Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Genetic markers of risk of neurological complications in cardiac surgery. Part 3

Authors: Koksheneva I.V., Zakaraya I.T.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-3-193-200

UDC: 616.831-005.4:616.12-089

Link: Clinical Physiology of Blood Circulaiton. 2021; 3 (18): 193-200

Quote as: Koksheneva I.V., Zakaraya I.T. Genetic markers of risk of neurological complications in cardiac surgery. Part 3. Clinical Physiology of Circulation. 2021; 18 (3): 193–200 (in Russ.). DOI: 10.24022/1814-6910-2021-18-3-193-200

Received / Accepted:  22.10.2020 / 27.11.2020

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Abstract

Despite the improvement of surgical methods and anesthesia, the incidence of neurological complications after cardiac surgery, varying in severity from cerebral coma to focal stroke, is 1–3%, and cognitive deficit is up to 69%. That has a significant impact on mortality rates, and subsequently on the quality of life of patients. The pathophysiology of perioperative neurological damage is complex, including complex interactions between regulatory pathways of inflammation, hemostasis, lipid metabolism, and others. In each of these pathways, polymorphic genetic variants have been identified. Certain genetic polymorphisms can modulate the risk of neurological complications after cardiac surgery. This review presents the published data on identified genetic variants associated with perioperative neurological damage in patients undergoing cardiac surgery. These data hold promise for clinical use. First, to better predict the risk of neurological complications before cardiac surgery. Secondly, preoperative genetic screening may allow a change in surgical tactics, with the introduction of procedures aimed at reducing this risk. For example, avoid clamping the aorta during surgery. In addition, the use of neuroprotective strategies and/or pharmacological agents, especially in patients at highest risk, may reduce the risks of neurological complications.

About Authors

  • Inna V. Koksheneva, Dr. Med. Sci., Senior Researcher; ORCID
  • Irakliy T. Zakaraya, Junior Researcher

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