# Placental hemodynamic effects on brain development in infants with congenital heart disease

> **NIH NIH K23** · UT SOUTHWESTERN MEDICAL CENTER · 2022 · $194,384

## Abstract

Rachel Leon, MD, PhD is a Neonatal-Perinatal Medicine physician with a PhD in neuroscience at UT
Southwestern Medical Center (UTSW). Her goal is to become an independently funded investigator with
expertise in neuroplacentology, a field that focuses on elucidating mechanisms of placental influence on fetal
brain development. She plans to study placental and cerebrovascular hemodynamics in fetuses with congenital
heart disease (CHD) using advanced imaging techniques. In pregnant people with fetuses diagnosed with left or
right ventricular outflow tract obstruction CHD (LVOTO and RVOTO, respectively), and healthy controls, her
specific aims are to 1) evaluate placental perfusion longitudinally and determine associated differences in
placental size and histopathology, 2) determine the impact of placental perfusion on cerebral autoregulation from
the fetal period to the early postnatal adaptation, and 3) determine how placental perfusion affects the trajectory
of regional brain growth. Dr. Leon will combine arterial spin labeling magnetic resonance imaging (MRI) to
determine placental perfusion at two timepoints in pregnancy with pathologic evaluation of placentas to explore
histopathologic underpinnings of perfusion abnormalities. Using serial Doppler ultrasound of the middle cerebral
and umbilical arteries, as well as postnatal cerebral near infrared spectroscopy and blood pressure, she will
determine the maturational changes of cerebral autoregulation from prenatal to postnatal life, and how this
relates to placental perfusion. She will perform fetal brain MRI twice prenatally and again in the early postnatal
period to determine the relationship of placental perfusion to the trajectory of regional brain growth. Dr. Leon’s
innovative approach to studying the CHD placenta-brain connection will elucidate possible pathophysiologic
mechanisms for impaired brain development in the CHD population, a necessary first step for the discovery of
targeted fetal interventions. Dr. Leon has assembled a multidisciplinary team of mentors and collaborators with
expertise in key areas: cerebral autoregulation (Lina Chalak, MD), advanced placental and fetal imaging (Diane
Twickler, MD and Ashok Panigrahy, MD), placental physiology (Catherine Spong, MD and Dinesh Rakheja, MD),
and CHD (Mohammad Tarique Hussain, MD, PhD). The UTSW hospital system and its strong clinical research
operation are the ideal environment to conduct the proposed studies with their robust Fetal Heart Program, a
dedicated Center for Translational Medicine, and a strong record of clinical research participation. Dr. Leon’s
Career Development Plan includes a comprehensive strategy to address the specific key training goals that
will allow her to establish her research program, including 1) gaining expertise in advanced fetal brain and
placental MRI techniques and their correlation to pathophysiology, 2) developing expertise in the maturation of
cerebral autoregulatory mechanisms and analytical too...

## Key facts

- **NIH application ID:** 10525213
- **Project number:** 1K23HL161617-01A1
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** Rachel L Leon
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $194,384
- **Award type:** 1
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10525213

## Citation

> US National Institutes of Health, RePORTER application 10525213, Placental hemodynamic effects on brain development in infants with congenital heart disease (1K23HL161617-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10525213. Licensed CC0.

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