Serologic Markers of Brain Injury and Cognitive Function After Cardiopulmonary Bypass

Ramlawi, Basel; Rudolph, James L.; Mieno, Shigetoshi; Khabbaz, Kamal R.; Sodha, Neel R.; Boodhwani, Munir; Levkoff, Sue E.; Marcantonio, Edward R.; Sellke, Frank W.

doi:10.1097/01.sla.0000239087.00826.b4

Cited by 79 publications

(96 citation statements)

References 40 publications

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“…8) Ramlawi et al reported that serum NSE, one of the five isozymes of the glycolytic enzyme, appears to be another marker of brain injury. 9) NSE has a molecular weight of 78 kDa and is found in large amounts in neurons. 10) Different studies have demonstrated a good correlation between the s-100β protein 11) and NSE 12) levels and the neurocongnitive function, although other studies were unable to find evidence to support the hypothesis that early release of the s-100β protein may reflect short 13) or long-term 14) neurologic injury capable of producing cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

Release of Serum S-100.BETA. Protein and Neuron-Specific Enolase after Off-Pump Coronary Artery Bypass Grafting with and without Intracranial and Cervical Artery Stenosis

Tamura

Imamaki

Shimura

et al. 2011

ATCS

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Purpose: The aim of this study was to quantify the amount of brain damage suffered by patients who underwent off-pump coronary artery bypass grafting (OPCAB) in which S-100β protein and neuron-specific enolase were used. Methods: Thirty-four patients undergoing scheduled OPCAB were enrolled in the study. The patients were divided into two groups according to the results of their magnetic resonance angiography (MRA) and cervical ultrasonography: 13 patients had cervical or intracranial arterial stenosis (Group A), and 21 patients did not (Group B). Blood samples were collected from the arterial catheters immediately before surgery, upon arrival to the intensive care unit, and 6 and 24 hours after surgery. Results: In blood samples collected from patients upon arrival to the intensive care unit, the maximum concentration of serum s-100β protein in Group A was significantly higher than that of Group B (p = 0.029). Though patients in Group A tended to have higher maximum neuron-specific enolase (NSE) concentrations, there were no significant differences in NSE concentrations at any point between the two groups. Conclusions: Our findings show a correlation between the stenosis detected by MRA or cervical ultrasonography and brain damage after OPCAB.

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Section: Discussionmentioning

confidence: 99%

Release of Serum S-100.BETA. Protein and Neuron-Specific Enolase after Off-Pump Coronary Artery Bypass Grafting with and without Intracranial and Cervical Artery Stenosis

Tamura

Imamaki

Shimura

et al. 2011

ATCS

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“…isturbed sleep and sleep-wake rhythms represent a major problem for patients after surgery 1 and may result in prolonged postoperative convalescence, 2 cardiovascular morbidity, [3][4][5] cognitive dysfunction, 6,7 and impaired immune function. [8][9][10][11] Furthermore, improved morbidity and mortality has been correlated with a more marked rest-activity rhythm.…”

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confidence: 99%

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Madsen

Rosenberg²,

Gögenur³

2013

Journal of Clinical Sleep Medicine

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Study Objectives: Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. methods: A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. Results: Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep effi ciency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery.Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. Conclusion: Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery. keywords: Actigraphy, surgery, sleep disturbances, sleepwake rhythm, and activity Citation: Madsen MT; Rosenberg J; Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013;9(4):387-394.http://dx.doi.org/10.5664/jcsm.2598 R e v I e W A R T I C l e D isturbed sleep and sleep-wake rhythms represent a major problem for patients after surgery 1 and may result in prolonged postoperative convalescence, 2 cardiovascular morbidity, 3-5 cognitive dysfunction, 6,7 and impaired immune function. [8][9][10][11] Furthermore, improved morbidity and mortality has been correlated with a more marked rest-activity rhythm. 12,13The golden standard for measuring sleep is polysomnography (PSG). Although ambulatory devices have been developed the method includes multiple electrodes, resulting in reduced mobility and discomfort.14 The analysis of a PSG recording is also resource demanding, 15 and there exists no automatic analysis scoring system with suffi cient reliability.16 An actigraph, which is a small wrist-worn device, can be used to measure sleep, circadian rhythm, activity rhythm, and activity in general. 17 The advantages of actigraphy are high level of mobility, 14 the possibility of measuring over longer periods of time (days to months), 18 low cost, 18 and minimal data editing required for data analysis. 15,19 Actigraphy has been validated against polysomnography with high levels of sensitivity and specifi city in various nonsurgical patient populations. 17,18,20,21 In this systematic review, we present an overview of studies where actigraphy has been used to describe sleep and sleep-wake rhythms in relation to surgery, including patients undergoing cardiac surgery, general surgery, and ambulatory surgery. The strengths and weaknesses of actigraphy...

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“…In patients with ischemic stroke, the release of NSE has been associated with neurological outcomes and infarct volume (17,18,27). Increased NSE level is significant associated with postoperative neurocognitive dysfunction (28).…”

Section: Discussionmentioning

confidence: 99%

Cardio-ankle vascular index may be an important marker of silent neuronal injury after percutaneous coronary angiography and intervention: a prospective observational study on diagnostic accuracy

Aykan¹,

Gökdeniz²,

Bektaş³

et al. 2014

Anadolu Kardiyol Derg

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Objective: The relationship between silent neuronal injury (SNI) and arterial stiffness assessed by cardio-ankle vascular index (CAVI) has not been evaluated in patients treated with coronary angiography and intervention due to acute coronary syndrome (ACS). The aim of this study is to evaluate the value of CAVI in prediction of SNI after percutaneous coronary angiography and intervention in patients presented with ACS. Methods: Eighty-three consecutive patients presented with ACS, who underwent percutaneous coronary angiography and intervention, were included in this prospective observational study on diagnostic accuracy. Neuron specific enolase (NSE) was studied before and 18 hour after the coronary angiography and intervention. CAVI was measured by VaSera-1000 instrument. Clinical and echocardiographic characteristics were analyzed and independent predictors of SNI were evaluated. Chi-square, Student t-test, Mann-Whithney U test, correlation analysis and logistic regression analysis was used for statistical analysis. Results: NSE levels significantly increased after cardiac catheterization (9.82±3.22 mg/dL vs. 13.15±8.55 mg/dL, p<0.001). CAVI (OR=2.992, 95% CI: 1.494-5.713, p=0.002), left ventricular ejection fraction (LVEF) (OR=0.911, 95% CI: 0.843-0.983, p=0.017) and undergoing percutaneous coronary intervention (OR=4.430, 95% CI: 1.034-18.97, p=0.045) were the independent predictors of SNI in logistic regression analysis. The cut-off value to show SNI for CAVI was 10.45 (sensitivity=71.8%, specificity=91.5%) in receiver operator charecteristic (ROC) curve analysis. The area under curve was 0.832 (95% CI=0.746-0.918, p<0.001). Conclusion: Besides undergoing PCI and having LVEF, measurement of CAVI may be a useful tool for predicting the development of SNI after percutaneous coronary angiography and intervention in patients with ACS. (Anadolu Kardiyol Derg 2014; 14: 606-11)

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Serologic Markers of Brain Injury and Cognitive Function After Cardiopulmonary Bypass

Abstract: NSE and tau are better associated with NCD and less influenced by cardiotomy suction compared with S-100beta. Inflammatory and oxidative stress is associated with NCD post-CPB.

Cited by 79 publications

References 40 publications

Release of Serum S-100.BETA. Protein and Neuron-Specific Enolase after Off-Pump Coronary Artery Bypass Grafting with and without Intracranial and Cervical Artery Stenosis

Release of Serum S-100.BETA. Protein and Neuron-Specific Enolase after Off-Pump Coronary Artery Bypass Grafting with and without Intracranial and Cervical Artery Stenosis

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Cardio-ankle vascular index may be an important marker of silent neuronal injury after percutaneous coronary angiography and intervention: a prospective observational study on diagnostic accuracy

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