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Neurodevelopmental outcomes in congenital heart disease: Usefulness of biomarkers of brain injury

Authors: Laia Vega Puyal; Elisa Llurba; Queralt Ferrer; Paola Dolader Codina; Olga Sánchez García; Alba Montoliu Ruiz; Joan Sanchez-de-Toledo;

Neurodevelopmental outcomes in congenital heart disease: Usefulness of biomarkers of brain injury

Abstract

At present, neurodevelopmental abnormalities are the most frequent type of complication in school-aged children with congenital heart disease (CHD). We analysed the incidence of acute neurologic events (ANEs) in patients with operated CHD and the usefulness of neuromarkers for the prediction of neurodevelopment outcomes.Prospective observational study in infants with a prenatal diagnosis of CHD who underwent cardiac surgery in the first year of life. We assessed the following variables: (1) serum biomarkers of brain injury (S100B, neuron-specific enolase) in cord blood and preoperative blood samples; (2) clinical and laboratory data from the immediate postnatal and perioperative periods; (3) treatments and complications; (4) neurodevelopment (Bayley-III scale) at age 2 years.the study included 84 infants with a prenatal diagnosis of CHD who underwent cardiac surgery in the first year of life. Seventeen had univentricular heart, 20 left ventricular outflow obstruction and 10 genetic syndromes. The postoperative mortality was 5.9% (5/84) and 10.7% (9/84) patients experienced ANEs. The mean overall Bayley-III scores were within the normal range, but 31% of patients had abnormal scores in the cognitive, motor or language domains. Patients with genetic syndromes, ANEs and univentricular heart had poorer neurodevelopmental outcomes. Elevation of S100B in the immediate postoperative period was associated with poorer scores.children with a history of cardiac surgery for CHD in the first year of life are at risk of adverse neurodevelopmental outcomes. Patients with genetic syndromes, ANEs or univentricular heart had poorer outcomes. Postoperative ANEs may contribute to poorer outcomes. Elevation of S100B levels in the postoperative period was associated with poorer neurodevelopmental outcomes at 2 years. Studies with larger samples and longer follow-ups are needed to define the role of these biomarkers of brain injury in the prediction of neurodevelopmental outcomes in patients who undergo surgery for management of CHD.

Keywords

Heart Defects, Congenital, Enolasa neuronal específica, PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastornos del desarrollo neurológico, Neurodesarrollo, S100B, Pediatrics, Univentricular Heart, RJ1-570, Cor - Cirurgia, ENFERMEDADES::enfermedades cardiovasculares::anomalías cardiovasculares::cardiopatías congénitas, DISEASES::Cardiovascular Diseases::Cardiovascular Abnormalities::Heart Defects, Congenital, Trastorns del desenvolupament, Pregnancy, Humans, Cardiac Surgical Procedures, Infant, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Cardiac Surgical Procedures, NAMED GROUPS::Persons::Age Groups::Child::Child, Preschool, Cardiopatía congénita, Biomarcadores, Child, Preschool, Brain Injuries, Cardiopatia congènita en els infants, Female, DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño::niño preescolar, PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Neurodevelopmental Disorders, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos cardiovasculares::procedimientos quirúrgicos cardíacos, Biomarkers

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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