Structural brain abnormalities in adults with congenital heart disease: Prevalence and association with estimated intelligence quotient.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 05 2020
Historique:
received: 28 08 2019
revised: 18 01 2020
accepted: 23 02 2020
pubmed: 8 3 2020
medline: 20 5 2021
entrez: 8 3 2020
Statut: ppublish

Résumé

Little is known about the prevalence of structural brain abnormalities and cognitive functioning in the growing population of patients with adult congenital heart disease (ACHD). Thus, our aim was to assess structural abnormalities on brain magnetic resonance imaging (MRI) and their association with intelligence quotient (IQ) in ACHD patients. Cross-sectional study in ACHD patients and healthy controls as comparison group. Brain MRI was performed on a 3 T MR scanner, and inspection of structural abnormalities was performed blinded to ACHD or control status. IQ was estimated using the vocabulary and matrix reasoning subtests from the Wechsler Adult Intelligence Scale, Fourth Edition. A total number of 67 (55% males) ACHD patients and 55 (51% males) controls were included (mean age 26.9 and 26.0 years respectively). Abnormalities on brain MRI were detected in 29 of 46 (63%) ACHD patients and in none of the controls. Abnormalities consisted of focal infarction or atrophy, white matter lesions, microhemorrhages, and global atrophy. Mean estimated IQ was significantly lower in ACHD patients than in controls (98.51 versus 104.38; 95% CI: -10.09 to -1.66; P value = 0.007). Comparison between patients with and without cerebral abnormalities revealed no significant difference in estimated IQ. Our findings indicate a high prevalence and wide spectrum of structural brain abnormalities in ACHD patients. Furthermore, this population is at a higher risk of impaired intellectual functioning than healthy controls. However, the present study could not establish a statistically significant association between MRI findings and estimated IQ. ClinicalTrials.gov ID: NCT04041557; URL: https://clinicaltrials.gov/ct2/show/NCT04041557?term=NCT04041557&rank=1.

Sections du résumé

BACKGROUND
Little is known about the prevalence of structural brain abnormalities and cognitive functioning in the growing population of patients with adult congenital heart disease (ACHD). Thus, our aim was to assess structural abnormalities on brain magnetic resonance imaging (MRI) and their association with intelligence quotient (IQ) in ACHD patients.
METHODS
Cross-sectional study in ACHD patients and healthy controls as comparison group. Brain MRI was performed on a 3 T MR scanner, and inspection of structural abnormalities was performed blinded to ACHD or control status. IQ was estimated using the vocabulary and matrix reasoning subtests from the Wechsler Adult Intelligence Scale, Fourth Edition.
RESULTS
A total number of 67 (55% males) ACHD patients and 55 (51% males) controls were included (mean age 26.9 and 26.0 years respectively). Abnormalities on brain MRI were detected in 29 of 46 (63%) ACHD patients and in none of the controls. Abnormalities consisted of focal infarction or atrophy, white matter lesions, microhemorrhages, and global atrophy. Mean estimated IQ was significantly lower in ACHD patients than in controls (98.51 versus 104.38; 95% CI: -10.09 to -1.66; P value = 0.007). Comparison between patients with and without cerebral abnormalities revealed no significant difference in estimated IQ.
CONCLUSION
Our findings indicate a high prevalence and wide spectrum of structural brain abnormalities in ACHD patients. Furthermore, this population is at a higher risk of impaired intellectual functioning than healthy controls. However, the present study could not establish a statistically significant association between MRI findings and estimated IQ.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov ID: NCT04041557; URL: https://clinicaltrials.gov/ct2/show/NCT04041557?term=NCT04041557&rank=1.

Identifiants

pubmed: 32143921
pii: S0167-5273(19)34253-6
doi: 10.1016/j.ijcard.2020.02.061
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04041557']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

61-66

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Nora Kessler (N)

Child Development Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.

Maria Feldmann (M)

Child Development Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.

Ladina Schlosser (L)

Child Development Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland.

Sarah Rometsch (S)

Child Development Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland.

Peter Brugger (P)

Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland; Psychiatric University Clinic PUK, University Hospital Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Valens Rehabilitation Centre, Taminaplatz 1, 7317 Valens, Switzerland.

Raimund Kottke (R)

Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Diagnostic Imaging, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.

Walter Knirsch (W)

Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.

Angela Oxenius (A)

Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Matthias Greutmann (M)

Department of Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Beatrice Latal (B)

Child Development Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland. Electronic address: bea.latal@kispi.uzh.ch.

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Classifications MeSH