Association of Cerebrovascular Stability Index and Head Circumference Between Infants With and Without Congenital Heart Disease

Nhu N. Tran*, Michelle Tran, Ashok Panigrahy, Ken M. Brady, Jodie K. Votava-Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Congenital heart disease (CHD) is a common birth defect in the United States. CHD infants are more likely to have smaller head circumference and neurodevelopmental delays; however, the cause is unknown. Altered cerebrovascular hemodynamics may contribute to neurologic abnormalities, such as smaller head circumference, thus we created a novel Cerebrovascular Stability Index (CSI), as a surrogate for cerebral autoregulation. We hypothesized that CHD infants would have an association between CSI and head circumference. We performed a prospective, longitudinal study in CHD infants and healthy controls. We measured CSI and head circumference at 4 time points (newborn, 3, 6, 9 months). We calculated CSI by subtracting the average 2-min sitting from supine cerebral oxygenation (rcSO2) over three consecutive tilts (0–90°), then averaged the change score for each age. Linear regressions quantified the relationship between CSI and head circumference. We performed 177 assessments in total (80 healthy controls, 97 CHD infants). The average head circumference was smaller in CHD infants (39.2 cm) compared to healthy controls (41.6 cm) (p < 0.001) and head circumference increased by 0.27 cm as CSI improved in the sample (p = 0.04) overall when combining all time points. Similarly, head circumference increased by 0.32 cm as CSI improved among CHD infants (p = 0.04). We found CSI significantly associated with head circumference in our sample overall and CHD infants alone, which suggests that impaired CSI may affect brain size in CHD infants. Future studies are needed to better understand the mechanism of interaction between CSI and brain growth.

Original languageEnglish (US)
Pages (from-to)1624-1630
Number of pages7
JournalPediatric cardiology
Issue number7
StatePublished - Oct 2022


  • Cerebrovascular Stability Index
  • Congenital heart disease
  • Head circumference
  • Infants
  • Near infrared spectroscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health


Dive into the research topics of 'Association of Cerebrovascular Stability Index and Head Circumference Between Infants With and Without Congenital Heart Disease'. Together they form a unique fingerprint.

Cite this