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Brain volume tied to neurodevelopment in CHD infants undergoing bypass surgery

11 Aug 2019

In infants undergoing bypass surgery for severe congenital heart disease (CHD), a lowered cerebral volume increases the risk of poor neurodevelopmental outcomes, a recent study has shown.

Researchers performed a prospective cohort study on 77 infants with severe CHD (75.3 percent male), in whom pre- and postoperative magnetic resonance imaging (MRI) was performed for the measurement of brain volumes and for the detection of brain abnormalities. The Bayley-III scale was used to score one-year neurodevelopmental outcomes. Forty-four controls (45.5 percent male) were also included.

One infant died before the assessment after 1 year and two of the survivors were lost to follow-up. Mean results in the Bayley-III motor (MCS; 92.7±15.4 vs 103.8±10.9; p=0.0002) and cognitive (CCS; 105±15.3 vs 117.1±11.3; p<0.0001) composite scores were significantly lower in those with CHD than in controls.

These scores remained significantly reduced in CHD infants even after controlling for socioeconomic status. The length of stay in the ICU was inversely and significantly correlated with both MCS (p=0.036) and CCS (p=0.045).

Postoperative total and regional brain volumes were also correlated with neurodevelopmental outcomes. Infants with higher frontal (β, 0.02, 95 percent CI, 0.00–0.04; p=0.043), temporal (β, 0.039, 0.01–0.07, p=0.014) and cerebellar (β, 0.056, 0.01–0.10; p=0.018) volumes tended to have better CCS.

Language composite scores, on the other hand, were significantly and independently associated with cortical (β, 0.0079, 0.00–0.02; p=0.045), temporal (β, 0.032; 0.00–0.06; p=0.046) and frontal (β, 0.021, 0.00–0.04; p=0.027) brain volumes. Preoperative MRI measurements did not show such relationships with neurodevelopmental outcomes.

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