Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role
<b>Introduction</b>: The objectives of this study were to assess the role of neuromarkers like glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), protein S100 (pS100), and neuron-specific enolase (NSE) as diagnostic markers of acute brain injury and also as...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/13/5/113 |
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| author | Lacramioara Eliza Chiperi Adina Huţanu Cristina Tecar Iolanda Muntean |
| author_facet | Lacramioara Eliza Chiperi Adina Huţanu Cristina Tecar Iolanda Muntean |
| author_sort | Lacramioara Eliza Chiperi |
| collection | DOAJ |
| description | <b>Introduction</b>: The objectives of this study were to assess the role of neuromarkers like glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), protein S100 (pS100), and neuron-specific enolase (NSE) as diagnostic markers of acute brain injury and also as prognostic markers for short-term neurodevelopmental impairment. <b>Methods</b>: Pediatric patients with congenital heart defects (CHDs) undergoing elective cardiac surgery were included. Neurodevelopmental functioning was assessed preoperatively and 4–6 months postoperatively using the Denver Developmental Screening Test II. Blood samples were collected preoperatively and postoperatively. During surgery, regional cerebral tissue oxygen saturation was monitored using near-infrared spectroscopy (NIRS). <b>Results</b>: Forty-two patients were enrolled and dichotomized into cyanotic and non-cyanotic groups based on peripheric oxygen saturation. Nineteen patients (65.5%) had abnormal developmental scores in the non-cyanotic group and eleven (84.6%) in the cyanotic group. A good diagnostic model was observed between NIRS values and GFAP in the cyanotic CHD group (AUC = 0.7). A good predicting model was observed with GFAP and developmental scores in the cyanotic CHD group (AUC = 0.667). A correlation was found between NSE and developmental quotient scores (r = 0.09, <i>p</i> = 0.046). <b>Conclusions</b>: From all four neuromarkers studied, only GFAP was demonstrated to be a good diagnostic and prognostic factor in cyanotic CHD patients. NSE had only prognostic value. |
| first_indexed | 2024-03-10T21:20:25Z |
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| institution | Directory Open Access Journal |
| issn | 2039-7283 |
| language | English |
| last_indexed | 2024-03-10T21:20:25Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-2b476b30d9ce45a1a34857fa2572fda82023-11-19T16:07:31ZengMDPI AGClinics and Practice2039-72832023-10-011351253126510.3390/clinpract13050113Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic RoleLacramioara Eliza Chiperi0Adina Huţanu1Cristina Tecar2Iolanda Muntean3Clinic of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Heart Transplant, 540136 Targu Mures, RomaniaDepartment of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, RomaniaDepartment of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400129 Cluj-Napoca, RomaniaClinic of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Heart Transplant, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania<b>Introduction</b>: The objectives of this study were to assess the role of neuromarkers like glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), protein S100 (pS100), and neuron-specific enolase (NSE) as diagnostic markers of acute brain injury and also as prognostic markers for short-term neurodevelopmental impairment. <b>Methods</b>: Pediatric patients with congenital heart defects (CHDs) undergoing elective cardiac surgery were included. Neurodevelopmental functioning was assessed preoperatively and 4–6 months postoperatively using the Denver Developmental Screening Test II. Blood samples were collected preoperatively and postoperatively. During surgery, regional cerebral tissue oxygen saturation was monitored using near-infrared spectroscopy (NIRS). <b>Results</b>: Forty-two patients were enrolled and dichotomized into cyanotic and non-cyanotic groups based on peripheric oxygen saturation. Nineteen patients (65.5%) had abnormal developmental scores in the non-cyanotic group and eleven (84.6%) in the cyanotic group. A good diagnostic model was observed between NIRS values and GFAP in the cyanotic CHD group (AUC = 0.7). A good predicting model was observed with GFAP and developmental scores in the cyanotic CHD group (AUC = 0.667). A correlation was found between NSE and developmental quotient scores (r = 0.09, <i>p</i> = 0.046). <b>Conclusions</b>: From all four neuromarkers studied, only GFAP was demonstrated to be a good diagnostic and prognostic factor in cyanotic CHD patients. NSE had only prognostic value.https://www.mdpi.com/2039-7283/13/5/113congenital heart defectneuromarkerheart surgeryglial fibrillary acidic proteinbrain-derived neurotrophic factorprotein S100 |
| spellingShingle | Lacramioara Eliza Chiperi Adina Huţanu Cristina Tecar Iolanda Muntean Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role Clinics and Practice congenital heart defect neuromarker heart surgery glial fibrillary acidic protein brain-derived neurotrophic factor protein S100 |
| title | Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role |
| title_full | Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role |
| title_fullStr | Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role |
| title_full_unstemmed | Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role |
| title_short | Serum Markers of Brain Injury in Pediatric Patients with Congenital Heart Defects Undergoing Cardiac Surgery: Diagnostic and Prognostic Role |
| title_sort | serum markers of brain injury in pediatric patients with congenital heart defects undergoing cardiac surgery diagnostic and prognostic role |
| topic | congenital heart defect neuromarker heart surgery glial fibrillary acidic protein brain-derived neurotrophic factor protein S100 |
| url | https://www.mdpi.com/2039-7283/13/5/113 |
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