Koroner arter bypass greft ameliyatı geçiren hastalarda serum YKL-40, HMGB1, BDNF, NGF düzeyleri ve bilişsel disfonksiyonlar arasındaki ilişkinin incelenmesi

Öz

ÖZET Amaç: Postoperative bilişsel disfonksiyon (POBD) demans, dikkat eksikliği, hafıza ve davranışsal bozulmalar gibi planlama yapamama gibi semptomlarla karakterize bir tablodur. Pek çok cerrahi işlem sonrası rastlanabilmekle beraber kardiak cerrahi sonrası görülme sıklığı fazladır. Bu çalışmada, nöroinflamasyon ve nörotrofik faktör parametreleri ile kognitif test arasındaki korelasyon varlığını göstermeyi amaçladık. Gereç ve yöntemler: Elektif koroner arter bypass greft ameliyatı olan 24 hasta prospektif olarak incelendi. Preoperatif 2.gün ve postoperatif 5-7.gün serum örnekleri alındı ve eş zamanlı olarak kognitif test uygulandı.YKL-40, BDNF, NGF ve HMGB1 ile kognitif test skorları arasındaki korelasyon değerlendirildi. Bulgular: Çalışma sonucunda NGF değerinde postoperatif anlamlı düşüklük bulunmuştur. (p=0.006). NGF ile postoperatif kognitif test arasında pozitif korelasyon saptanmıştır. (r=0.542, p=0.006).Bellek puanı postoperatif artmış (p<0.0001),oryantasyon ve uyanıklık ise postoperatif azalmış olarak bulundu. (p=0.032 ve p=0.022, sırasıyla).Preoperatif ve postoperatif HMGB1 (r=0.529, p=0.008), NGF (r=0.454, p=0.026) ve kognitif test skorları (r=0.825, p <0.0001) arasında ise pozitif korelasyon saptandı. Postoperatif kognitif test skorları ile yaş (r=-0.447, p=0.029), kardiyopulmoner bypass (r=-0.403, p=0.039) ve operasyon süresi (r=-0.506, p=0.012) arasında ise negatif korelasyon görüldü. Sonuç: Çalışmamız sonucunda NGF ‘nin POBD değerlendirmesinde önemli bir parametre olabileceğine dair veri elde edilmiştir. HMGB1’in kardiak hastalıklarda bir marker olarak araştırılması gündeme gelmiştir. Kognitif fonksiyonlar ile nöroinflamasyon ve nörotrofik parametreler arasındaki ilişkinin detaylandırılmasının uygun tanı ve tedavi stratejilerinin belirlenmesi açısından önemli olduğunu düşünüyoruz.

Anahtar Kelimeler

• Koroner arter bypass greft
• NGF
• postoperatif komplikasyon
• kognisyon

Proje Numarası

01/2020-05_5856.

Evaluation of the relationship between serum YKL-40, HMGB1, BDNF, NGF levels, and cognitive functions in patients undergoing coronary artery bypass grafting

Öz

ABSTRACT Objective: Postoperative cognitive dysfunction (POCD) is characterized by symptoms that may inhibit planning, such as dementia, memory loss, attention deficiency, and behavioral impairment. Although it is frequently in cardiac surgery, all manner of surgery can cause POCD. In this manuscript, we aimed to show the existence of a correlation among neuroinflammation markers High-mobility group box 1 (HMGB1) and YKL-40 and neurotrophic factors; brain-derived neurotrophic factor (BDNF) and Nerve growth factor (NGF), with the cognitive functions. Material and methods: Twenty-four patients who underwent coronary artery bypass graft (CABG) were analyzed prospectively. Preoperative 2nd and postoperative 5-7th day blood samples were collected, and we performed cognitive test synchronously. Correlations between YKL-40, BDNF, NGF, HMGB1, and cognitive test score (CTS) were examined. Results: We found a significant postoperative decrease in NGF (p=0.006). There was a positive correlation between NGF and postoperative CTS (r=0.542, p=0.006). Postoperative memory score was increased (p<0.0001), but orientation and vigilance scores were decreased (p=0.032 and p=0.022, respectively). There were also self-reliant positive correlations between preoperative and postoperative CTS (r=0.825, p <0.0001), preoperative and postoperative HMGB1 (r=0.529, p=0.008) and preoperative and postoperative NGF scores (r=0.454, p=0.026). Postoperative CTS had a negative correlation with age (r=-0.447, p=0.029), duration of operation (r=-0.506, p=0.012), and cardiopulmonary bypass (CPB) (r=-0.403, p=0.039). Conclusion: Data in this study suggested that NGF can be a notable parameter in POCD, and HMGB1 may be a crucial marker in heart disorders. To define appropriate diagnosis and treatment strategies, it is essential to detail the relationship between cognitive functions, neuroinflammation, and neurotrophic factors.

Anahtar Kelimeler

• Coronary artery bypass grafting
• NGF
• postoperative cognitive dysfunction
• cognitive impairment

Destekleyen Kurum

Gazi University Scientific Investment Project Department supported this study within the scope of Project number 01/2020-05_5856.

Proje Numarası

01/2020-05_5856.

Etik Beyan

The authors declare that they have no competing interests.

Kaynakça

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