Predictors of cognitive decline after cardiac operation

Newman, Mark F.; Croughwell, Narda D.; Blumenthal, James A.; Lowry, Edward; White, William D.; Spillane, William; Davis, Robert D.; Glower, Donald D.; Smith, L. R.; Mahanna, Elizabeth; Rêves, J. G.

doi:10.1016/0003-4975(95)00076-w

Cited by 196 publications

(101 citation statements)

References 32 publications

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“…In some, 40-80% of patients with AD possess at least one apoE4 allele (12). Likewise, apoE4 is associated with earlier onset, progression, or severity of head trauma (13)(14)(15)(16)(17)(18)(19), stroke (20,21), complications after coronary artery bypass surgery (22,23), Parkinson's disease (24)(25)(26)(27), amyotrophic lateral sclerosis (28)(29)(30)(31)(32), multiple sclerosis (33,34), diabetic neuropathy (35), sleep apnea (36), Lewy body disorders (37), and CNS ischemia (38).…”

Section: Apoe and Neuropathologymentioning

confidence: 99%

Apolipoprotein E4: A causative factor and therapeutic target in neuropathology, including Alzheimer’s disease

Mahley

Weisgraber

Huang

2006

Proc. Natl. Acad. Sci. U.S.A.

834

801

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The premise of this review is that apolipoprotein (apo) E4 is much more than a contributing factor to neurodegeneration. ApoE has critical functions in redistributing lipids among CNS cells for normal lipid homeostasis, repairing injured neurons, maintaining synaptodendritic connections, and scavenging toxins. In multiple pathways affecting neuropathology, including Alzheimer's disease, apoE acts directly or in concert with age, head injury, oxidative stress, ischemia, inflammation, and excess amyloid ␤ peptide production to cause neurological disorders, accelerating progression, altering prognosis, or lowering age of onset. We envision that unique structural features of apoE4 are responsible for apoE4-associated neuropathology. Although the structures of apoE2, apoE3, and apoE4 are in dynamic equilibrium, apoE4, which is detrimental in a variety of neurological disorders, is more likely to assume a pathological conformation. Importantly, apoE4 displays domain interaction (an interaction between the N-and C-terminal domains of the protein that results in a compact structure) and molten globule formation (the formation of stable, reactive intermediates with potentially pathological activities). In response to CNS stress or injury, neurons can synthesize apoE. ApoE4 uniquely undergoes neuron-specific proteolysis, resulting in bioactive toxic fragments that enter the cytosol, alter the cytoskeleton, disrupt mitochondrial energy balance, and cause cell death. Our findings suggest potential therapeutic strategies, including the use of ''structure correctors'' to convert apoE4 to an ''apoE3-like'' molecule, protease inhibitors to prevent the generation of toxic apoE4 fragments, and ''mitochondrial protectors'' to prevent cellular energy disruption. mitochondria ͉ neurodegeneration ͉ cytoskeleton ͉ protein folding A polipoprotein (apo) E plays a fundamental role in the maintenance and repair of neurons, but its three isoforms differ in their abilities to accomplish these critical tasks (1-3). ApoE4 is associated with a wide variety of neuropathological processes. We hypothesize that different insults associated with a variety of disorders, in concert with apoE4, can lead to neuropathology. We believe that those processes are mediated by the cellular origin of apoE (astrocytes, neurons, or microglia), the nature of various injurious factors (''second hits''), and the structure of apoE4. Thus, understanding the structure and function of the apoE isoforms will yield new strategies for treating neuropathologies.Although apoE is involved in many neuropathologies, we will focus on its role in Alzheimer's disease (AD). We will consider the unique structural features that distinguish apoE4 from apoE3 and apoE2, the sites of synthesis and normal roles of apoE in the nervous system, and the pathological roles of apoE4 with or without amyloid ␤ (A␤) peptide. The evidence suggests that apoE4 is considerably more than a simple contributing factor in AD pathogenesis. ApoE and NeuropathologyApoE4's involvement in neuropathology is we...

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Section: Apoe and Neuropathologymentioning

confidence: 99%

Apolipoprotein E4: A causative factor and therapeutic target in neuropathology, including Alzheimer’s disease

Mahley

Weisgraber

Huang

2006

Proc. Natl. Acad. Sci. U.S.A.

834

801

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“…Health related quality of life is the value assigned to duration of life as modified by the impairments, functional status perceptions and social opportunities that are influenced by disease, injury, treatment or policy. As an outcome measure Health related quality of life (HRQL) more pragmatically represent what patients say about how they feel and function in their daily lives as a result of a disease or treatment and it generally include physical function and symptoms, psychological state and social interactions [2]. Health-related quality of life [HRQL] has been defined by various authors; examples include HRQL as a measure of the patient's perspective representing the "functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient" and that proposed by Patrick and colleagues as "the value assigned to duration of life as modified by the impairments, functional states, perceptions, and social opportunities that influenced by disease, injury, treatment, or policy".…”

Section: Adaptability Is Not Imitation Means Power Of Resistance and mentioning

confidence: 99%

A Descriptive Study Done to Assessthe Quality of Life among Post Myocardial Infarction Patients Attending Cardiac OPDs

Kaur¹

2017

MOJWH

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Introduction: Quality of life of post Myocardial infarction patient's condition refers to the satisfaction and dissatisfaction of life experienced by persons living with Myocardial Infarction. MI is one of the major causes of death among coronary artery diseases. Health related quality of life is an important measure of patient's recovery after an illness. It has suggested that different treatment may affect health related quality of life of patients with Myocardial Infarction. A descriptive study done to assess the quality of life among post myocardial infarction patients attending cardiac OPDs. The objective of the study was to assess the quality of life score among MI patients. To associate the quality of life score with selected socio demographic variables of post MI patients.Method: Qualitative research approach was selected to assess the Quality of Life among post Myocardial Infarction patients. Total 60 cardiac patients were purposively selected to collect data using a checklist. Results:i. 9(15%) patients having good quality of life.ii. 38(63.33%) patients having average quality of life.iii. 13 (21.67%) patients having poor quality of life. Conclusion:According to gender, the maximum mean score 13.76 belonged to male gender followed by 11.6 in female gender. There was an association between quality of life and male gender. This study shows that gender is the only factor which is significant or affects the quality of life of Myocardial Infarction patients.

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“…Potential perioperative events that may negatively interact with preoperative leukoaraiosislacunae volume include acute anemia (60)(61)(62)(63), hypotension (64), oxygen desaturation (65)(66)(67), and the production of emboli. In our sample, we acquired valid emboli data on 15 of our surgery participants.…”

Section: Considerations For Neuropsychological Measures and Potentialmentioning

confidence: 99%

A Pilot Study Evaluating Presurgery Neuroanatomical Biomarkers for Postoperative Cognitive Decline After Total Knee Arthroplasty in Older Adults

Price

Tanner

Schmalfuss

et al. 2014

Survey of Anesthesiology

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Background-Total knee arthroplasty improves quality of life but is associated with postoperative cognitive dysfunction in older adults. This prospective longitudinal pilot study with a parallel control group tested the hypotheses that: 1) nondemented adults would exhibit primary memory and executive difficulties after total knee arthroplasty, and 2) reduced preoperative hippocampus/entorhinal volume would predict postoperative memory change, whereas preoperative leukoaraiosis and lacunae volumes would predict postoperative executive dysfunction.

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Predictors of cognitive decline after cardiac operation

Cited by 196 publications

References 32 publications

Apolipoprotein E4: A causative factor and therapeutic target in neuropathology, including Alzheimer’s disease

Apolipoprotein E4: A causative factor and therapeutic target in neuropathology, including Alzheimer’s disease

A Descriptive Study Done to Assessthe Quality of Life among Post Myocardial Infarction Patients Attending Cardiac OPDs

A Pilot Study Evaluating Presurgery Neuroanatomical Biomarkers for Postoperative Cognitive Decline After Total Knee Arthroplasty in Older Adults

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