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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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