Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome.

Steger, Céline; Feldmann, Maria; Borns, Julia; Hagmann, Cornelia; Latal, Beatrice; Held, Ulrike; Jakab, András; O'Gorman Tuura, Ruth; Knirsch, Walter (2023). Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome. Pediatric research, 93(6), pp. 1642-1650. Nature Publishing Group 10.1038/s41390-022-02253-y

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BACKGROUND

Altered neurometabolite ratios in neonates undergoing cardiac surgery for congenital heart defects (CHD) may serve as a biomarker for altered brain development and neurodevelopment (ND).

METHODS

We analyzed single voxel 3T PRESS H1-MRS data, acquired unilaterally in the left basal ganglia and white matter of 88 CHD neonates before and/or after neonatal cardiac surgery and 30 healthy controls. Metabolite ratios to Creatine (Cr) included glutamate (Glu/Cr), myo-Inositol (mI/Cr), glutamate and glutamine (Glx/Cr), and lactate (Lac/Cr). In addition, the developmental marker N-acetylaspartate to choline (NAA/Cho) was evaluated. All children underwent ND outcome testing using the Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) at 1 year of age.

RESULTS

White matter NAA/Cho ratios were lower in CHD neonates compared to healthy controls (group beta estimate: -0.26, std. error 0.07, 95% CI: -0.40 - 0.13, p value <0.001, FDR corrected p value = 0.010). We found no correlation between pre- or postoperative white matter NAA/Cho with ND outcome while controlling for socioeconomic status and CHD diagnosis.

CONCLUSION

Reduced white matter NAA/Cho in CHD neonates undergoing cardiac surgery may reflect a delay in brain maturation. Further long-term MRS studies are needed to improve our understanding of the clinical impact of altered metabolites on brain development and outcome.

IMPACT

NAA/Cho was reduced in the white matter, but not the gray matter of CHD neonates compared to healthy controls. No correlation to the 1-year neurodevelopmental outcome (Bayley-III) was found. While the rapid change of NAA/Cho with age might make it a sensitive marker for a delay in brain maturation, the relationship to neurodevelopmental outcome requires further investigation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Borns, Julia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0031-3998

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Pubmed Import

Date Deposited:

24 Aug 2022 10:12

Last Modified:

12 May 2023 00:11

Publisher DOI:

10.1038/s41390-022-02253-y

PubMed ID:

35995938

BORIS DOI:

10.48350/172340

URI:

https://boris.unibe.ch/id/eprint/172340

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