Background

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Children with TOF would be confronted with neurological impairment across their lifetime. Our study aimed to identify the risk factors for cerebral morphology changes and cognition in postoperative preschool-aged children with TOF.

Methods

We used mass spectrometry (MS) technology to assess the levels of serum metabolites, Wechsler preschool and primary scale of intelligence-Fourth edition (WPPSI-IV) index scores to evaluate neurodevelopmental levels and multimodal magnetic resonance imaging (MRI) to detect cortical morphological changes.

Results

Multiple linear regression showed that preoperative levels of serum cortisone were positively correlated with the gyrification index of the left inferior parietal gyrus in children with TOF and negatively related to their lower visual spaces index and nonverbal index. Meanwhile, preoperative SpO₂ was negatively correlated with levels of serum cortisone after adjusting for all covariates. Furthermore, after intervening levels of cortisone in chronic hypoxic model mice, total brain volumes were reduced at both postnatal (P) 11.5 and P30 days.

Conclusions

Our results suggest that preoperative serum cortisone levels could be used as a biomarker of neurodevelopmental impairment in children with TOF. Our study findings emphasized that preoperative levels of cortisone could influence cerebral development and cognition abilities in children with TOF.

中文翻译：

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术前血清可的松水平与学龄前法洛四联症矫正手术后儿童的认知相关：来自人群和小鼠的新证据

背景

法洛四联症（TOF）是最常见的紫绀型先天性心脏病。患有 TOF 的儿童一生中都会面临神经损伤。我们的研究旨在确定 TOF 术后学龄前儿童脑形态变化和认知的危险因素。

方法

我们使用质谱（MS）技术评估血清代谢物水平，使用韦氏学龄前和初级智力量表第四版（WPPSI-IV）指数评分评估神经发育水平，并使用多模态磁共振成像（MRI）检测皮质形态变化。

结果

多元线性回归显示TOF患儿术前血清可的松水平与左顶下回回旋指数呈正相关，与下视空间指数和非语言指数呈负相关。同时，调整所有协变量后，术前 SpO ₂与血清可的松水平呈负相关。此外，对慢性缺氧模型小鼠进行可的松干预后，出生后 (P) 11.5 和 P30 天的总脑容量均减少。

结论

我们的结果表明，术前血清可的松水平可以作为 TOF 儿童神经发育障碍的生物标志物。我们的研究结果强调，术前可的松水平可能会影响 TOF 儿童的大脑发育和认知能力。