Abstract #3448
Is fetal hypoxia a precursor of neonatal white matter changes in congenital heart disease?
Prakash Muthusami 1 , Sujana Madathil 2 , Susan Blaser 3 , Edgar Jaeggi 2 , Lars Grosse-Wortmann 2 , Shi-Joon Yoo 1 , John Kingdom 4 , Edward Hickey 5 , John Sled 6 , Christopher Macgowan 6 , Steven Miller 7 , and Mike Seed 2
1
Division of Cardiac Imaging, Department of
Diagnostic Imaging, The Hospital for Sick Children,
University of Toronto, Toronto, Ontario, Canada,
2
Division
of Cardiology, Department of Pediatrics, The Hospital
for Sick Children, University of Toronto, Toronto,
Ontario, Canada,
3
Division
of Neuroradiology, Department of Diagnostic Imaging, The
Hospital for Sick Children, University of Toronto,
Toronto, Ontario, Canada,
4
Department
of Obstetrics and Gynaecology, Mount Sinai Hospital,
Toronto, Ontario, Canada,
5
Department
of Cardiovascular Surgery, The Hospital for Sick
Children, University of Toronto, Toronto, Ontario,
Canada,
6
Department of Physiology &
Experimental Medicine, The Hospital for Sick Children,
University of Toronto, Toronto, Ontario, Canada,
7
Department
of Neurology, The Hospital for Sick Children, University
of Toronto, Toronto, Ontario, Canada
Congenital heart disease (CHD) in neonates is known to
be associated with an increased risk of perioperative
white matter (WM) injury. This is a prospective study to
answer the question of whether a correlation exists
between altered fetal hemodynamics and subsequent
neonatal brain WM changes in CHD, by comparing fetal
blood flows and neonatal white matter scores against
healthy fetuses. The study showed reduced total and
cerebral oxygen consumption in fetuses with CHD as
compared to normals, as well as increased white matter
T2-scores. Furthermore, a positive correlation existed
between increased fetal superior vena caval flow, known
to occur in hypoxic states, and neonatal brain apparent
diffusion coefficient values. These results appear to
suggest a role of altered fetal cerebral hemodynamics in
the brain changes that occur in CHD.
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