Anna Lonyai Harbison1, Jodie K Votava-Smith1, Sylvia Del Castillo2, S Ram Kumar3, Vince Lee4, Vincent Schmithorst4, Hollie A Lai5, Sharon O'Neil6, Stefan Bluml5, Lisa Paquette7, Ashok Panigrahy8. 1. Division of Cardiology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA. 2. Department of Anesthesiology, Critical Care Medicine, Children's Hospital of Los Angeles, Los Angeles, CA. 3. Division of Cardiac Surgery, Department of Surgery, Children's Hospital of Los Angeles/University of Southern California, Los Angeles, CA. 4. Department of Pediatric Radiology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, PA. 5. Division of Radiology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA. 6. Division of Neurology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA. 7. Division of Neonatology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA. 8. Department of Pediatric Radiology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: panigrahya@upmc.edu.
Abstract
OBJECTIVE: To determine associations between patient and clinical factors with postnatal brain metabolism in term neonates with congenital heart disease (CHD) via the use of quantitative magnetic resonance spectroscopy. STUDY DESIGN: Neonates with CHD were enrolled prospectively to undergo pre- and postoperative 3T brain magnetic resonance imaging. Short-echo single-voxel magnetic resonance spectroscopy of parietal white matter was used to quantify metabolites related to brain maturation (n-acetyl aspartate, choline, myo- inositol), neurotransmitters (glutamate and gamma-aminobutyric acid), energy metabolism (glutamine, citrate, glucose, and phosphocreatine), and injury/apoptosis (lactate and lipids). Multivariable regression was performed to search for associations between (1) patient-specific/prenatal/preoperative factors with concurrent brain metabolism and (2) intraoperative and postoperative factors with postoperative brain metabolism. RESULTS: A total of 83 magnetic resonance images were obtained on 55 subjects. No patient-specific, prenatal, or preoperative factors associated with concurrent metabolic brain dysmaturation or elevated lactate could be identified. Chromosome 22q11 microdeletion and age at surgery were predictive of altered concurrent white matter phosphocreatine (P < .0055). The only significant intraoperative association found was increased deep hypothermic circulatory arrest time with reduced postoperative white matter glutamate and gamma-aminobutyric acid (P < .0072). Multiple postoperative factors, including increased number of extracorporeal membrane oxygenation days (P < .0067), intensive care unit, length of stay (P < .0047), seizures in the intensive care unit (P < .0009), and home antiepileptic use (P < .0002), were associated with reduced postoperative white matter n-acetyl aspartate. CONCLUSION: Multiple postoperative factors were found to be associated with altered brain metabolism in term infants with CHD, but not patient-specific, preoperative, or intraoperative factors.
OBJECTIVE: To determine associations between patient and clinical factors with postnatal brain metabolism in term neonates with congenital heart disease (CHD) via the use of quantitative magnetic resonance spectroscopy. STUDY DESIGN: Neonates with CHD were enrolled prospectively to undergo pre- and postoperative 3T brain magnetic resonance imaging. Short-echo single-voxel magnetic resonance spectroscopy of parietal white matter was used to quantify metabolites related to brain maturation (n-acetyl aspartate, choline, myo- inositol), neurotransmitters (glutamate and gamma-aminobutyric acid), energy metabolism (glutamine, citrate, glucose, and phosphocreatine), and injury/apoptosis (lactate and lipids). Multivariable regression was performed to search for associations between (1) patient-specific/prenatal/preoperative factors with concurrent brain metabolism and (2) intraoperative and postoperative factors with postoperative brain metabolism. RESULTS: A total of 83 magnetic resonance images were obtained on 55 subjects. No patient-specific, prenatal, or preoperative factors associated with concurrent metabolic brain dysmaturation or elevated lactate could be identified. Chromosome 22q11 microdeletion and age at surgery were predictive of altered concurrent white matter phosphocreatine (P < .0055). The only significant intraoperative association found was increased deep hypothermic circulatory arrest time with reduced postoperative white matterglutamate and gamma-aminobutyric acid (P < .0072). Multiple postoperative factors, including increased number of extracorporeal membrane oxygenation days (P < .0067), intensive care unit, length of stay (P < .0047), seizures in the intensive care unit (P < .0009), and home antiepileptic use (P < .0002), were associated with reduced postoperative white mattern-acetyl aspartate. CONCLUSION: Multiple postoperative factors were found to be associated with altered brain metabolism in term infants with CHD, but not patient-specific, preoperative, or intraoperative factors.
Authors: Catherine Limperopoulos; Wayne Tworetzky; Doff B McElhinney; Jane W Newburger; David W Brown; Richard L Robertson; Nicolas Guizard; Ellen McGrath; Judith Geva; David Annese; Carolyn Dunbar-Masterson; Bethany Trainor; Peter C Laussen; Adré J du Plessis Journal: Circulation Date: 2009-12-21 Impact factor: 29.690
Authors: J William Gaynor; Susan C Nicolson; Gail P Jarvik; Gil Wernovsky; Lisa M Montenegro; Nancy B Burnham; Diane M Hartman; Andy Louie; Thomas L Spray; Robert R Clancy Journal: J Thorac Cardiovasc Surg Date: 2005-10-13 Impact factor: 5.209
Authors: Constantinos Chrysostomou; Victor O Morell; Bradley A Kuch; Elizabeth O'Malley; Ricardo Munoz; Peter D Wearden Journal: J Thorac Cardiovasc Surg Date: 2012-12-08 Impact factor: 5.209
Authors: Jane W Newburger; David Wypij; David C Bellinger; Adre J du Plessis; Karl C K Kuban; Leonard A Rappaport; Daniel Almirall; David L Wessel; Richard A Jonas; Gil Wernovsky Journal: J Pediatr Date: 2003-07 Impact factor: 4.406
Authors: Ariane Marelli; Steven P Miller; Bradley Scott Marino; Angela L Jefferson; Jane W Newburger Journal: Circulation Date: 2016-05-17 Impact factor: 29.690
Authors: Jennifer M Lynch; Erin M Buckley; Peter J Schwab; Ann L McCarthy; Madeline E Winters; David R Busch; Rui Xiao; Donna A Goff; Susan C Nicolson; Lisa M Montenegro; Stephanie Fuller; J William Gaynor; Thomas L Spray; Arjun G Yodh; Maryam Y Naim; Daniel J Licht Journal: J Thorac Cardiovasc Surg Date: 2014-06-27 Impact factor: 5.209
Authors: Stephen Ashwal; Barbara A Holshouser; Michael J del Rio; Karen A Tong; Richard L Applegate; Leonard L Bailey Journal: Pediatr Neurol Date: 2003-08 Impact factor: 3.372
Authors: Sarah U Morton; Lara Maleyeff; David Wypij; Hyuk Jin Yun; Caitlin K Rollins; Christopher G Watson; Jane W Newburger; David C Bellinger; Amy E Roberts; Michael J Rivkin; P Ellen Grant; Kiho Im Journal: Cereb Cortex Date: 2021-08-26 Impact factor: 5.357
Authors: Nina Gertsvolf; Jodie K Votava-Smith; Rafael Ceschin; Sylvia Del Castillo; Vince Lee; Hollie A Lai; Stefan Bluml; Lisa Paquette; Ashok Panigrahy Journal: Sci Rep Date: 2018-09-19 Impact factor: 4.996
Authors: Angela Satriano; Alessandro Varrica; Alessandro Frigiola; Alessandro Graziosi; Caterina Di Battista; Adele Patrizia Primavera; Giacomo Centini; Antonio Maconi; Chiara Strozzi; Antonio D W Gavilanes; Luc J Zimmermann; Hans J S Vles; Diego Gazzolo Journal: Diagnostics (Basel) Date: 2021-06-24