JTCS KCI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Jarle Vaage
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Vaage, J.
Right arrow Articles by Anderson, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vaage, J.
Right arrow Articles by Anderson, R.
Related Collections
Right arrow Cerebral protection
Right arrowRelated Article

J Thorac Cardiovasc Surg 2001;122:853-855
© 2001 The American Association for Thoracic Surgery

Editorials

Biochemical markers of neurologic injury in cardiac surgery: The rise and fall of S100ß

Jarle Vaage, MD, PhD, FETCSa, Russell Anderson, MD, PhDb

From the Departments of Thoracic Surgerya and Thoracic Anaesthetics and Intensive Care,b Karolinska Hospital, Stockholm, Sweden.

Received for publication July 3, 2001. Accepted for publication July 13, 2001. Address for reprints: Jarle Vaage, MD, Department of Thoracic Surgery, Karolinska Hospital, S-17176, Stockholm, Sweden (E-mail: jarle.vaage@ks.se).

See related article on page 1019.


Figure Removed (Available Only in the Full Text)
View larger version (123K):
[in this window]
[in a new window]
  		Dr Vaage

 
With the change in patient population toward older and sicker patients undergoing cardiac surgery, neurologic injury has emerged as perhaps the most important perioperative complication, and its frequency increases exponentially with increasing age.Go 1 Particular attention has been paid to the role of cardiopulmonary bypass per seGo 2 and thromboembolization from the ascending aorta.Go 3 However, neurologic injury is not limited to only stroke and comaGo 1; increasingly there is a focus on the more subtle neurocognitive dysfunction and its consequences on quality of life.Go Go 4,5

The majority of cases of gross neurologic injury do not represent a diagnostic problem, as at the time of diagnosis the injury is usually manifest and irreversible. Neurocognitive dysfunction, however, is less accessible for quantification, which requires time-consuming neuropsychologic testing. With only a few exceptions, such testing has been unavailable for the cardiac surgeon. Prompted by the increasing awareness of neurologic injury, as well as the emergence of minimally invasive cardiac surgery, there is at present an increasing interest in cognitive testing. However, such testing will remain a research method and not available in everyday clinical practice because of the time and manpower it consumes.

A biochemical marker in the blood of the patients—"a troponin of the brain"—would represent a revolution in the investigation and diagnosis of neurologic injury in cardiac surgery. A serum marker could potentially identify which aspect(s) of cardiac surgery are responsible for cognitive dysfunction and evaluate the efficacy of alternative surgical techniques. Additionally, if marker concentrations during or directly after surgery could be related to cognitive dysfunction or shown to predict gross neurologic injury that became clinically evident after some hours (or days), then potentially neuroprotective interventions might be indicated.

The ideal biochemical marker should have the following properties:

  1. Central nervous specificity
  2. Rapid and significant . . . [Full Text of this Article]


Related Article

Changes in S100ß protein levels in cerebrospinal fluid after thoracoabdominal aortic operations
Takashi Kunihara, Norihiko Shiiya, and Keishu Yasuda
J. Thorac. Cardiovasc. Surg. 2001 122: 1019-1020. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Clin. Chem.Home page
O. F. Laterza, L. Lim, P. W. Garrett-Engele, K. Vlasakova, N. Muniappa, W. K. Tanaka, J. M. Johnson, J. F. Sina, T. L. Fare, F. D. Sistare, et al.
Plasma MicroRNAs as Sensitive and Specific Biomarkers of Tissue Injury
Clin. Chem., November 1, 2009; 55(11): 1977 - 1983.
[Abstract] [Full Text] [PDF]

Home page
 Ann Clin BiochemHome page
N. Nagdyman, P. Ewert, K. Schmitt, M. Hubler, B. Stiller, C. Muller, and F. Berger
Protein S-100 is present in extracerebral fluids before and after cardiac surgery in children
Ann Clin Biochem, July 1, 2008; 45(4): 409 - 412.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
D.C. Whitaker, A.J.E. Green, J. Stygall, M.J.G. Harrison, and S.P. Newman
Evaluation of an alternative S100b assay for use in cardiac surgery: relationship with microemboli and neuropsychological outcome
Perfusion, July 1, 2007; 22(4): 267 - 272.
[Abstract] [PDF]

Home page
 Clin. Chem.Home page
O. F. Laterza, V. R. Modur, D. L. Crimmins, J. V. Olander, Y. Landt, J.-M. Lee, and J. H. Ladenson
Identification of Novel Brain Biomarkers
Clin. Chem., September 1, 2006; 52(9): 1713 - 1721.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
E. C. Lases, M. A. Schepens, F. J. Haas, L. P. Aarts, H. T. ter Beek, E. P. van Dongen, H. P. Siegers, I. van der Tweel, and E. H. Boezeman
Clinical prospective study of biochemical markers and evoked potentials for identifying adverse neurological outcome after thoracic and thoracoabdominal aortic aneurysm surgery
Br. J. Anaesth., November 1, 2005; 95(5): 651 - 661.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Baufreton, P. Allain, A. Chevailler, F. Etcharry-Bouyx, J. J. Corbeau, D. Legall, and J. L. de Brux
Brain Injury and Neuropsychological Outcome After Coronary Artery Surgery Are Affected by Complement Activation
Ann. Thorac. Surg., May 1, 2005; 79(5): 1597 - 1605.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. Motallebzadeh and M. Jahangiri
The effect of the dynamic air bubble trap on cerebral microemboli and S100{beta}
J. Thorac. Cardiovasc. Surg., July 1, 2004; 128(1): 154 - 154.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Shiiya, T. Kunihara, T. Miyatake, K. Matsuzaki, and K. Yasuda
Tau protein in the cerebrospinal fluid is a marker of brain injury after aortic surgery
Ann. Thorac. Surg., June 1, 2004; 77(6): 2034 - 2038.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Dogan, K. Graubitz, T. Aybek, M. F. Khan, P. Kessler, A. Moritz, and G. Wimmer-Greinecker
How safe is the port access technique in minimally invasive coronary artery bypass grafting?
Ann. Thorac. Surg., November 1, 2002; 74(5): 1537 - 1543.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The American Association for Thoracic Surgery.