Department of Psychology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
J Heart Lung Transplant. 2010 Jul;29(7):764-70. doi: 10.1016/j.healun.2010.02.008. Epub 2010 Apr 24.
Pediatric heart transplant recipients exhibit cognitive delays, as evident in assessments of their general intelligence. Less is known about their specific neurocognitive impairments.
All 19 children in Finland aged 6 to 16 years who had undergone heart transplantation (HTx) participated. Of these, 12 (63%) had cardiomyopathy (CM) and 7 (37%) had congenital heart disease (CHD). They were assessed on average 5.5 (SD, 3.6) years post-operatively at a mean age of 12.0 (SD, 3.1) years. A standardized test of intelligence (Wechsler Intelligence Scale for Children [WISC]-III), a neuropsychological test battery (NEPSY-II), and a parental developmental questionnaire (FTF) were administered. The neuropsychological test profile of the HTx group was compared with that of a matched control group.
HTx children had a lower mean Performance Intelligence Quotient (PIQ; 82.2, p = 0.001) and Full-Scale IQ (FSIQ; 85.6, p = 0.004) compared with population norms. HTx children scored generally lower than the control group on the neuropsychological tests (p = 0.002). Seven patients with pre-HTx neurologic sequelae (n = 6) or extreme prematurity (n = 1) had lower mean FSIQ (72.1) than did children without major pre-HTx risk factors (93.5, p = 0.012). The latter group scored below average on only 1 of 6 WISC-III sub-tests and 2 of 10 NEPSY-II sub-tests, all measuring visuoconstructional performance.
Children without major neurologic risk factors pre-HTx may have normal general intelligence after HTx but deficits in the visuoconstructional domain.
儿科心脏移植受者表现出认知延迟，这在他们的一般智力评估中显而易见。他们的具体神经认知障碍知之甚少。
芬兰所有 19 名年龄在 6 至 16 岁之间接受心脏移植（HTx）的儿童均参与了研究。其中，12 名（63%）患有心肌病（CM），7 名（37%）患有先天性心脏病（CHD）。他们在平均 5.5（SD，3.6）年后进行了术后评估，平均年龄为 12.0（SD，3.1）岁。进行了标准化智力测试（韦氏儿童智力量表 [WISC]-III）、神经心理学测试套件（NEPSY-II）和父母发育问卷（FTF）。将 HTx 组的神经心理学测试结果与匹配的对照组进行比较。
与人群正常值相比，HTx 儿童的表现智商（PIQ；82.2，p = 0.001）和全量表智商（FSIQ；85.6，p = 0.004）均较低。与对照组相比，HTx 儿童在神经心理学测试中的得分普遍较低（p = 0.002）。6 名有 HTx 前神经后遗症（n = 6）或极端早产（n = 1）的患者的平均 FSIQ（72.1）低于无重大 HTx 前风险因素的儿童（93.5，p = 0.012）。后一组仅在 6 项 WISC-III 分项测试中的 1 项和 10 项 NEPSY-II 分项测试中的 2 项中得分低于平均水平，所有这些测试均测量视觉建构表现。
无重大 HTx 前神经风险因素的儿童在 HTx 后可能具有正常的一般智力，但在视觉建构领域存在缺陷。
