Pediatric research · 2026
Cerebral hemodynamics in early adolescents with congenital heart disease after infant open-heart surgery.
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Mojon François, Latal Beatrice, Kottke Raimund, Kretschmar Oliver, Tuura O'Gorman Ruth, Ehrler Melanie
Аннотация
BACKGROUND: Fetuses and infants with congenital heart disease (CHD) show altered cerebral hemodynamics. However, little is known about whether those alterations persist throughout childhood.
METHODS: We assessed cerebral hemodynamics in 83 adolescents 10-15 years (34 with CHD who underwent infant open-heart surgery, 49 healthy controls) using phase-contrast magnetic resonance imaging. Anterior hemodynamics were assessed in the internal carotid arteries (ICA) and internal jugular veins (IJV), and posterior hemodynamics in the vertebral arteries (VA), corrected for vessel angle (post-hoc). Average and peak blood velocity and average blood flow were quantified. Indexed cerebral blood flow (iCBF) was calculated as ICA blood flow adjusted for total brain volume. Cerebral hemodynamics were compared between patients and healthy controls and correlated with executive functions adjusted for age and sex.
RESULTS: Anterior hemodynamics did not significantly differ between patients with CHD and controls (all FDR-corrected p > 0.1, β:0.00-0.30), but blood flow in the left VA was significantly lower in patients than controls (FDR-corrected p = 0.033, β = 0.31). Hemodynamic parameters were not significantly associated with executive functions (all FDR-corrected p > 0.8, β:0.02-0.12).
DISCUSSION: Adolescents with CHD have widely preserved anterior cerebral hemodynamics but may show alterations to their posterior circulation. Furthermore, current cerebral hemodynamics may not impact cognition in adolescents with CHD. IMPACT: Adolescents with congenital heart disease (CHD) who underwent infant open-heart surgery show largely preserved anterior cerebral hemodynamics but possibly exhibit mild to moderate alterations in the posterior circulation. Preserved anterior hemodynamics may be related to the stable cardiac status in most adolescents with CHD. The current cerebral hemodynamics in adolescents with CHD may not explain cognitive impairments in these patients.
METHODS: We assessed cerebral hemodynamics in 83 adolescents 10-15 years (34 with CHD who underwent infant open-heart surgery, 49 healthy controls) using phase-contrast magnetic resonance imaging. Anterior hemodynamics were assessed in the internal carotid arteries (ICA) and internal jugular veins (IJV), and posterior hemodynamics in the vertebral arteries (VA), corrected for vessel angle (post-hoc). Average and peak blood velocity and average blood flow were quantified. Indexed cerebral blood flow (iCBF) was calculated as ICA blood flow adjusted for total brain volume. Cerebral hemodynamics were compared between patients and healthy controls and correlated with executive functions adjusted for age and sex.
RESULTS: Anterior hemodynamics did not significantly differ between patients with CHD and controls (all FDR-corrected p > 0.1, β:0.00-0.30), but blood flow in the left VA was significantly lower in patients than controls (FDR-corrected p = 0.033, β = 0.31). Hemodynamic parameters were not significantly associated with executive functions (all FDR-corrected p > 0.8, β:0.02-0.12).
DISCUSSION: Adolescents with CHD have widely preserved anterior cerebral hemodynamics but may show alterations to their posterior circulation. Furthermore, current cerebral hemodynamics may not impact cognition in adolescents with CHD. IMPACT: Adolescents with congenital heart disease (CHD) who underwent infant open-heart surgery show largely preserved anterior cerebral hemodynamics but possibly exhibit mild to moderate alterations in the posterior circulation. Preserved anterior hemodynamics may be related to the stable cardiac status in most adolescents with CHD. The current cerebral hemodynamics in adolescents with CHD may not explain cognitive impairments in these patients.