A Reductive Metabolic Switch Protects Infants with Transposition of Great Arteries Undergoing Atrial Septostomy against Oxidative Stress
José David Piñeiro-Ramos,
Otto Rahkonen,
Virpi Korpioja,
Guillermo Quintás,
Jaana Pihkala,
Olli Pitkänen-Argillander,
Paula Rautiainen,
Sture Andersson,
Julia Kuligowski,
Máximo Vento
Affiliations
José David Piñeiro-Ramos
Neonatal Research Unit, Health Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
Otto Rahkonen
Department of Paediatric Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland
Virpi Korpioja
Department of Children and Adolescents, Oulu University Hospital, P.O. Box 23, FIN-90029 OYS, 90570 Oulu, Finland
Guillermo Quintás
Health & Biomedicine Unit, Leitat Technological Center, Par Cientific Barcelona, 08028 Barcelona, Spain
Jaana Pihkala
Department of Paediatric Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland
Olli Pitkänen-Argillander
Department of Paediatric Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland
Paula Rautiainen
Department of Anaesthesia and Intensive Care, New Children’s Hospital, Helsinki University Hospital and University of Helsinki, Stenbackinkatu 9, 00029 Helsinki, Finland
Sture Andersson
Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital and University of Helsinki, Stenbackinkatu 9, 00029 Helsinki, Finland
Julia Kuligowski
Neonatal Research Unit, Health Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
Máximo Vento
Neonatal Research Unit, Health Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
Transposition of the great arteries (TGA) is one of the most common cyanotic congenital heart diseases requiring neonatal surgical intervention. Parallel circulations that result in impaired cerebral oxygen delivery already in utero may lead to brain damage and long-term neurodevelopmental delay. Balloon atrial septostomy (BAS) is often employed to mix deoxygenated and oxygenated blood at the atrial level. However, BAS causes a sudden increase in arterial blood oxygenation and oxidative stress. We studied changes in oxygen saturation as well as metabolic profiles of plasma samples from nine newborn infants suffering from TGA before and until 48 h after undergoing BAS. The plasma metabolome clearly changed over time and alterations of four metabolic pathways, including the pentose phosphate pathway, were linked to changes in the cerebral tissue oxygen extraction. In contrast, no changes in levels of lipid peroxidation biomarkers over time were observed. These observations suggest that metabolic adaptations buffer the free radical burst triggered by re-oxygenation, thereby avoiding structural damage at the macromolecular level. This study enhances our understanding of the complex response of infants with TGA to changes in oxygenation induced by BAS.
