Protein Profiling in Serum and Cerebrospinal Fluid Following Complex Surgery on the Thoracic Aorta Identifies Biological Markers of Neurologic Injury

J Cardiovasc Transl Res. 2018 Dec;11(6):503-516. doi: 10.1007/s12265-018-9835-8. Epub 2018 Oct 26.


Surgery on the arch or descending aorta is associated with significant risk of neurological complications. As a consequence of intubation and sedation, early neurologic injury may remain unnoticed. Biomarkers to aid in the initial diagnostics could prove of great value as immediate intervention is critical. Twenty-three patients operated in the thoracic aorta with significant risk of perioperative neurological injury were included. Cerebrospinal fluid (CSF) and serum were obtained preoperatively and in the first and second postoperative days and assessed with a panel of 92 neurological-related proteins. Three patients suffered spinal cord injury (SCI), eight delirium, and nine hallucinations. There were markers in both serum and CSF that differed between the affected and non-affected patients (SCI; IL6, GFAP, CSPG4, delirium; TR4, EZH2, hallucinations; NF1). The study identifies markers in serum and CSF that reflect the occurrence of neurologic insults following aortic surgery, which may aid in the care of these patients.

Keywords: Biomarkers; Cardiovascular surgery; Neurologic injury; Thoracic aortic disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aorta, Thoracic / surgery*
  • Aortic Diseases / surgery*
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Blood Proteins / metabolism*
  • Cerebrospinal Fluid Proteins / cerebrospinal fluid*
  • Delirium / blood
  • Delirium / cerebrospinal fluid
  • Delirium / diagnosis
  • Female
  • Hallucinations / blood
  • Hallucinations / cerebrospinal fluid
  • Hallucinations / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proteomics / methods*
  • Risk Factors
  • Spinal Cord Injuries / blood
  • Spinal Cord Injuries / cerebrospinal fluid
  • Spinal Cord Injuries / diagnosis
  • Trauma, Nervous System / blood
  • Trauma, Nervous System / cerebrospinal fluid
  • Trauma, Nervous System / diagnosis*
  • Trauma, Nervous System / etiology
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects*


  • Biomarkers
  • Blood Proteins
  • Cerebrospinal Fluid Proteins