Abnormal brain development in newborns with congenital heart disease
Abnormal brain development in newborns with congenital heart disease
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DOI：
10.1056/nejmoa067393
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发表时间：
2007-11-08
影响因子：
158.5
通讯作者：
Vigneron, Daniel B.
中科院分区：
文献类型：
--
作者：
Miller, Steven P.;McQuillen, Patrick S.;Vigneron, Daniel B.
研究背景新生儿先天性心脏病与整体发育障碍有关。我们的特点是脑代谢和微观结构，作为脑成熟的措施，在新生儿先天性心脏病之前，他们接受了心脏surgery.MethodsWe研究了41名足月新生儿先天性心脏病- 29谁有大动脉转位和12谁有单心室生理-与使用磁共振成像（MRI），磁共振波谱（MRS），和弥散张量成像（DTI）。我们计算了N-乙酰天冬氨酸与胆碱的比率（随大脑成熟而增加）、乳酸与胆碱的比率（随成熟而降低）、平均扩散率（随成熟而降低）和白质束的各向异性分数（随成熟而增加）。结果先天性心脏病组与对照组比较，N-乙酰天冬氨酸/胆碱比值降低10%（P=0.003），乳酸/胆碱比值升高28%（P = 0.08），平均弥散度升高4%（P= 0.001），平均弥散度升高28%（P= 0.001）。
BackgroundCongenital 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.MethodsWe 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.ResultsAs 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