Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease

Pike, Nancy A.; Roy, Bhaswati; Cabrera-Mino, Cristina; Halnon, Nancy J.; Lewis, Alan B.; Shao, Xingfeng; Wang, Danny J. J.; Kumar, Rajesh

doi:10.3390/jcdd11080236

Open AccessArticle

Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease

by

Nancy A. Pike

^1,2,*,

Bhaswati Roy

³,

Cristina Cabrera-Mino

⁴

,

Nancy J. Halnon

⁵,

Alan B. Lewis

⁶,

Xingfeng Shao

⁷

,

Danny J. J. Wang

⁷

and

Rajesh Kumar

⁸

¹

Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA 92697, USA

²

The Heart Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA

³

Departments of Anesthesiology, University of California Los Angeles, Los Angeles, CA 90095, USA

⁴

School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA

⁵

Division of Pediatric Cardiology, Mattel Children’s Hospital UCLA, Los Angeles, CA 90095, USA

⁶

Division of Pediatric Cardiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA

⁷

Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA

⁸

Departments of Anesthesiology, Radiological Sciences & Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA

^*

Author to whom correspondence should be addressed.

J. Cardiovasc. Dev. Dis. 2024, 11(8), 236; https://doi.org/10.3390/jcdd11080236

Submission received: 3 June 2024 / Revised: 21 July 2024 / Accepted: 25 July 2024 / Published: 29 July 2024

(This article belongs to the Section Pediatric Cardiology and Congenital Heart Disease)

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Abstract

(1) Introduction: Adolescents with complex congenital heart disease (CCHD) show brain tissue injuries in regions associated with cognitive deficits. Alteration in cerebral arterial perfusion (CAP), as measured by arterial transit time (ATT), may lead to perfusion deficits and potential injury. Our study aims to compare ATT values between CCHD patients and controls and assess the associations between ATT values, MD values, and cognitive scores in adolescents with CCHD. (2) Methods: 37 CCHD subjects, 14–18 years of age, who had undergone surgical palliation and 30 healthy controls completed cognitive testing and brain MRI assessments using a 3.0-Tesla scanner. ATT values and regional brain mean diffusivity [MD] were assessed for the whole brain using diffusion tensor imaging. (3) Results: The mean MoCA values [23.1 ± 4.1 vs. 28.1 ± 2.3; p < 0.001] and General Memory Index, with a subscore of WRAML2 [86.8 ± 15.4 vs. 110.3 ± 14.5; p < 0.001], showed significant cognitive deficits in CCHD patients compared to controls. The mean global ATT was significantly higher in CCHD patients versus controls (mean ± SD, s, 1.26 ± 0.11 vs. 1.19 ± 0.11, p = 0.03), respectively. The partial correlations between ATT values, MD values, and cognitive scores (p < 0.005) showed significant associations in areas including the hippocampus, prefrontal cortices, cerebellum, caudate, anterior and mid cingulate, insula, thalamus, and lingual gyrus. (4) Conclusions: Adolescents with CCHD had prolonged ATTs and showed correlation with clinical measurements of cognitive impairment and MRI measurements of brain tissue integrity. This suggests that altered CAP may play a role in brain tissue injury and cognitive impairment after surgical palliation.

Keywords: single ventricle; memory; magnetic resonance imaging; arterial transit time

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MDPI and ACS Style

Pike, N.A.; Roy, B.; Cabrera-Mino, C.; Halnon, N.J.; Lewis, A.B.; Shao, X.; Wang, D.J.J.; Kumar, R. Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease. J. Cardiovasc. Dev. Dis. 2024, 11, 236. https://doi.org/10.3390/jcdd11080236

AMA Style

Pike NA, Roy B, Cabrera-Mino C, Halnon NJ, Lewis AB, Shao X, Wang DJJ, Kumar R. Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease. Journal of Cardiovascular Development and Disease. 2024; 11(8):236. https://doi.org/10.3390/jcdd11080236

Chicago/Turabian Style

Pike, Nancy A., Bhaswati Roy, Cristina Cabrera-Mino, Nancy J. Halnon, Alan B. Lewis, Xingfeng Shao, Danny J. J. Wang, and Rajesh Kumar. 2024. "Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease" Journal of Cardiovascular Development and Disease 11, no. 8: 236. https://doi.org/10.3390/jcdd11080236

APA Style

Pike, N. A., Roy, B., Cabrera-Mino, C., Halnon, N. J., Lewis, A. B., Shao, X., Wang, D. J. J., & Kumar, R. (2024). Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease. Journal of Cardiovascular Development and Disease, 11(8), 236. https://doi.org/10.3390/jcdd11080236

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Compromised Cerebral Arterial Perfusion, Altered Brain Tissue Integrity, and Cognitive Impairment in Adolescents with Complex Congenital Heart Disease

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