Brain Injury and Dysmaturation in Newborns with Congenital Heart Disease Born Preterm

早产先天性心脏病新生儿的脑损伤和发育不良

基本信息

批准号：
10586934
负责人：
Patrick Sean McQuillen
金额：
$ 89.5万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-01 至 2028-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10586934
关键词：
Accounting Address Affect Age Anesthetics Birth Brain Brain Injuries Bypass Cardiac Categories Chromatin Cilia Clinical Common Ventricle Complex Country Developed Countries Development Diagnosis Diffusion Duct (organ) structure Equilibrium Evaluation Genes Genetic Gestational Age Goals Growth Heart Heart Abnormalities Image Infant Inherited Injury Intervention Knowledge Live Birth Magnetic Resonance Imaging Measures Molecular Abnormality Morbidity - disease rate Morphology Nature Neonatal Mortality Neurodevelopmental Disorder Newborn Infant Operative Surgical Procedures Outcome Oxygen Palliative Surgery Parents Patients Pattern Perioperative Physiology Positioning Attribute Postoperative Period Predisposition Premature Birth Premature Infant Reporting Resources Risk Risk Factors Severity of illness Shunt Device Socioeconomic Status Source Spectrum Analysis Staging Stents Structure Syndrome Term Birth Testing Time Variant Vulnerable Populations Weight brain abnormalities brain magnetic resonance imaging cardiac repair clinical risk comorbidity comparative congenital heart disorder experience genetic variant gray matter improved machine learning model multimodality neurodevelopment operation optimal treatments palliation palliative perinatal morbidity personalized decision premature preterm newborn prevent primary outcome repaired sedative sex surgical risk white matter white matter injury

项目摘要

Brain Injury and Dysmaturation in Newborns with Congenital Heart Disease Born Preterm. Abstract: Preterm birth and congenital heart disease (CHD) are two of the most common sources of perinatal morbidity in high resource countries. Both conditions are associated with acquired brain injury and adverse neurodevelopmental outcomes. Very little is known about the combined risk for newborns with congenital heart disease that are born preterm and how this risk is affected by variable approaches to palliative or definitive surgical strategies to repair heart defects. In addition to brain injury, an increasing number of genetic anomalies have been identified in CHD that may contribute to ND outcomes. Our extensive experience imaging term babies with CHD and preterm babies without CHD, combined with high and increasing volume of this vulnerable population at our two centers uniquely positions us to describe the risk and magnitude of acquired brain injury as well as comparative brain development in CHD newborns born preterm with respect to intervention strategies. Our long-term goal is to optimize neurodevelopmental outcomes. In this proposal, we will leverage cross-center practice variability in timing and choice of surgical interventions, palliative versus definitive, to determine the association of surgical intervention strategy with brain development and risk of brain injury. We will also perform a comprehensive genetic evaluation to determine how genetic anomalies alter susceptibility to brain injury and ND outcome.

早产先天性心脏病新生儿的脑损伤和发育不良。抽象的：早产和先天性心脏病 (CHD) 是围产期发病率的两个最常见来源在资源丰富的国家。这两种情况都与获得性脑损伤和不良反应有关神经发育结果。对于先天性新生儿的综合风险知之甚少早产心脏病以及不同的姑息或治疗方法如何影响这种风险修复心脏缺陷的明确手术策略。除了脑损伤外，越来越多的遗传因素已发现先心病中可能导致 ND 结果的异常。我们丰富的经验对患有 CHD 的足月婴儿和无 CHD 的早产儿进行成像，并结合大量且不断增加的我们两个中心的弱势群体使我们能够独特地描述风险和严重程度早产先天性心脏病新生儿获得性脑损伤以及相对脑发育干预策略。我们的长期目标是优化神经发育结果。在这个提案中，我们将利用手术干预时间和选择的跨中心实践差异，姑息治疗与明确的，以确定手术干预策略与大脑发育和大脑风险的关系受伤。我们还将进行全面的遗传评估，以确定遗传异常如何改变对脑损伤和 ND 结果的易感性。