Fetal markers of neurodevelopmental outcomes in congenital heart disease

先天性心脏病神经发育结果的胎儿标志物

• 批准号: 10162674
• 负责人: Shabnam Peyvandi
• 金额: $ 18.82万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10162674
• 关键词: Acute; Adult; Advisory Committees; Area; Award; Behavioral; Birth; Blood; Brain; Brain Injuries; Brain imaging; Cardiac; Cardiology; Cardiovascular Physiology; Cerebrovascular Circulation; Cerebrum; Child; Childhood; Chronic; Clinical Research; Clinical Trials; Cognitive; Complex; Congenital Abnormality; Consumption; Cross-Sectional Studies; Data; Development; Echocardiography; Educational Activities; Emotional; Environment; Etiology; Exhibits; Faculty; Fetus; Funding; Future; Goals; Heart; Homeostasis; Hyperoxia; Hypoplastic Left Heart Syndrome; Hypoxia; Impairment; Infant Development; Infrastructure; Intervention; Intervention Studies; Lesion; Link; Literature; Longterm Follow-up; Magnetic Resonance Imaging; Measures; Mentors; Mentorship; Metabolism; Methods; Mothers; Motor; Neonatal; Neurodevelopmental Impairment; Neurologic; Neurological outcome; Newborn Infant; Operative Surgical Procedures; Organ; Outcome; Oxygen; Oxygen Therapy Care; Patients; Perfusion; Perioperative; Physiological; Physiology; Population; Pregnancy; Program Development; Prospective cohort study; Protocols documentation; Regulation; Research; Research Personnel; Research Proposals; Resources; Risk; Secondary to; Structure; Techniques; Therapeutic; Third Pregnancy Trimester; Time; Training; Training Programs; Transposition of Great Vessels; Ultrasonography; Vascular resistance; Vasodilation; Work; base; blood oxygen level dependent; brain health; career; career development; cerebral hemodynamics; cerebrovascular; comparative; congenital heart disorder; experience; fetal; high risk population; hypoperfusion; imaging program; imaging study; improved; improved outcome; neonate; operation; postnatal; prenatal; recruit; response; risk stratification; student mentoring; tissue oxygenation; tool; white matter injury

PROJECT SUMMARY This proposal describes a five-year training program for development of a career in clinical research focused on fetal predictors of neurodevelopmental (ND) outcome in critical congenital heart disease (CHD). The candidate has training in pediatric and fetal cardiology. The goals of this award are to rigorously conduct this research proposal, to use the training obtained to develop into a mentor to other trainees and junior faculty and to use this award as a vehicle to become a federally funded independent investigator. To achieve these goals, the applicant has set up a training plan that will include mentoring, course work, hands-on conduct of research and didactic educational activities. This project will be carried out under the mentorship of Patrick McQuillen, MD, a leader in neurodevelopmental outcomes of children with CHD. Complementary mentorship will be provided by Drs. Donna Ferriero and Jim Barkovich, experts in establishing correlations between brain imaging and neurologic outcomes. This mentoring team has successfully mentored students, fellows and junior faculty, including K-level awards. An advisory committee has been assembled to help guide the candidate's career development. This application focuses on understanding the regulation of cerebral blood flow and oxygenation in fetuses with critical CHD as compared to a normal comparative group. Furthermore, the protocol aims to identify the link between fetal cerebral regulation and adaptation with postnatal structural and functional neurologic outcomes in patients with transposition of the great arteries (TGA) and hypoplastic left heart syndrome (HLHS), two common yet physiologically distinct cardiac lesions. Literature demonstrates that these patients have evidence of delayed brain development in late gestation and at birth and are vulnerable to peri- operative white matter injury. The etiology of these findings is likely related to abnormalities in cerebral oxygen delivery as a result of CHD, which may be secondary to decreased cerebral perfusion, decreased blood oxygen content, changes in metabolism or a combination of all. The first part of this proposal focuses on the prenatal time period. We plan to demonstrate differences in regulation of cerebral blood flow (as measured by trans-cranial Doppler) and oxygenation (as measured by T2* MRI) in CHD fetuses as compared to normal fetuses by utilizing brief administration of maternal hyperoxia to acutely alter physiology. To achieve this, we plan to perform a cross-sectional study comparing these measures between CHD and normal fetuses. The second component of this proposal extends to the postnatal time period and aims to understand the relationship between fetal cerebral regulation and postnatal brain structure (MRI at birth) and function (ND outcome at 12 months) in CHD. To achieve this, we plan to conduct a prospective cohort study of fetuses with TGA and HLHS to assess this relationship and to assess differences by cardiac lesion. This proposal will identify fetal physiologic effects on ND outcome in fetuses with CHD, providing critical information to set up future intervention studies with an eventual goal of improving ND outcomes in children with complex CHD.

项目总结

项目成果

Fetal cerebrovascular response to maternal hyperoxygenation in congenital heart disease: effect of cardiac physiology.

• DOI: 10.1002/uog.22024
• 发表时间: 2021-05
• 期刊: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
• 作者: Hogan WJ;Moon-Grady AJ;Zhao Y;Cresalia NM;Nawaytou H;Quezada E;Brook M;McQuillen P;Peyvandi S
• 通讯作者: Peyvandi S

Neonatal Brain Injury and Timing of Neurodevelopmental Assessment in Patients With Congenital Heart Disease.

• DOI: 10.1016/j.jacc.2018.02.068
• 发表时间: 2018-05-08
• 期刊: Journal of the American College of Cardiology
• 影响因子: 24
• 作者: Peyvandi S;Chau V;Guo T;Xu D;Glass HC;Synnes A;Poskitt K;Barkovich AJ;Miller SP;McQuillen PS
• 通讯作者: McQuillen PS

Measuring Up Before Birth: The New Normal.

出生前测量：新常态。

• DOI: 10.1161/circimaging.118.008008
• 发表时间: 2018
• 期刊: Circulation. Cardiovascular imaging
• 作者: Moon-Grady,AnitaJ;Peyvandi,Shabnam
• 通讯作者: Peyvandi,Shabnam

Fetal brain growth and risk of postnatal white matter injury in critical congenital heart disease.

• DOI: 10.1016/j.jtcvs.2020.09.096
• 发表时间: 2021-09
• 期刊: The Journal of thoracic and cardiovascular surgery
• 作者: Peyvandi S;Lim JM;Marini D;Xu D;Reddy VM;Barkovich AJ;Miller S;McQuillen P;Seed M
• 通讯作者: Seed M

Effect of Fetal Growth on 1-Year Mortality in Neonates With Critical Congenital Heart Disease.

• DOI: 10.1161/jaha.118.009693
• 发表时间: 2018-09-04
• 期刊: Journal of the American Heart Association
• 影响因子: 5.4
• 作者: Steurer MA;Baer RJ;Burke E;Peyvandi S;Oltman S;Chambers CD;Norton ME;Rand L;Rajagopal S;Ryckman KK;Feuer SK;Liang L;Paynter RA;McCarthy M;Moon-Grady AJ;Keller RL;Jelliffe-Pawlowski LL
• 通讯作者: Jelliffe-Pawlowski LL