Cortical β-amyloid levels and neurocognitive performance after cardiac surgery.
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INTRODUCTION: Neurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to several years after surgery. More importantly, perioperative cognitive decline is predictive of long-term cognitive dysfunction, reduced quality of life and increased mortality. The proposed mechanisms to explain the cognitive decline associated with cardiac surgery include the neurotoxic accumulation of β-amyloid. This study will be the first to provide molecular imaging to assess the relationship between neocortical β-amyloid deposition and postoperative cognitive dysfunction. METHODS AND ANALYSIS: 40 patients providing informed consent for participation in this Institutional Review Board-approved study and undergoing cardiac (coronary artery bypass graft (CABG), valve or CABG+valve) surgery with cardiopulmonary bypass will be enrolled based on defined inclusion and exclusion criteria. At 6 weeks after surgery, participants will undergo (18)F-florbetapir positron emission tomography imaging to assess neocortical β-amyloid burden along with a standard neurocognitive battery and blood testing for apolipoprotein E ε-4 genotype. RESULTS: The results will be compared to those of 40 elderly controls and 40 elderly patients with mild cognitive impairment who have previously completed (18)F-florbetapir imaging. ETHICS AND DISSEMINATION: This study has been approved by the Duke University Institutional Review Board. The results will provide novel mechanistic insights into postoperative cognitive dysfunction that will inform future studies into potential treatments or preventative therapies of long-term cognitive decline after cardiac surgery.
Published Version (Please cite this version)10.1136/bmjopen-2013-003669
Publication InfoKlinger, Rebecca Y; James, Olga G; Wong, Terence Z; Newman, Mark F; Doraiswamy, P Murali; & Mathew, Joseph P (2013). Cortical β-amyloid levels and neurocognitive performance after cardiac surgery. BMJ Open, 3(9). pp. e003669. 10.1136/bmjopen-2013-003669. Retrieved from https://hdl.handle.net/10161/11134.
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Professor of Psychiatry and Behavioral Sciences
Murali Doraiswamy MBBS FRCP is Professor of Psychiatry and Professor in Medicine at Duke University School of Medicine where he is a highly cited physician scientist at the Duke Institute for Brain Sciences. He is also a Senior Fellow at the Duke Center for the Study of Aging and an Affiliate Faculty at the Duke Center for Precision Medicine and Applied Genomics as well as the Duke Microbiome Center. He directs a clinical trials unit that has been involved in the development of ma
Assistant Professor of Radiology
Assistant Professor of Anesthesiology
Jerry Reves, M.D. Distinguished Professor of Cardiac Anesthesiology
Current research interests include:1. The relationship between white matter patency, functional connectivity (fMRI) and neurocognitive function following cardiac surgery.2. The relationship between global and regional cortical beta-amyloid deposition and postoperative cognitive decline.3. The effect of lidocaine infusion upon neurocognitive function following cardiac surgery.4. The association between genotype and outcome after cardiac surgery.5. Atrial fibrillation
Merel H. Harmel Distinguished Professor Emeritus of Anesthesiology
Best known for his work in assessing and improving clinical outcomes and quality of life following cardiac surgery, Dr. Mark Newman is President of the Duke Private Diagnostic Clinic (The Duke Faculty Practice Organization) and the Merel H. Harmel Professor of Anesthesiology at Duke University Medical Center. In addition, Dr. Newman developed the Multicenter Perioperative Outcomes Research Group of the Duke Clinical Research Institute established at Duke in 2001 to further the study of strategie
Professor of Radiology
1. Anatomic/functional oncologic Imaging: SPECT/CT, PET/CT, novel PET radiotracers 2. Radiotheranostics, Radionuclide therapy of cancer, Radiation Therapy Planning 3. Imaging biomarkers for guiding treatment strategies 4. Multicenter clinical trial development (NCI National Clinical Trials Network)
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