{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:52:06Z","timestamp":1782442326467,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Beijing Laboratory for Cardiovascular Precision Medicine","award":["BZ116211"],"award-info":[{"award-number":["BZ116211"]}]},{"name":"Beijing Key Laboratory for Fetal Heart Disease of Maternal Fetal Medicine","award":["BZ0803"],"award-info":[{"award-number":["BZ0803"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Background and Objective<\/jats:title>It is hypothesized that diminished cerebral vascular resistance or the \u201cbrain sparing effect\u201d is associated with fetuses with complex congenital heart defects (CHD<\/jats:styled-content>) and may affect their neurodevelopmental outcome. An alternative explanation is that it is related to the location, cardiac output, pressure, and resistance in left heart obstructive CHD<\/jats:styled-content>s. We sought to determine the effects of various left and right heart obstructive defects on the cerebral and placental hemodynamics and to evaluate the utility of these variables for the assessment and prognosis of CHD<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 290 fetal echocardiograms were reviewed, including 91 fetuses with CHD<\/jats:styled-content> and 199 normal ones. The CHD<\/jats:styled-content> fetuses were divided into four groups, that is, left\u2010sided obstructive lesions (LSOL<\/jats:styled-content>), hypoplastic left heart syndrome (HLHS<\/jats:styled-content>), right\u2010sided obstructive lesions (RSOL<\/jats:styled-content>), and hypoplastic right heart syndrome (HRHS<\/jats:styled-content>). The pulsatility index of middle cerebral artery (MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content>) and umbilical artery (UA<\/jats:styled-content>\u2010PI<\/jats:styled-content>) were measured by pulse\u2010wave Doppler, and their Z scores were also derived. Cerebroplacental ratio (CPR<\/jats:styled-content>) was calculated as: CPR<\/jats:styled-content>=MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content>\/UA<\/jats:styled-content>\u2010PI<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>There was no significant difference in MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content> between the 4 CHD<\/jats:styled-content> and normal control groups (P<\/jats:italic>>.05). However, MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content> and Z score decreased in aortic stenosis but not in interrupted aortic arch or coarctation subgroups, whereas they increased in pulmonary atresia but not pulmonary stenosis or tetralogy of Fallot subgroups compared with normal group (P<\/jats:italic><.05). There was no significant difference in CPR<\/jats:styled-content> between any study group or subgroup and normal control group.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our study suggests MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content> is lower in aortic stenosis and high in pulmonary atresia but not significantly different in other LSOL<\/jats:styled-content>, HLHS<\/jats:styled-content>, RSOL<\/jats:styled-content>, and HRHS<\/jats:styled-content>. MCA<\/jats:styled-content>\u2010PI<\/jats:styled-content> regulation in CHD<\/jats:styled-content> is probably more associated with left and right outflow obstruction, location of the obstruction, and hemodynamics rather than \u201cbrain sparing effect\u201d or preferential shunting of blood to the fetal brain, heart, and adrenals in the stressed fetus (eg, IUGR<\/jats:styled-content>). CPR<\/jats:styled-content> may not be a sensitive measure for the effect of CHD<\/jats:styled-content>s and their severity on cerebral and placental circulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13572","type":"journal-article","created":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T17:16:31Z","timestamp":1514567791000},"page":"1867-1871","source":"Crossref","is-referenced-by-count":13,"title":["Cerebrovascular hemodynamics in fetuses with congenital heart disease"],"prefix":"10.1111","volume":"34","author":[{"given":"Tingting","family":"Man","sequence":"first","affiliation":[{"name":"Department of Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihua","family":"He","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-4329","authenticated-orcid":false,"given":"Shuping","family":"Ge","sequence":"additional","affiliation":[{"name":"Section of Cardiology St. Christopher's Hospital for Children and Drexel University College of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1785"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.547961"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000209203"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.045"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-002-0404-0"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000439527"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(87)90166-9"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(95)00025-M"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1990.18.3.165"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11147"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn233"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7474"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14798"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12448"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13373"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.13572","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.13572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T23:59:19Z","timestamp":1696031959000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.13572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/echo.13572"],"URL":"https:\/\/doi.org\/10.1111\/echo.13572","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12]]}}}