Adrenomedullin Blood Concentrations in Infants Subjected to Cardiopulmonary Bypass: Correlation with Monitoring Parameters and Prediction of Poor Neurological Outcome

Florio, Pasquale; Abella, Raúl; Marinoni, Emanuela; Iorio, Raffaele; Letizia, Claudio; Meli, Marco; Torre, Teresa de la; Cazzaniga, Alessandro; Giamberti, Alessandro; Frigiola, Alessandro; Gazzolo, Diego

doi:10.1373/clinchem.2007.087700

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…In congenital heart disease (CHD) term newborns complicated (n = 40) or not (n = 10) by adverse 1-year neurological outcome, decreased AM levels were observed in neurologically abnormal infants. At a cut-off of 17.4 ng/L, AM as a predictor of neurological abnormalities achieved a sensitivity of 100%, a specificity of 73.0%, and positive (PLHr) and negative (NLHr) likelihood ratios of 3.7 and 0.0, respectively [41]. Furthermore, in CHD infants complicated (n = 9) or not (n = 48) by intra-operative low cardiac output syndrome (LCOS), Abella et al found lower AM in LCOS infants.…”

Section: Bloodmentioning

confidence: 99%

Early predictors of perinatal brain damage: the role of neurobiomarkers

Bersani

Pluchinotta

Dotta

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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The early detection of perinatal brain damage in preterm and term newborns (i.e. intraventricular hemorrhage, periventricular leukomalacia and perinatal asphyxia) still constitute an unsolved issue. To date, despite technological improvement in standard perinatal monitoring procedures, decreasing the incidence of perinatal mortality, the perinatal morbidity pattern has a flat trend. Against this background, the measurement of brain constituents could be particularly useful in the early detection of cases at risk for short-/long-term brain injury. On this scenario, the main European and US international health-care institutions promoted perinatal clinical and experimental neuroprotection research projects aimed at validating and including a panel of biomarkers in the clinical guidelines. Although this is a promising attempt, there are several limitations that do not allow biomarkers to be included in standard monitoring procedures. The main limitations are: (i) the heterogeneity of neurological complications in the perinatal period, (ii) the small cohort sizes, (iii) the lack of multicenter investigations, (iv) the different techniques for neurobiomarkers assessment, (iv) the lack of consensus for the validation of assays in biological fluids such as urine and saliva, and (v), the lack of reference curves according to measurement technique and biological fluid. In the present review we offer an up-to-date overview of the most promising developments in the use of biomarkers in the perinatal period such as calcium binding proteins (S100B protein), vasoactive agents (adrenomedullin), brain biomarkers (activin A, neuron specific enolase, glial fibrillary acidic protein, ubiquitin carboxyl-terminal hydrolase-L1) and oxidative stress markers.

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Section: Bloodmentioning

confidence: 99%

Early predictors of perinatal brain damage: the role of neurobiomarkers

Bersani

Pluchinotta

Dotta

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Results reported the highest MCA PI values and lowest AM levels, at the end of CPB and of the surgical procedure, in brain damaged patients. As single markers able to predict neurological abnormalities, AM achieved a sensitivity of 100% and a specificity of 73.0%, whilst MCA PI reached a sensitivity of 100% and a specificity of 56.8% [178].…”

Section: Adrenomedullinmentioning

confidence: 98%

“…In addition, a tiny increment in AM plasma levels, it has been reported between the coronary sinus and aorta in heart failure [174], suggesting a putative cardiac involvement in the incresead levels observed in such disease. In according with this finding is AM immunoreactivity and gene expression increase in the cardiac ventricles of animals and patients with heart failure [174][175][176][177][178]. In a heart failure rat model, it has been shown that the main source cardiac AM might be myocardial blood vessels [174][175][176][177][178].…”

Section: Adrenomedullinmentioning

confidence: 99%

“…Finally, Florio et al [178], in CHD 50 infants (age <1 year), investigated whether CPB affects cerebrovascular resistance (Doppler velocimetry waveform patterns in middle cerebral artery, MCA PI) and AM plasma levels in samples collected at five predetermined timepoints (before surgery, during surgery before CPB, at the end of CPB, at the end of surgery, and at 12 h after surgery). Primary endpoint was the occurrence of brain injury at 2-year follow-up.…”

Section: Adrenomedullinmentioning

confidence: 99%

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Biochemical Markers for Brain Injury Monitoring in Children with or without Congenital Heart Diseases

Abella

Varrica

Satriano

et al. 2015

CNSNDDT

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Perinatal asphyxia (PA) still constitutes a common complication involving a large number of infants with or without congenital heart diseases (CHD). PA affects 0.2-0.6% of full-term neonates, 20% of which suffer mortal hypoxic-ischemic encephalopathy, and among survivors 25% exhibit permanent consequences at neuropsychological level. Each year, about one third of 1000 live births underwent to surgical intervention in early infancy and/or are at risk for ominous outcome. Advances in brain monitoring, in anesthetic and cardiothoracic surgical techniques, including selective or total body cooling, cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest, have essentially reduced mortality expanding the possibility to address functional neurologic and cardiac outcomes in long-term survivors. However, open-heart surgery constitutes a time-frame of planned ischemia-reperfusion injury, which is a price to pay in the treatment or palliation of CHD. Infants who underwent heart surgery and non-CHD infants complicated by PA share similarities in their neurodevelopmental profile and a common form of brain damage due to hypoxic-ischemic injury. The purpose of the present review was to evaluate different mechanisms implicated in brain injury following CPB and PA and how it is possible to monitor such injury by means of available biomarkers (S100B protein, Activin A, Adrenomedullin).

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“…Hilar SRIF interneurons undergo extensive degeneration in patients with hippocampal sclerosis (de Lanerolle et al, 1989; Robbins et al, 1991). Recently, this selective neurodegeneration has been linked to the specific enrichment of somatostatinergic neurons in striatum-enriched phosphatase, an enzyme that counteracts the MAPK neuroprotective pathway (Choi et al, 2007; Florio et al, 2008). SRIF receptors may represent potential therapeutic targets for TLE.…”

Section: Somatostatinergic Network In Pathological Conditionsmentioning

confidence: 99%

Somatostatinergic systems: an update on brain functions in normal and pathological aging

et al. 2012

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Somatostatin is highly expressed in mammalian brain and is involved in many brain functions such as motor activity, sleep, sensory, and cognitive processes. Five somatostatin receptors have been described: sst1, sst2 (A and B), sst3, sst4, and sst5, all belonging to the G-protein-coupled receptor family. During the recent years, numerous studies contributed to clarify the role of somatostatin systems, especially long-range somatostatinergic interneurons, in several functions they have been previously involved in. New advances have also been made on the alterations of somatostatinergic systems in several brain diseases and on the potential therapeutic target they represent in these pathologies.

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Adrenomedullin Blood Concentrations in Infants Subjected to Cardiopulmonary Bypass: Correlation with Monitoring Parameters and Prediction of Poor Neurological Outcome

Cited by 14 publications

References 14 publications

Early predictors of perinatal brain damage: the role of neurobiomarkers

Early predictors of perinatal brain damage: the role of neurobiomarkers

Biochemical Markers for Brain Injury Monitoring in Children with or without Congenital Heart Diseases

Somatostatinergic systems: an update on brain functions in normal and pathological aging

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