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Hasselman TE, Marriott KT, Verda M, Zumpf KB, McGraw KE, Hasselman AM. Executive function deficits in congenital heart surgical patients: prevalence and timing of presentation. Cardiol Young 2024:1-7. [PMID: 39364541 DOI: 10.1017/s1047951124025800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
BACKGROUND Congenital heart patients undergoing congenital heart surgery in the first year of life are at high risk of having a neurodevelopmental disorder. The most common difficulties are related to executive functioning. The following questions were assessed in the current project: Are patients having congenital heart surgery after one year of life at lower risk for neurodevelopmental disorders? At what age do executive function deficits manifest? METHODS We evaluated executive function in four groups of congenital heart patients who had undergone congenital heart surgery. These groups were high-risk patients with and without a genetic syndrome associated with a neurodevelopmental disorder and low-risk patients with and without a genetic syndrome associated with a neurodevelopmental disorder. We evaluated executive function using the Behavior Rating Inventory of Executive Function - Preschool Version, Behavior Rating Inventory of Executive Function-2, and Minnesota Executive Function Scale at various ages. We compared the rates of executive function deficits in the high- and low-risk groups as well as compared that to the published norms for age. We also assessed at what age these deficits become apparent. CONCLUSION We found that both high- and low-risk groups had higher levels of executive functioning deficits compared to the norms for age. The low-risk group's degree of executive function deficits appeared a little lower than the high-risk group. However, it was difficult to comment on the statistical significance. We also saw that executive function deficits often do not become apparent for many years after surgery. This finding highlights the need for continued evaluation of functioning as these kids mature.
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Affiliation(s)
| | - Kara T Marriott
- Department of Pediatrics, OSF St Francis Medical Center, Peoria, IL, USA
| | | | - Katelyn B Zumpf
- Department of Pediatrics, OSF St Francis Medical Center, Peoria, IL, USA
| | - Kristin E McGraw
- Department of Pediatrics, OSF St Francis Medical Center, Peoria, IL, USA
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Zhao Y, Deng W, Wang Z, Wang Y, Zheng H, Zhou K, Xu Q, Bai L, Liu H, Ren Z, Jiang Z. Genetics of congenital heart disease. Clin Chim Acta 2024; 552:117683. [PMID: 38030030 DOI: 10.1016/j.cca.2023.117683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
During embryonic development, the cardiovascular system and the central nervous system exhibit a coordinated developmental process through intricate interactions. Congenital heart disease (CHD) refers to structural or functional abnormalities that occur during embryonic or prenatal heart development and is the most common congenital disorder. One of the most common complications in CHD patients is neurodevelopmental disorders (NDD). However, the specific mechanisms, connections, and precise ways in which CHD co-occurs with NDD remain unclear. According to relevant research, both genetic and non-genetic factors are significant contributors to the co-occurrence of sporadic CHD and NDD. Genetic variations, such as chromosomal abnormalities and gene mutations, play a role in the susceptibility to both CHD and NDD. Further research should aim to identify common molecular mechanisms that underlie the co-occurrence of CHD and NDD, possibly originating from shared genetic mutations or shared gene regulation. Therefore, this review article summarizes the current advances in the genetics of CHD co-occurring with NDD, elucidating the application of relevant gene detection techniques. This is done with the aim of exploring the genetic regulatory mechanisms of CHD co-occurring with NDD at the gene level and promoting research and treatment of developmental disorders related to the cardiovascular and central nervous systems.
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Affiliation(s)
- Yuanqin Zhao
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Wei Deng
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Zhaoyue Wang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Yanxia Wang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Hongyu Zheng
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Kun Zhou
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Qian Xu
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Le Bai
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Huiting Liu
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Zhong Ren
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
| | - Zhisheng Jiang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan Province, International Joint Laboratory for Arteriosclerotic Disease Research of Hunan Province, University of South China, Hengyang 421001, China.
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Long D, Anderson VA, Crossley L, Sood NT, Charles KR, MacDonald AD, Bora S, Pestell CF, Murrell K, Pride NA, Anderson PJ, Badawi N, Rose B, Baillie H, Masterson K, Chumbes Flores J, Sherring C, Raman S, Beca J, Erickson S, Festa M, Anderson BW, Venugopal P, Yim D, Andrews D, Cheung M, Brizard C, Gentles TL, Iyengar A, Nicholson I, Ayer J, Butt W, Schlapbach LJ, Gibbons KS. Longitudinal cohort study investigating neurodevelopmental and socioemotional outcomes in school-entry aged children after open heart surgery in Australia and New Zealand: the NITRIC follow-up study protocol. BMJ Open 2023; 13:e075429. [PMID: 37648380 PMCID: PMC10471882 DOI: 10.1136/bmjopen-2023-075429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Despite growing awareness of neurodevelopmental impairments in children with congenital heart disease (CHD), there is a lack of large, longitudinal, population-based cohorts. Little is known about the contemporary neurodevelopmental profile and the emergence of specific impairments in children with CHD entering school. The performance of standardised screening tools to predict neurodevelopmental outcomes at school age in this high-risk population remains poorly understood. The NITric oxide during cardiopulmonary bypass to improve Recovery in Infants with Congenital heart defects (NITRIC) trial randomised 1371 children <2 years of age, investigating the effect of gaseous nitric oxide applied into the cardiopulmonary bypass oxygenator during heart surgery. The NITRIC follow-up study will follow this cohort annually until 5 years of age to assess outcomes related to cognition and socioemotional behaviour at school entry, identify risk factors for adverse outcomes and evaluate the performance of screening tools. METHODS AND ANALYSIS Approximately 1150 children from the NITRIC trial across five sites in Australia and New Zealand will be eligible. Follow-up assessments will occur in two stages: (1) annual online screening of global neurodevelopment, socioemotional and executive functioning, health-related quality of life and parenting stress at ages 2-5 years; and (2) face-to-face assessment at age 5 years assessing intellectual ability, attention, memory and processing speed; fine motor skills; language and communication; and socioemotional outcomes. Cognitive and socioemotional outcomes and trajectories of neurodevelopment will be described and demographic, clinical, genetic and environmental predictors of these outcomes will be explored. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Children's Health Queensland (HREC/20/QCHQ/70626) and New Zealand Health and Disability (21/NTA/83) Research Ethics Committees. The findings will inform the development of clinical decision tools and improve preventative and intervention strategies in children with CHD. Dissemination of the outcomes of the study is expected via publications in peer-reviewed journals, presentation at conferences, via social media, podcast presentations and medical education resources, and through CHD family partners. TRIAL REGISTRATION NUMBER The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry as 'Gene Expression to Predict Long-Term Neurodevelopmental Outcome in Infants from the NITric oxide during cardiopulmonary bypass to improve Recovery in Infants with Congenital heart defects (NITRIC) Study - A Multicentre Prospective Trial'. TRIAL REGISTRATION ACTRN12621000904875.
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Affiliation(s)
- Debbie Long
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Vicki A Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Psychology Service, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Louise Crossley
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nikita Tuli Sood
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Karina R Charles
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Anna D MacDonald
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Samudragupta Bora
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Kathryn Murrell
- Consult Liaison Team, Starship Children's Hospital, Auckland, New Zealand
| | - Natalie A Pride
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Brian Rose
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Australian and New Zealand Fontan Advocacy Committee, HeartKids Australia Inc, Sydney, New South Wales, Australia
| | - Heidi Baillie
- Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kate Masterson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Paediatric Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jenipher Chumbes Flores
- Paediatric Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Claire Sherring
- Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand
| | - Sainath Raman
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - John Beca
- Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand
| | - Simon Erickson
- Paediatric Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Marino Festa
- Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Benjamin W Anderson
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Prem Venugopal
- School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Cardiac Surgery, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Deane Yim
- Department of Paediatric Cardiology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - David Andrews
- Department of Cardiothoracic Surgery, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Michael Cheung
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Christian Brizard
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Cardiac Surgery, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Thomas L Gentles
- Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand
- Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand
| | - Ajay Iyengar
- Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Ian Nicholson
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Julian Ayer
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Warwick Butt
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Paediatric Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Luregn J Schlapbach
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Intensive Care and Neonatology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Kristen S Gibbons
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
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Basgoze S, Temur B, Ozcan ZS, Gokce I, Guvenc O, Aydin S, Guzelmeric F, Altan Kus A, Erek E. The effect of extracorporeal membrane oxygenation on neurodevelopmental outcomes in children after repair of congenital heart disease: A pilot study from Turkey. Front Pediatr 2023; 11:1131361. [PMID: 37077331 PMCID: PMC10106672 DOI: 10.3389/fped.2023.1131361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/13/2023] [Indexed: 04/21/2023] Open
Abstract
Background Extracorporeal membrane oxygenation (ECMO) is widely used after congenital heart surgery. The purpose of this study is to analyze the neurodevelopmental (ND) outcomes in patients who receivedECMO support after congenital cardiac surgery. Methods Between January 2014 and January 2021, 111 patients (5.8%) receivedECMO support after congenital heart operations, and 29 (26,1%) of these patients were discharged. Fifteen patients who met the inclusion criteria were included. A propensity score matching (PSM) analysis model was established using eight variables (age, weight, sex, Modified Aristotle Comprehensive Complexityscores, seizures, cardiopulmonary bypass duration, number of operations, and repair method) with 1:1 matching. According to the PSM model, 15 patients who underwent congenital heart operations were selected as the non-ECMO group. The Ages & Stages Questionnaire Third Edition (ASQ-3) was used for ND screening;it includes communication, physical skills (gross and fine motor), problem-solving, and personal-social skills domains. Results There were no statistically significant differences between the patients' preoperative and postoperative characteristics. All patients were followed up for a median of 29 months (9-56 months). The ASQ-3 results revealed that communication, fine motor, and personal-social skills assessments were not statistically different between the groups. Gross motor skills (40 vs. 60), problem-solving skills (40 vs. 50), and overall scores (200 vs. 250) were better in the non-ECMO patients (P = 0.01, P = 0.03, and P = 0.03, respectively). Nine patients (%60) in the ECMO group and 3 patients (%20) in the non-ECMO group were with neurodevelopmental delay (P = 0,03). Conclusion ND delay may occur in congenital heart surgery patients who receivedECMO support. We recommend ND screening in all patients with congenital heart disease, especially those who receivedECMO support.
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Affiliation(s)
- Serdar Basgoze
- Department of Pediatric Heart Surgery, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
- Correspondence: Serdar Basgoze
| | - Bahar Temur
- Department of Cardiovascular Surgery, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Zeynep Sila Ozcan
- School of Medicine, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Ibrahim Gokce
- School of Medicine, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Osman Guvenc
- Department of Pediatric Cardiology, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Selim Aydin
- Department of Cardiovascular Surgery, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Fusun Guzelmeric
- Department of Anesthesiology, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Aylin Altan Kus
- Department of Radiology, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
| | - Ersin Erek
- Department of Pediatric Heart Surgery, Faculty of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey
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7
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Lépine J, Gagnon K, Prud'homme J, Vinay MC, Doussau A, Fourdain S, Provost S, Belval V, Bernard C, Gallagher A, Poirier N, Simard MN. Utility of the Ages and Stages Questionnaires 3rd Edition for Developmental Screening in Children with Surgically Repaired Congenital Heart Disease. Dev Neurorehabil 2022; 25:125-132. [PMID: 34365887 DOI: 10.1080/17518423.2021.1960918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Aim: This study sought to evaluate the accuracy of the Ages and Stages Questionnaires 3rd Edition (ASQ-3) in identifying developmental delay (DD) in children with congenital heart disease (CHD) born at term who underwent surgical repair.Methods: Participants had to complete ASQ-3 and Bayley Scales of Infant and Toddler Development 3rd Edition (BSID-III) at 12 and 24 months. A child was considered at risk of DD for a ASQ-3 domain when he scored below the cutoff (≤-1SD or ≤-2SD). A child had a DD in a BSID-III domain when the score was ≤-1SD. The validity for each ASQ-3 domain and for overall ASQ-3 was measured.Results: At 12 months (n = 64), overall ASQ-3 (≤-2SD) sensitivity was 88%, specificity 74%. At 24 months (n = 82), overall ASQ-3 (≤-2SD) sensitivity was 74%, specificity 88%.Conclusion: The results support the utility of the ASQ-3 for screening the overall risk of DD in children with CHD.
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Affiliation(s)
- Julien Lépine
- Faculty of Medicine, Université De Montréal, Montreal, Quebec, Canada
| | - Karine Gagnon
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Joëlle Prud'homme
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Marie Claude Vinay
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Amélie Doussau
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Solène Fourdain
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada.,Department of Psychology, Université De Montréal, Montreal, Quebec, Canada
| | - Sarah Provost
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada.,Department of Psychology, Université De Montréal, Montreal, Quebec, Canada
| | - Véronique Belval
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Catherine Bernard
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Anne Gallagher
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada.,Department of Psychology, Université De Montréal, Montreal, Quebec, Canada
| | - Nancy Poirier
- Faculty of Medicine, Université De Montréal, Montreal, Quebec, Canada.,Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada
| | - Marie-Noëlle Simard
- Sainte-Justine University Health Centre Research Center, Montreal, Quebec, Canada.,School of Rehabilitation, Faculty of Medecine, Université De Montréal, Montreal, Quebec, Canada
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