{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T04:31:08Z","timestamp":1784349068114,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"6-7","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 NS099422"],"award-info":[{"award-number":["K23 NS099422"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Fetuses with complex congenital heart disease have altered physiology, contributing to abnormal neurodevelopment. The effects of altered physiology on brain development have not been well studied. We used multi\u2010modal imaging to study fetal circulatory physiology and brain development in hypoplastic left heart syndrome (HLHS) and d\u2010transposition of the great arteries (TGA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective, cross\u2010sectional study investigated individuals with fetal congenital heart disease and controls undergoing fetal echocardiography and fetal brain MRI. MRI measured total brain volume and cerebral oxygenation by the MRI quantification method T2*. Indexed cardiac outputs (CCOi) and vascular impedances were calculated by fetal echocardiography. Descriptive statistics assessed MRI and echocardiogram measurement relationships by physiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010six participants enrolled (control\u00a0=\u00a020; HLHS\u00a0=\u00a025; TGA\u00a0=\u00a021), mean gestational age 33.8\u00a0weeks (95% CI: 33.3\u201334.2). Total brain volume and T2* were significantly lower in fetuses with cardiac disease. CCOi was lower in HLHS, correlating with total brain volume \u2010 for every 10% CCOi increase, volume increased 8\u00a0mm<jats:sup>3<\/jats:sup> (95% CI: 1.78\u201314.1; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012). Echocardiography parameters and cerebral oxygenation showed no correlation. TGA showed no CCOi or aortic output correlation with MRI measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In HLHS, lower cardiac output is deleterious to brain development. Our findings provide insight into the role of fetal cardiovascular physiology in brain health.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6450","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T04:41:58Z","timestamp":1697085718000},"page":"856-864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Fetal circulatory physiology and brain development in complex congenital heart disease: A multi\u2010modal imaging study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-5850","authenticated-orcid":false,"given":"Stephan","family":"Juergensen","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology Columbia University Vagelos College of Physicians and Surgeons and New York\u2010Presbyterian Morgan Stanley Children's Hospital  New York New York USA"},{"name":"Department of Pediatrics Division of Pediatric Cardiology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita 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