Clinical prospective study of biochemical markers and evoked potentials for identifying adverse neurological outcome after thoracic and thoracoabdominal aortic aneurysm surgery

Lases, E.C.; Schepens, Marc A.A.M.; Haas, Fred J. L. M.; Aarts, Leon; Beek, Huub T. ter; Dongen, Eric van; Siegers, H. P.; Tweel, I. van de; Boezeman, Eduard H.

doi:10.1093/bja/aei239

Cited by 23 publications

(21 citation statements)

References 31 publications

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“…The authors argued that surgical trauma itself may be responsible for serum S100B increments in the absence of central nervous injury. 66 A similar study showed that at 5 and 24 h after operation, S100B was significantly higher in patients who underwent hypothermic circulatory arrest than those who did not undergo circulatory arrest. 67 Furthermore, there was a positive correlation between duration of the circulatory arrest and the postoperative levels of the biomarker.…”

Section: S100b In Non-cardiac Surgerymentioning

confidence: 86%

“…An investigation of the predictive value of NSE from CSF and serum in patients undergoing aortic aneurysm repair concluded that neither NSE nor S100B could replace or add information to the transcranial motor-evoked potentials monitoring during surgery. 66 In a small cohort of patients who had descending thoracic or thoracoabdominal aorta repair, NSE concentrations in the CSF increased in patients with and without neurological symptoms 65 (Table 3). The increase in NSE after internal cardiac defibrillator implantation was associated with impaired attention and memory after operation.…”

Section: Nse In Non-cardiac Surgerymentioning

confidence: 99%

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Neurological biomarkers in the perioperative period

Cata

Abdelmalak

Farag

2011

British Journal of Anaesthesia

101

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The rapid detection and evaluation of patients presenting with perioperative neurological dysfunction is of great clinical relevance. Biomarkers have been defined as biological molecules that can be used as an indicator of new onset or progression of a biological process or effect of treatment. Biomarkers have become increasingly important in this setting to supplement other modalities of diagnosis such as EEG, sensory- or motor-evoked potential, transcranial Doppler, near-infrared spectroscopy, or imaging methods. A number of neuro-proteins have been identified and are currently under investigation for potential to provide insights into injury severity, outcome, and the ability to monitor cellular damage and molecular events that occur during neurological injury. S100B is a protein released by glial cells and is considered a marker of blood-brain barrier dysfunction. Clinical studies in patients undergoing cardiac and non-cardiac surgery indicate that serum levels of S100B are increased intraoperatively and after operation. The neurone-specific enolase has also been extensively investigated as a potential marker of neuronal injury in the context of cardiac and non-cardiac surgery. A third biomarker of interest is the Tau protein, which has been linked to neurodegenerative disorders. Tau appears to be more specific than the previous two biomarkers since it is only found in the central nervous system. The metalloproteinase and ubiquitin C terminal hydroxylase-L1 (UCH-L1) are the most recently researched markers; however, their usefulness is still unclear. This review presents a comprehensive overview of S100B, neuronal-specific enolase, metalloproteinases, and UCH-L1 in the perioperative period.

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Section: S100b In Non-cardiac Surgerymentioning

confidence: 86%

Section: Nse In Non-cardiac Surgerymentioning

confidence: 99%

Neurological biomarkers in the perioperative period

Cata

Abdelmalak

Farag

2011

British Journal of Anaesthesia

101

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“…23–24 Calponin 1 is a regulator of vascular smooth muscle tone and has been shown to be a target of MMP2, 25 whereas S100‐A4 is a calcium signal transducer that has been shown to positively regulate the secretion of MMPs from endothelial cells and fibroblasts and to regulate the transcriptional activation of collagenase 3 (MMP‐13) mRNA followed by subsequent release of MMP protein and the proteolytic degradation of extracellular matrix. 26–28 α‐Enolase is a multifunctional protein and is involved in the synthesis of pyruvate but also acts as a plasminogen receptor, where it regulates the activation of plasmin leading to MMP activation and extracellular matrix degradation. 20 CSRP1 is expressed in vascular smooth muscle, and CRP2 is a cofactor for smooth muscle cell differentiation.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Biomarkers for Identification of Human Ascending Thoracic Aortic Aneurysm

Black

Masuzawa

Hagberg

et al. 2013

JAHA

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BackgroundHuman ascending thoracic aortic aneurysms (ATAAs) are life threatening and constitute a leading cause of mortality in the United States. Previously, we demonstrated that collagens α2(V) and α1(XI) mRNA and protein expression levels are significantly increased in ATAAs.Methods and ResultsIn this report, the authors extended these preliminary studies using high‐throughput proteomic analysis to identify additional biomarkers for use in whole blood real‐time RT‐PCR analysis to allow for the identification of ATAAs before dissection or rupture. Human ATAA samples were obtained from male and female patients aged 65±14 years. Both bicuspid and tricuspid aortic valve patients were included and compared with nonaneurysmal aortas (mean diameter 2.3 cm). Five biomarkers were identified as being suitable for detection and identification of ATAAs using qRT‐PCR analysis of whole blood. Analysis of 41 samples (19 small, 13 medium‐sized, and 9 large ATAAs) demonstrated the overexpression of 3 of these transcript biomarkers correctly identified 79.4% of patients with ATAA of ≥4.0 cm (P<0.001, sensitivity 0.79, CI=0.62 to 0.91; specificity 1.00, 95% CI=0.42 to 1.00).ConclusionA preliminary transcript biomarker panel for the identification of ATAAs using whole blood qRT‐PCR analysis in men and women is presented.

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“…A few studies have exploited the indwelling spinal drain as a real-time source of potential biochemical markers [5][6][7]. Such markers will generally reflect release from any CNS tissue.…”

Section: Introductionmentioning

confidence: 99%