Clinical & Experimental Cardiology
Open Access

Neuropsychological Development of Children with Congenital Heart Disease: What does the Future Hold?

Shuantong Lin^1*, Juan Lu² and Jianyue Wang^{3 *}Correspondence: Shuantong Lin, Department of Anesthesioloy, Eastern Bund Healthcare, Shanghai, China, Email:

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Congenital Heart Disease (CHD) accounts for nearly one-third of all congenital birth defects and affects approximately 1 in 100 births each year in the United States [1]. A meta-analysis of 260 studies incorporating global data concluded that the prevalence of CHD continued to rise [2]. Nonindustrialized countries exhibited unfavorable or worsening risks for recent time periods and birth cohorts [3]. While 95% of children with simple CHD and 75% to 90% of children with complex CHD can survive into adulthood, approximately 50% of children with CHD experience neurocognitive deficits and impairments [4,5]. Nonindustrialized countries face challenges in the prevention and treatment of CHD [3].

Approximately 16% of children with CHD are born prematurely, with a 2-fold higher incidence of CHD among premature infants than among full-term infants [6]. As foetal echocardiogram became widely available, prenatal diagnosis of critical CHD became possible [7]. Although many factors, including surgical treatment, anesthetic medications and Intensive Care Unit (ICU) management, are related to the neuropsychological development of children with CHD, and examinations such as Magnetic Resonance Imaging (MRI) have clearly shown that these children exhibit abnormalities in brain structure development, the impact of genetic factors in children with CHD should not be overlooked. With the development of Massively Parallel Sequencing (MPS), researchers and diagnostic laboratories can now interrogate numerous genes simultaneously, up to the whole genome, to identify sequencing variants. As a result, diagnostic standards are rapidly evolving [8]. There is no doubt that the precise diagnosis of CHD is the first step in medical and interventional management.

Approximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women [9]. A study conducted by Chourpiliadis et al., involving 211200 individuals with a mean Standard Deviation (SD) follow-up of 21.0 (6.7) years suggested that 16256 individuals were diagnosed with depression, anxiety, or stress-related disorders [10]. There is a genetic association between congenital heart disease and autism, by exploring the shared genetic factors between CHD and autism, researchers may uncover common pathways involved in both conditions. This could lead to a better understanding of the biological processes contributing to CHD development and progression.

As the population with mental health disorders increases, whether parents experiencing heightened perceptual stress may lead to an increased probability of congenital heart disease in their offspring, as well as an increased likelihood of mental health disorders appearing in the offspring's lifetime, should warrant the attention of healthcare professionals.

The incidence of metabolic disorders such as diabetes mellitus and hyperlipidemia in children with CHD who have neurodevelopmental abnormalities throughout their lifespan still needs to be confirmed by long term follow-up studies. Comprehensive monitoring throughout the entire lifespan can help improve the prognosis and enhance the quality of life for children with CHD who have neurodevelopmental abnormalities.

Improvements in diagnosis and management have secured a higher quality for children with CHD, it is clear that comprehensive understanding of neuropsychological development should be implemented and the neuropsychological development could be modified by lifestyle and further advances in multidisciplinary collaboration.

References

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