Cargando…
Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management
BACKGROUND: Prognostication after cardiac arrest (CA) needs a multimodal approach, but the optimal method is not known. We tested the hypothesis that the combination of neuron-specific enolase (NSE) and neuroimaging could improve outcome prediction after CA treated with targeted temperature manageme...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529296/ https://www.ncbi.nlm.nih.gov/pubmed/33002033 http://dx.doi.org/10.1371/journal.pone.0239979 |
_version_ | 1783589408700628992 |
---|---|
author | Kim, Soo Hyun Kim, Hyo Joon Park, Kyu Nam Choi, Seung Pill Lee, Byung Kook Oh, Sang Hoon Jeung, Kyung Woon Cho, In Soo Youn, Chun Song |
author_facet | Kim, Soo Hyun Kim, Hyo Joon Park, Kyu Nam Choi, Seung Pill Lee, Byung Kook Oh, Sang Hoon Jeung, Kyung Woon Cho, In Soo Youn, Chun Song |
author_sort | Kim, Soo Hyun |
collection | PubMed |
description | BACKGROUND: Prognostication after cardiac arrest (CA) needs a multimodal approach, but the optimal method is not known. We tested the hypothesis that the combination of neuron-specific enolase (NSE) and neuroimaging could improve outcome prediction after CA treated with targeted temperature management (TTM). METHODS: A retrospective observational cohort study was performed on patients who underwent at least one NSE measurement between 48 and 72 hr; received both a brain computed tomography (CT) scan within 24 hr and diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after return of spontaneous circulation (ROSC); and were treated with TTM after out-of-hospital CA between 2009 and 2017 at the Seoul St. Mary’s Hospital in Korea. The primary outcome was a poor neurological outcome at 6 months after CA, defined as a cerebral performance category of 3–5. RESULTS: A total of 109 subjects underwent all three tests and were ultimately included in this study. Thirty-four subjects (31.2%) experienced good neurological outcomes at 6 months after CA. The gray matter to white matter attenuation ratio (GWR) was weakly correlated with the mean apparent diffusion coefficient (ADC), PV400 and NSE (Spearman’s rho: 0.359, -0.362 and -0.263, respectively). NSE was strongly correlated with the mean ADC and PV400 (Spearman’s rho: -0.623 and 0.666, respectively). Serum NSE had the highest predictive value among the single parameters (area under the curve (AUC) 0.912, sensitivity 70.7% for maintaining 100% specificity). The combination of a DWI parameter (mean ADC or PV400) and NSE had better prognostic performance than the combination of the CT parameter (GWR) and NSE. The addition of the GWR to a DWI parameter and NSE did not improve the prediction of neurological outcomes. CONCLUSION: The GWR (≤ 24 hr) is weakly correlated with the mean ADC (≤ 7 days) and NSE (highest between 48 and 72 hr). The combination of a DWI parameter and NSE has better prognostic performance than the combination of the GWR and NSE. The addition of the GWR to a DWI parameter and NSE does not improve the prediction of neurological outcomes after CA treatment with TTM. |
format | Online Article Text |
id | pubmed-7529296 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-75292962020-10-08 Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management Kim, Soo Hyun Kim, Hyo Joon Park, Kyu Nam Choi, Seung Pill Lee, Byung Kook Oh, Sang Hoon Jeung, Kyung Woon Cho, In Soo Youn, Chun Song PLoS One Research Article BACKGROUND: Prognostication after cardiac arrest (CA) needs a multimodal approach, but the optimal method is not known. We tested the hypothesis that the combination of neuron-specific enolase (NSE) and neuroimaging could improve outcome prediction after CA treated with targeted temperature management (TTM). METHODS: A retrospective observational cohort study was performed on patients who underwent at least one NSE measurement between 48 and 72 hr; received both a brain computed tomography (CT) scan within 24 hr and diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after return of spontaneous circulation (ROSC); and were treated with TTM after out-of-hospital CA between 2009 and 2017 at the Seoul St. Mary’s Hospital in Korea. The primary outcome was a poor neurological outcome at 6 months after CA, defined as a cerebral performance category of 3–5. RESULTS: A total of 109 subjects underwent all three tests and were ultimately included in this study. Thirty-four subjects (31.2%) experienced good neurological outcomes at 6 months after CA. The gray matter to white matter attenuation ratio (GWR) was weakly correlated with the mean apparent diffusion coefficient (ADC), PV400 and NSE (Spearman’s rho: 0.359, -0.362 and -0.263, respectively). NSE was strongly correlated with the mean ADC and PV400 (Spearman’s rho: -0.623 and 0.666, respectively). Serum NSE had the highest predictive value among the single parameters (area under the curve (AUC) 0.912, sensitivity 70.7% for maintaining 100% specificity). The combination of a DWI parameter (mean ADC or PV400) and NSE had better prognostic performance than the combination of the CT parameter (GWR) and NSE. The addition of the GWR to a DWI parameter and NSE did not improve the prediction of neurological outcomes. CONCLUSION: The GWR (≤ 24 hr) is weakly correlated with the mean ADC (≤ 7 days) and NSE (highest between 48 and 72 hr). The combination of a DWI parameter and NSE has better prognostic performance than the combination of the GWR and NSE. The addition of the GWR to a DWI parameter and NSE does not improve the prediction of neurological outcomes after CA treatment with TTM. Public Library of Science 2020-10-01 /pmc/articles/PMC7529296/ /pubmed/33002033 http://dx.doi.org/10.1371/journal.pone.0239979 Text en © 2020 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kim, Soo Hyun Kim, Hyo Joon Park, Kyu Nam Choi, Seung Pill Lee, Byung Kook Oh, Sang Hoon Jeung, Kyung Woon Cho, In Soo Youn, Chun Song Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title | Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title_full | Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title_fullStr | Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title_full_unstemmed | Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title_short | Neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
title_sort | neuron-specific enolase and neuroimaging for prognostication after cardiac arrest treated with targeted temperature management |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529296/ https://www.ncbi.nlm.nih.gov/pubmed/33002033 http://dx.doi.org/10.1371/journal.pone.0239979 |
work_keys_str_mv | AT kimsoohyun neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT kimhyojoon neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT parkkyunam neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT choiseungpill neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT leebyungkook neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT ohsanghoon neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT jeungkyungwoon neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT choinsoo neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement AT younchunsong neuronspecificenolaseandneuroimagingforprognosticationaftercardiacarresttreatedwithtargetedtemperaturemanagement |