@article{6a8be2f5042d4277a2289a04f096295a,
title = "OSA and Neurocognitive Impairment in Children With Congenital Heart Disease",
abstract = "Background: Children with congenital heart disease (CHD) have an increased risk of neurocognitive impairment. No prior studies have evaluated the role of OSA, which is associated with neurocognitive impairment in children without CHD. Research Question: Is OSA is associated with neurocognitive impairment in children with CHD? Study Design and Methods: Children aged 6 to 17 years with corrected moderate to complex CHD without syndromes that may affect neurocognition were recruited from the pediatric cardiology clinic. Participants underwent home sleep testing and neurocognitive testing, including a validated Intellectual Quotient (IQ) test as well as validated tests of memory (Paired Associates Learning test), executive function (Intra-Extra Dimensional set shift test), and attention (Simple Reaction Test) from the CANTAB neurocognitive testing battery. Results: Complete results were available for 30 children. Seventeen children (57%) were found to have OSA. Total IQ was markedly lower in children with CHD and comorbid OSA compared with children with CHD without comorbid OSA (mean, 86 ± 12 vs 98 ± 11; P = .01). Children with CHD and OSA did significantly worse on the Paired Associates Learning test, with a median of eight total errors (interquartile range [IQR], 2.25-15) compared with children with CHD without OSA (median total errors, 2, IQR, 1-8; P = .02). Interpretation: Children with CHD and comorbid OSA have impaired neurocognition compared with children with CHD without comorbid OSA. OSA may be a reversible cause of neurocognitive impairment in children with CHD. Further research is needed to evaluate the effects of OSA treatment on neurocognitive impairment in children with CHD.",
keywords = "OSA, cognitive function, congenital heart, pediatric cardiology",
author = "Daniel Combs and Edgin, {Jamie O.} and Scott Klewer and Barber, {Brent J.} and Morgan, {Wayne J.} and Hsu, {Chiu Hsieh} and Ivo Abraham and Sairam Parthasarathy",
note = "Funding Information: Financial/nonfinancial disclosures: The authors have reported to CHEST the following: J. O. E. consults for Ovid Therapeutics and reports grants from the Arizona Alzheimer's Research Consortium, the LuMind Foundation, and the National Institutes of Health ( HD088409 ). W. J. M. reports funding from NIH, the Cystic Fibrosis Foundation , consultant fees from the Cystic Fibrosis Foundation and Genentech Inc., and speaker honoraria from the American Thoracic Society and the American College of Chest Physicians. These relationships are unrelated to this paper. I. A. reports grants, contracts, and fellowships from various institutes of the NIH, Health Resources and Services Administration, Agency for Healthcare Research and Quality, Flemish Ministry of Research and Innovation, the Belgian Ministry of Health, Saudi Arabian Cultural Mission , W.K. Kellogg Foundation , Pew Charitable Trusts, John A. Hartford Foundation , Cleveland Foundation , American Society of Health-System Pharmacists Foundation, Adolph Coors Foundation, National Science Council of Taiwan, Japan Society for the Promotion of Science, Swiss Federal Agency for Social Insurance, and the University Healthsystem Consortium. I. A. is a partner in Matrix45 and was a partner in The Epsilon Group and Health Sciences Development, which provide research and consulting services to the health and life sciences industries. By company policy, he is prohibited from owning equity in, providing services independently to, or receiving compensation independently from sponsoring companies. Matrix45 provides services on a nonexclusivity basis. I. A. is an equity shareholder in Belgamis, ExAnte International, and TheraSolve. Dr Parthasarathy reports grants from ASMF (169-SR-17), NIH/NHLBI (HL13877, HL126140), grants from Patient-Centered Outcomes Research Institute (IHS-1306-2505, EAIN #3394-UoA , PPRND-1507-31666), grants from US Department of Defense, grants from NIH/NCI (1R21CA184920), grants from Johrei Institute, personal fees from American Academy of Sleep Medicine , personal fees from UpToDate Inc., grants from Younes Sleep Technologies, Ltd., grants from Niveus Medical Inc., personal fees from Vapotherm, Inc., personal fees from Merck, Inc., grants from Philips-Respironics, Inc., personal fees from Philips-Respironics, Inc., personal fees from Bayer, Inc. outside the submitted work. In addition, Dr. Parthasarathy has a patent UA 14-018 U.S.S.N. 61/884,654; PTAS 502570970 (Home breathing device) issued. None declared (D. C., S. K., B. J. B., C.-H. H.). Funding Information: FUNDING/SUPPORT: Funding for this project was provided by an American Academy of Sleep Medicine Foundation Jr Faculty award, American Heart Association Career Development Award ( 19CDA34740005 ), National Institutes of Health ( R61HL151254 ), and a University of Arizona Health Sciences Career Development Award to Dr Combs. Funding Information: FUNDING/SUPPORT: Funding for this project was provided by an American Academy of Sleep Medicine Foundation Jr Faculty award, American Heart Association Career Development Award (19CDA34740005), National Institutes of Health (R61HL151254), and a University of Arizona Health Sciences Career Development Award to Dr Combs.Author contributions: D. C. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. D. C. J. O. E. S. K. B. J. B. W. J. M. C. H. H. I. A. and S. P. contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: J. O. E. consults for Ovid Therapeutics and reports grants from the Arizona Alzheimer's Research Consortium, the LuMind Foundation, and the National Institutes of Health (HD088409). W. J. M. reports funding from NIH, the Cystic Fibrosis Foundation, consultant fees from the Cystic Fibrosis Foundation and Genentech Inc. and speaker honoraria from the American Thoracic Society and the American College of Chest Physicians. These relationships are unrelated to this paper. I. A. reports grants, contracts, and fellowships from various institutes of the NIH, Health Resources and Services Administration, Agency for Healthcare Research and Quality, Flemish Ministry of Research and Innovation, the Belgian Ministry of Health, Saudi Arabian Cultural Mission, W.K. Kellogg Foundation, Pew Charitable Trusts, John A. Hartford Foundation, Cleveland Foundation, American Society of Health-System Pharmacists Foundation, Adolph Coors Foundation, National Science Council of Taiwan, Japan Society for the Promotion of Science, Swiss Federal Agency for Social Insurance, and the University Healthsystem Consortium. I. A. is a partner in Matrix45 and was a partner in The Epsilon Group and Health Sciences Development, which provide research and consulting services to the health and life sciences industries. By company policy, he is prohibited from owning equity in, providing services independently to, or receiving compensation independently from sponsoring companies. Matrix45 provides services on a nonexclusivity basis. I. A. is an equity shareholder in Belgamis, ExAnte International, and TheraSolve. Dr Parthasarathy reports grants from ASMF (169-SR-17), NIH/NHLBI (HL13877, HL126140), grants from Patient-Centered Outcomes Research Institute (IHS-1306-2505, EAIN #3394-UoA, PPRND-1507-31666), grants from US Department of Defense, grants from NIH/NCI (1R21CA184920), grants from Johrei Institute, personal fees from American Academy of Sleep Medicine, personal fees from UpToDate Inc. grants from Younes Sleep Technologies, Ltd. grants from Niveus Medical Inc. personal fees from Vapotherm, Inc. personal fees from Merck, Inc. grants from Philips-Respironics, Inc. personal fees from Philips-Respironics, Inc. personal fees from Bayer, Inc. outside the submitted work. In addition, Dr. Parthasarathy has a patent UA 14-018 U.S.S.N. 61/884,654; PTAS 502570970 (Home breathing device) issued. None declared (D. C. S. K. B. J. B. C.-H. H.). Role of the sponsors: The sponsors (American Academy of Sleep Medicine Foundation, American Heart Association, National Institutes of Health, and University of Arizona Health Sciences) had no input into study design or manuscript development. Other contributions: The authors are grateful for participants who volunteered their time. Additionally, data from the TuCASA study was used with permission of Stuart Quan, MD. Publisher Copyright: {\textcopyright} 2020 American College of Chest Physicians",
year = "2020",
month = sep,
doi = "10.1016/j.chest.2020.03.021",
language = "English (US)",
volume = "158",
pages = "1208--1217",
journal = "CHEST",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "3",
}