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Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement

Introduction: Although transfemoral aortic valve replacement (TAVR) is a safe treatment for elderly patients with severe aortic valve stenosis, postoperative microembolism has been described. In this secondary endpoint analysis of the POST-TAVR trial, we aimed to investigate whether changes in neuro...

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Autores principales: Nübel, Jonathan, Buhre, Charlotte, Hoffmeister, Meike, Oess, Stefanie, Labrenz, Oliver, Jost, Kerstin, Hauptmann, Michael, Schön, Julika, Fritz, Georg, Butter, Christian, Haase-Fielitz, Anja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672434/
https://www.ncbi.nlm.nih.gov/pubmed/37998499
http://dx.doi.org/10.3390/jcdd10110441
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author Nübel, Jonathan
Buhre, Charlotte
Hoffmeister, Meike
Oess, Stefanie
Labrenz, Oliver
Jost, Kerstin
Hauptmann, Michael
Schön, Julika
Fritz, Georg
Butter, Christian
Haase-Fielitz, Anja
author_facet Nübel, Jonathan
Buhre, Charlotte
Hoffmeister, Meike
Oess, Stefanie
Labrenz, Oliver
Jost, Kerstin
Hauptmann, Michael
Schön, Julika
Fritz, Georg
Butter, Christian
Haase-Fielitz, Anja
author_sort Nübel, Jonathan
collection PubMed
description Introduction: Although transfemoral aortic valve replacement (TAVR) is a safe treatment for elderly patients with severe aortic valve stenosis, postoperative microembolism has been described. In this secondary endpoint analysis of the POST-TAVR trial, we aimed to investigate whether changes in neuron-specific enolase (NSE)—a biomarker of neuronal damage—are associated with changes in memory function or postoperative delirium (POD). Materials and Methods: This was a prospective single-center study enrolling patients undergoing elective TAVR. Serum NSE was measured before and 24 h after TAVR. POD was diagnosed using CAM-ICU testing. Memory function was assessed before TAVR and before hospital discharge using the “Consortium to Establish a Registry for Alzheimer’s Disease” (CERAD) word list and the digit span task (DST) implemented in “∆elta-App”. Results: Subjects’ median age was 82 years (25th to 75th percentile: 77.5–85.0), 42.6% of subjects were women. CERAD scores significantly increased from pre- to post-TAVR, with p < 0.001. POD occurred in 4.4% (6/135) of subjects at median 2 days after TAVR. After TAVR, NSE increased from a median of 1.85 ng/mL (1.30–2.53) to 2.37 ng/mL (1.69–3.07), p < 0.001. The median increase in NSE was 40.4% (13.1–138.0) in patients with POD versus 17.3% (3.3–43.4) in those without POD (p = 0.17). Conclusions: Memory function improved after TAVR, likely due to learning effects, with no association to change in NSE. Patients with POD appear to have significantly higher postoperative levels of NSE compared to patients without POD after TAVR. This finding suggests that neuronal damage, as indicated by NSE elevation, may not significantly impair assessed memory function after TAVR.
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spelling pubmed-106724342023-10-25 Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement Nübel, Jonathan Buhre, Charlotte Hoffmeister, Meike Oess, Stefanie Labrenz, Oliver Jost, Kerstin Hauptmann, Michael Schön, Julika Fritz, Georg Butter, Christian Haase-Fielitz, Anja J Cardiovasc Dev Dis Article Introduction: Although transfemoral aortic valve replacement (TAVR) is a safe treatment for elderly patients with severe aortic valve stenosis, postoperative microembolism has been described. In this secondary endpoint analysis of the POST-TAVR trial, we aimed to investigate whether changes in neuron-specific enolase (NSE)—a biomarker of neuronal damage—are associated with changes in memory function or postoperative delirium (POD). Materials and Methods: This was a prospective single-center study enrolling patients undergoing elective TAVR. Serum NSE was measured before and 24 h after TAVR. POD was diagnosed using CAM-ICU testing. Memory function was assessed before TAVR and before hospital discharge using the “Consortium to Establish a Registry for Alzheimer’s Disease” (CERAD) word list and the digit span task (DST) implemented in “∆elta-App”. Results: Subjects’ median age was 82 years (25th to 75th percentile: 77.5–85.0), 42.6% of subjects were women. CERAD scores significantly increased from pre- to post-TAVR, with p < 0.001. POD occurred in 4.4% (6/135) of subjects at median 2 days after TAVR. After TAVR, NSE increased from a median of 1.85 ng/mL (1.30–2.53) to 2.37 ng/mL (1.69–3.07), p < 0.001. The median increase in NSE was 40.4% (13.1–138.0) in patients with POD versus 17.3% (3.3–43.4) in those without POD (p = 0.17). Conclusions: Memory function improved after TAVR, likely due to learning effects, with no association to change in NSE. Patients with POD appear to have significantly higher postoperative levels of NSE compared to patients without POD after TAVR. This finding suggests that neuronal damage, as indicated by NSE elevation, may not significantly impair assessed memory function after TAVR. MDPI 2023-10-25 /pmc/articles/PMC10672434/ /pubmed/37998499 http://dx.doi.org/10.3390/jcdd10110441 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nübel, Jonathan
Buhre, Charlotte
Hoffmeister, Meike
Oess, Stefanie
Labrenz, Oliver
Jost, Kerstin
Hauptmann, Michael
Schön, Julika
Fritz, Georg
Butter, Christian
Haase-Fielitz, Anja
Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title_full Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title_fullStr Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title_full_unstemmed Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title_short Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement
title_sort association between neuron-specific enolase, memory function, and postoperative delirium after transfemoral aortic valve replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672434/
https://www.ncbi.nlm.nih.gov/pubmed/37998499
http://dx.doi.org/10.3390/jcdd10110441
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