Pre- and postoperative levels of serum brain-derived neurotrophic factor in neonates with congenital heart defects

Karim Fatalov, Özden Turan, Murat Özkan, İlkay Erdoğan, Tijen Cankurtaran, Metin Aldemir, Deniz Anuk İnce, Meltem Aksu, Ayşe Nur Ecevit
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Abstract

Background. The objectives of this study were to assess the preoperative and postoperative serum brain- derived neurotrophic factor (BDNF) levels in neonates undergoing surgery for congenital heart defects (CHD). Also to explore the relationship between changes in BDNF levels and the impact of perioperative factors including intraoperative body temperature, aortic cross-clamp time, perfusion time, operation time, inotropic score, vasoactive inotropic score and lactate levels. Methods. Forty-four patients with CHD and 36 healthy neonates were included in the study. Blood samples for serum BDNF levels were collected three times: preoperatively, and at 24 and 72 hours postoperatively from each patient in the operated group. Additionally, samples were collected once from each individual in the non-operated case group and the control group. Serum BDNF levels were analyzed using the Elabscience ELISA (Enzyme-Linked Immunosorbent Assay) commercial kit. Cranial ultrasonography (USG) was performed on all infants with CHD. Following cardiac surgery, patients underwent second and third cranial USG examinations at 24 and 72 hours postoperatively, respectively. Results. Forty-four consecutive patients with CHD were divided into two groups as follows: the operated group (n=30) and the non-operated group (n=14). Although there were no differences in the baseline serum BDNF levels between the case and control groups, the preoperative serum BDNF levels were significantly lower in the patients operated compared to the non-operated patients. The serum BDNF levels at the 24th hour postoperatively were higher than the preoperative levels. However, no significant correlation was found between the serum BDNF levels at 24 and 72 hours postoperatively as well as the cranial USG findings at corresponding times. Conclusions. Serum BDNF levels were initially lower in neonates with CHD who underwent surgery, but increased during the early postoperative period. These results suggest that serum BDNF levels are influenced by CHD and the postoperative period. 
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先天性心脏缺损新生儿术前和术后血清脑源性神经营养因子水平
研究背景本研究旨在评估接受先天性心脏缺陷(CHD)手术的新生儿术前和术后血清脑源性神经营养因子(BDNF)水平。同时探讨BDNF水平的变化与围手术期因素(包括术中体温、主动脉交叉钳夹时间、灌注时间、手术时间、肌力评分、血管活性肌力评分和乳酸水平)的影响之间的关系。研究纳入了 44 名心脏畸形患者和 36 名健康新生儿。对手术组的每位患者进行了三次血样采集,以检测血清 BDNF 水平:术前、术后 24 小时和 72 小时。此外,还从未动过手术的病例组和对照组中各采集了一次血样。使用 Elabscience ELISA(酶联免疫吸附测定)商业试剂盒分析血清 BDNF 水平。对所有患有先天性心脏病的婴儿进行了头颅超声波检查(USG)。心脏手术后,患者分别在术后 24 小时和 72 小时接受了第二次和第三次头颅 USG 检查。连续 44 例患有先天性心脏病的患者被分为两组:手术组(30 例)和非手术组(14 例)。虽然病例组和对照组的基线血清 BDNF 水平没有差异,但手术组患者术前血清 BDNF 水平明显低于非手术组患者。术后第 24 小时的血清 BDNF 水平高于术前水平。然而,术后 24 小时和 72 小时的血清 BDNF 水平与相应时间的头颅 USG 结果之间没有发现明显的相关性。接受手术的患有先天性心脏病的新生儿的血清BDNF水平最初较低,但在术后早期有所上升。这些结果表明,血清BDNF水平受CHD和术后的影响。
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