Estimation of cerebrovascular reserve/reactivity (CVR) typically necessitates an invasive vasoactive stimulus. We here propose a metric to non-invasively estimate “resting-state” CVR (rCVR), the capacity of the vasculature to respond to resting-state metabolic demand, as the negative ratio of functional connectivity strength (FCS) to regional cerebral blood flow (CBF). Construct validity was demonstrated via prediction of end-tidal CO2 levels (PETCO2). rCVR was lower in older children with congenital heart disease (CHD) in default mode network (DMN), salience network (SN), and central executive network (CEN), and was positively associated with neurocognitive outcome (NIH Toolbox) and nasal nitric oxide (nNO) levels.
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