@Article{chd.12678,
AUTHOR = {Nurdan Ozturk Tasar, Pelin Kosger, Nevzat Uzuner, Birsen Ucar},
TITLE = {Alterations in cerebral blood flow in children with congestive heart failure due to ventricular septal defect},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {6},
PAGES = {1038--1044},
URL = {http://www.techscience.com/schd/v13n6/39087},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> We aimed to investigate the effect of ventricular septal defect (VSD) and 
heart failure on cerebral blood flow (CBF) in children, whether heart failure treatment improves CBF, and if there is any relationship between CBF and serum N‐
terminal pro‐brain natriuretic peptide (NT‐proBNP) level.<br/>
<b>Method:</b> Forty children with VSD (13 with heart failure) aged between 1 and 
36 months were studied. The control group comprised 25 healthy children in the 
same age group. Maximum, minimum, and mean blood flow velocities and pulsatility 
indices of the right and left middle cerebral arteries were assessed using transcranial 
Doppler ultrasonography. Measurements of CBF and serum NT‐proBNP levels were 
repeated in patients with heart failure a month post–heart failure treatment initiation. The groups were also compared in terms of defect diameters, cardiac structural 
changes, left ventricular systolic function, and findings related to pulmonary hypertension determined by echocardiography. Correlations between echocardiographic 
measurements and CBF parameters were analyzed.<br/>
<b>Results:</b> Although no significant difference was found between patient and control 
groups for CBF, right and left maximum CBF velocities significantly increased posttreatment in patients with heart failure (P = .04 and P = .01, respectively). Serum NT‐
proBNP levels in children with VSD associated with heart failure were significantly 
higher than those in children with VSD alone (P = .04) or in healthy children (P < .001). 
NT‐proBNP levels were negatively correlated with right and left maximum CBF velocities (r = −0.39, P = .013 and r = −0.32, P = .043, respectively).<br/>
<b>Conclusion:</b> Although no significant difference was found in CBF velocity among the 
study groups, increase in the CBF velocity post heart failure treatment and negative 
correlations between CBF velocity and both the VSD diameter and NT‐proBNP levels 
indicate that the hemodynamic status due to VSD associated with heart failure has 
an effect on CBF.},
DOI = {10.1111/chd.12678}
}