Term newborns with congenital heart disease have widespread brain abnormalities before they undergo cardiac surgery. The imaging findings in such newborns are similar to those in premature newborns and may reflect abnormal brain development in utero.

I find this very interesting and important! With more information paid to brain development, more research can be done to prevent damage from happening!