Heart Surgery Results in Significant Increase in Serum Markers for Neuronal Injury and Degeneration
Location
Philadelphia, PA
Start Date
9-5-2018 1:00 PM
Description
INTRODUCTION: Post-surgical cognitive decline is a significant problem among patients undergoing surgery. The extent of neuronal injury varies depending on the type and severity of the insult and individual susceptibility. Although much attention was paid to the elderly population, younger individuals may theoretically suffer from perioperative neuronal injury accelerating their cognitive decline in future despite apparent lack of harm at the time of surgery. Here, we hypothesize that cardiac surgery with the implementation of the cardiovascular bypass will result in elevation of neuronal markers of injury in a population of a patient scheduled for elective surgery.
METHODS: The study was done at the Hospital of the University of Pennsylvania between 2014-2016. A total of 20 patients scheduled for elective heart surgery were enrolled in the study. Blood was collected just before surgery (time 0 hours), 24 hours, 7 days and 3 months after the surgery for each patient. The serum level of tau protein, glial fibrillary acidic protein (GFAP), neurofilament light polypeptide (NFL) and ubiquitin C-terminal hydrolase L1 (UCHL1) were measured using single molecule array (SiMoA) technology.
RESULTS: Mean serum tau protein (ANOVA (27;3)=10.69, p=0.13) was significantly elevated after 24 hours and 7 days from heart surgery. UCHL1 serum level (ANOVA[24;3]=13.74;p=0.0032) increased significantly shortly after surgery but dropped to below baseline at 3 months. GFAP levels were not significantly changed by surgery (ANOVA[28;3)=2.48; p=0.47). NFL serum levels (ANOVA[28;3]=10.71;p=0.13) were not changed as well. Finally, we correlated the increase in serum levels of Tau, NFL, GFAP and UCHL1 with the time spent on bypass, operating time, nature of the surgery, and demographic factors.
CONCLUSIONS: In summary, we demonstrated that serum biomarkers of neuronal injury were elevated even after elective surgery. Most notably, some markers had persisted for months after the injury despite initial normalization suggesting that post-operative sequelae are far-reaching beyond what is believed to be acute illness.
Embargo Period
5-31-2018
Heart Surgery Results in Significant Increase in Serum Markers for Neuronal Injury and Degeneration
Philadelphia, PA
INTRODUCTION: Post-surgical cognitive decline is a significant problem among patients undergoing surgery. The extent of neuronal injury varies depending on the type and severity of the insult and individual susceptibility. Although much attention was paid to the elderly population, younger individuals may theoretically suffer from perioperative neuronal injury accelerating their cognitive decline in future despite apparent lack of harm at the time of surgery. Here, we hypothesize that cardiac surgery with the implementation of the cardiovascular bypass will result in elevation of neuronal markers of injury in a population of a patient scheduled for elective surgery.
METHODS: The study was done at the Hospital of the University of Pennsylvania between 2014-2016. A total of 20 patients scheduled for elective heart surgery were enrolled in the study. Blood was collected just before surgery (time 0 hours), 24 hours, 7 days and 3 months after the surgery for each patient. The serum level of tau protein, glial fibrillary acidic protein (GFAP), neurofilament light polypeptide (NFL) and ubiquitin C-terminal hydrolase L1 (UCHL1) were measured using single molecule array (SiMoA) technology.
RESULTS: Mean serum tau protein (ANOVA (27;3)=10.69, p=0.13) was significantly elevated after 24 hours and 7 days from heart surgery. UCHL1 serum level (ANOVA[24;3]=13.74;p=0.0032) increased significantly shortly after surgery but dropped to below baseline at 3 months. GFAP levels were not significantly changed by surgery (ANOVA[28;3)=2.48; p=0.47). NFL serum levels (ANOVA[28;3]=10.71;p=0.13) were not changed as well. Finally, we correlated the increase in serum levels of Tau, NFL, GFAP and UCHL1 with the time spent on bypass, operating time, nature of the surgery, and demographic factors.
CONCLUSIONS: In summary, we demonstrated that serum biomarkers of neuronal injury were elevated even after elective surgery. Most notably, some markers had persisted for months after the injury despite initial normalization suggesting that post-operative sequelae are far-reaching beyond what is believed to be acute illness.