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Ghosh S, Bleiweis MS, Jacobs JP, Candelario-Jalil E. Using interleukin-18, Eotaxin-1, and Eotaxin-3 to identify brain injury in neonates with congenital heart disease. J Neuroimmunol 2023; 385:578239. [PMID: 37976996 DOI: 10.1016/j.jneuroim.2023.578239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/03/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Serum biomarkers for brain injury in neonates with congenital heart disease (CHD) provide a bedside tool for early identification and intervention. In this preliminary study, we aim to evaluate IL-18, Eotaxin-1 and Eotaxin-3 as biomarkers for the detection of brain injury in neonates with CHD. METHODS We prospectively enrolled seven neonates diagnosed in-utero with CHD and obtained serum samples at birth, before and after surgery. Samples were analyzed using a human cytokine/chemokine multiplex assay. Brain injury was diagnosed on brain MRI before surgery. RESULTS Samples from seven neonates at four time points before surgery and three time points after surgery were analyzed. A significant difference was found in neonates with brain injury compared to CHD neonates without. Elevations in interleukin (IL)-18 pre- and post-operative (p = 0.007), IL-18 pre-operative (p = 0.046), Eotaxin-1 pre-operative (p = 0.011), and Eotaxin-3 pre- and post-operative (p = 0.026) were found in CHD neonates with brain injury. CONCLUSION This is the first published report on the use IL-18, Eotaxin-1, and Eotaxin-3 in the detection of brain injury for neonates with CHD. These biomarkers may provide an actionable target for neuroprotection through immunomodulation. Larger cohorts are needed to determine the significance and clinical utility of these biomarkers.
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Affiliation(s)
- Suman Ghosh
- Department of Neurology, SUNY Downstate College of Medicine, Brooklyn, NY, USA; Pediatric Neurology, Department of Neurology, NYC-HHC Kings County Hospital, Brooklyn, NY, USA.
| | - Mark S Bleiweis
- University of Florida Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL, USA
| | - Jeffrey P Jacobs
- University of Florida Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL, USA
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Kuhn JE, Pareja Zabala MC, Chavez MM, Almodóvar M, Mulinari LA, Sainathan S, de Rivero Vaccari JP, Wang KK, Muñoz Pareja JC. Utility of Brain Injury Biomarkers in Children With Congenital Heart Disease Undergoing Cardiac Surgery. Pediatr Neurol 2023; 148:44-53. [PMID: 37657124 DOI: 10.1016/j.pediatrneurol.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Congenital heart disease (CHD) affects roughly 40,000 children annually. Despite advancements, children undergoing surgery for CHD are at an increased risk for adverse neurological outcomes. At present, there is no gold standard for the diagnosis of cerebral injury during the perioperative period. OBJECTIVE To determine the utility of brain injury biomarkers in children undergoing cardiac surgery. METHODS We searched PUBMED, EMBASE, LILACS, EBSCO, ClinicalTrials.gov, Cochrane Databases, and OVID interface to search MEDLINE through July 2021 and assessed the literature following the snowball method. The search terms used were "congenital heart disease," "cardiopulmonary bypass," "biomarkers," "diagnosis," "prognosis," and "children." No language or publication date restrictions were used. Papers studying inflammatory and imaging biomarkers were excluded. The risk of bias, strengths, and limitations of the study were reported. Study was registered in PROSPERO ID: CRD42021258385. RESULTS A total of 1449 articles were retrieved, and 27 were included. Eight neurological biomarkers were examined. Outcomes assessed included prognosis of poor neurological outcome, mortality, readmission, and diagnosis of brain injury. Results from these studies support that significant perioperative elevations in brain injury biomarkers in cerebrospinal fluid and serum, including S100B, GFAP, NSE, and activin A, may be diagnostic of real-time brain injury and serve as an independent predictor of adverse neurological outcomes in patients with CHD undergoing cardiopulmonary bypass. CONCLUSIONS There are limited homogeneous data in the field, limiting the generalizability and comparability of the results. Further large-scale longitudinal studies addressing neurological biomarkers in children undergoing CHD corrective surgery are required to support the routine use of neuronal biomarkers in this population.
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Affiliation(s)
- Jessica E Kuhn
- University of Miami Miller School of Medicine, Miami, Florida
| | | | - Maria Mateo Chavez
- Knowledge and Research Evaluation Unit, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Melvin Almodóvar
- Division of Pediatric Cardiology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Leonardo A Mulinari
- Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Sandeep Sainathan
- Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery and the Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida
| | - Kevin K Wang
- Department of Emergency Medicine, Morehouse University, School of Medicine, Atlanta, Georgia; Center for Neurotrauma, Multiomics & Biomarkers (CNMB), Morehouse University, School of Medicine, Atlanta, Georgia
| | - Jennifer C Muñoz Pareja
- Department of Neurological Surgery and the Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida; Division of Pediatric Critical Care, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.
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Donnelly CG, Finno CJ. Vitamin E depletion is associated with subclinical axonal degeneration in juvenile horses. Equine Vet J 2023; 55:884-890. [PMID: 36516303 PMCID: PMC10264549 DOI: 10.1111/evj.13907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Phosphorylated neurofilament heavy, a marker of neuroaxonal damage, is increased in horses with equine neuroaxonal dystrophy. However, the temporal dynamics of this biomarker during the post-natal risk period are not understood. OBJECTIVE To measure serum and cerebrospinal fluid phosphorylated neurofilament heavy concentrations in juvenile foals across the post-natal window of susceptibility for equine neuroaxonal dystrophy. STUDY DESIGN Case-control in vivo experimental study. METHODS Concentrations of phosphorylated neurofilament heavy were measured using frozen serum and cerebrospinal fluid collected from 13 foals raised in a vitamin E deficient environment from 1 to 6 months of age. Four of these foals were produced by equine neuroaxonal dystrophy-affected dams, developed clinical signs consistent with equine neuroaxonal dystrophy and had a diagnosis confirmed by histopathology. The remaining nine foals, produced by healthy mares, were vitamin E depleted and remained clinically healthy. An additional cohort of foals, produced by healthy mares, were supplemented with vitamin E (α-tocopherol; α-TOH) from birth and sampled similarly. RESULTS Serum α-TOH concentrations were significantly higher in vitamin E supplemented healthy foals. Serum phosphorylated neurofilament heavy concentrations did not differ significantly between groups at any time point. Cerebrospinal fluid phosphorylated neurofilament heavy concentrations increased with age in healthy vitamin E depleted foals (p < 0.001); an effect that was not observed in healthy vitamin E supplemented foals. MAIN LIMITATIONS A genetically susceptible cohort supplemented with vitamin E was not available for comparison. CONCLUSION We demonstrate that vitamin E depletion may elevate cerebrospinal fluid phosphorylated neurofilament heavy in otherwise healthy juvenile foals by 6 months of age. We highlight an important cofactor to consider when interpreting cerebrospinal fluid phosphorylated neurofilament heavy concentrations in juvenile horses.
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Affiliation(s)
- Callum G. Donnelly
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Carrie J. Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA
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Brooks BA, Sinha P, Staffa SJ, Jacobs MB, Freishtat RJ, Patregnani JT. Children with single ventricle heart disease have a greater increase in sRAGE after cardiopulmonary bypass. Perfusion 2023:2676591231189357. [PMID: 37465929 DOI: 10.1177/02676591231189357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Reducing cardiopulmonary bypass (CPB) induced inflammatory injury is a potentially important strategy for children undergoing multiple operations for single ventricle palliation. We sought to characterize the soluble receptor for advanced glycation end products (sRAGE), a protein involved in acute lung injury and inflammation, in pediatric patients with congenital heart disease and hypothesized that patients undergoing single ventricle palliation would have higher levels of sRAGE following bypass than those with biventricular physiologies. METHODS This was a prospective, observational study of children undergoing CPB. Plasma samples were obtained before and after bypass. sRAGE levels were measured and compared between those with biventricular and single ventricle heart disease using descriptive statistics and multivariate analysis for risk factors for lung injury. RESULTS sRAGE levels were measured in 40 patients: 19 with biventricular and 21 with single ventricle heart disease. Children undergoing single ventricle palliation had a higher factor and percent increase in sRAGE levels when compared to patients with biventricular circulations (4.6 vs. 2.4, p = 0.002) and (364% vs. 181%, p = 0.014). The factor increase in sRAGE inversely correlated with the patient's preoperative oxygen saturation (Pearson correlation (r) = -0.43, p = 0.005) and was positively associated with red blood cell transfusion (coefficient = 0.011; 95% CI: 0.004, 0.017; p = 0.001). CONCLUSIONS Children with single ventricle physiology have greater increase in sRAGE following CPB as compared to children undergoing biventricular repair. Larger studies delineating the role of sRAGE in children undergoing single ventricle palliation may be beneficial in understanding how to prevent complications in this high-risk population.
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Affiliation(s)
- Bonnie A Brooks
- Division of Pediatric Critical Care Medicine, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA
- Division of Critical Care Medicine, Children's National Hospital, Washington, DC, USA
| | - Pranava Sinha
- Department of Pediatric Cardiac Surgery, M Health Fairview University of Minnesota, Minneapolis MN, USA
- Division of Cardiovascular Surgery, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard University, Boston Children's Hospital, Boston, MA, USA
| | - Marni B Jacobs
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, CA, USA
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA
| | - Robert J Freishtat
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC, USA
- Departments of Pediatrics, Emergency Medicine, and Genomics & Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Jason T Patregnani
- Division of Pediatric Critical Care Medicine, Maine Medical Center, Tufts University School of Medicine, Barbara Bush Children's Hospital, Portland, ME, USA
- Division of Pediatric Cardiac Critical Care, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA
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Moons P, Marelli A. Born to Age: When Adult Congenital Heart Disease Converges With Geroscience. JACC. ADVANCES 2022; 1:100012. [PMID: 38939088 PMCID: PMC11198429 DOI: 10.1016/j.jacadv.2022.100012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 06/29/2024]
Abstract
Advances in imaging, catheter-based interventions, congenital heart disease surgery, and clinical management of congenital heart disease (CHD) have yielded a dramatic change in age distribution of the CHD population. This implores clinicians and researchers to gain a better understanding of aging, as this will be the cornerstone to how we plan and manage this rapidly evolving group of patients. In this article, we first review the demographic changes in the CHD population and then describe the systemic complications of disease observed in young patients with CHD, following which we discuss general concepts in aging that may be transferable to the CHD population. Finally, we review inflammation and its potential impact on aging. We provide a new lens on aging in CHD and its functional consequences in CHD, with the goal of stimulating an exchange of knowledge between geroscientists and CHD.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Ariane Marelli
- McGill University Health Center, McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Montreal, Quebec, Canada
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Souza NMGD, Silva VMD, Lopes MVO. Teoria de Médio Alcance do Padrão Respiratório Ineficaz em Crianças com Cardiopatia Congênita. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5826.3784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Objetivo: desenvolver e avaliar uma teoria de médio alcance para o Diagnóstico de Enfermagem de Padrão Respiratório Ineficaz em crianças com cardiopatia congênita. Método: um estudo metodológico realizado em duas etapas: 1) desenvolvimento de uma teoria de médio alcance para padrão respiratório ineficaz em crianças com doenças cardíacas congênitas a partir da análise da taxonomia NANDA-Internacional, modelo de adaptação de Callista Roy e uma revisão da literatura; e 2) avaliação da teoria de médio alcance desenvolvida por meio da avaliação de painéis de especialistas. Resultados: após três avaliações de painéis, a versão final da teoria de médio alcance resultou em quatro metaparadigmas, dois conceitos-chave, dois diagramas pictóricos, duas propostas e uma descrição das inter-relações entre os conceitos-chave do Padrão Respiratório Ineficaz em crianças com cardiopatias congênitas e evidências para a prática de Enfermagem. Conclusão: a teoria do médio alcance desenvolvida e avaliada por especialistas identificou estímulos e comportamentos que podem auxiliar os enfermeiros na identificação das razões pelas quais o Padrão Respiratório Ineficaz é diagnosticado e como ele se manifesta em crianças com cardiopatia congênita, aumentando a compreensão das relações entre as causas e sua temporalidade.
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de Souza NMG, da Silva VM, Lopes MVO. Middle-Range Theory of Ineffective Breathing Pattern in children with Congenital Heart Disease. Rev Lat Am Enfermagem 2022; 30:e3783. [PMID: 36629731 PMCID: PMC9818354 DOI: 10.1590/1518-8345.5826.3783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/29/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE to develop and evaluate a middle-range theory for the Nursing Diagnosis of Ineffective Breathing Pattern in children with congenital heart disease. METHOD a methodological study carried out in two stages: 1) development of a middle- range theory for Ineffective Breathing Pattern in children with congenital heart diseases from the analysis of the NANDA-International taxonomy, Callista Roy's Adaptation Model and a literature review; and 2) assessment of the middle-range theory developed using expert panel evaluation. RESULTS after three panel evaluations, the final version of the middle-range theory resulted in four metaparadigms, two key concepts, two pictorial diagrams, two propositions and a description of the interrelationships between the key concepts of Ineffective Breathing Pattern in children with congenital heart diseases and evidence for the Nursing practice. CONCLUSION the middle-range theory developed and evaluated by experts identified stimuli and behaviors that can assist nurses in identifying the reasons why Ineffective Breathing Pattern is diagnosed and how it manifests itself in children with congenital heart disease, increasing understanding of the relationships between the causes and their temporality.
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Souza NMGD, Silva VMD, Lopes MVO. Teoría de Mediano Alcance del Patrón de Respiración Ineficiente en niños con cardiopatías congénitas. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5826.3782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumen Objetivo: desarrollar y evaluar una teoría de mediano alcance para el Diagnóstico de Enfermería “Patrón de Respiración Ineficiente” en niños con cardiopatías congénitas. Método: estudio metodológico desarrollado en dos etapas: 1) Desarrollo de una teoría de mediano alcance para el Patrón de Respiración Ineficiente en niños con cardiopatías congénitas a partir del análisis de la taxonomía NANDA-Internacional, del Modelo de Adaptación de Callista Roy y de una revisión de la literatura; y 2) Evaluación de la teoría de mediano alcance desarrollada por medio de una evaluación de un panel de expertos. Resultados: después de tres evaluaciones a cargo del panel, la versión final de la teoría de mediano alcance derivó en cuatro metaparadigmas, dos conceptos clave, dos pictogramas, dos propuestas y una descripción de las interrelaciones entre los conceptos clave del Patrón de Respiración Ineficiente en niños con cardiopatías congénitas y evidencia para la práctica de Enfermería. Conclusión: la teoría de mediano alcance desarrollada y evaluada por expertos identificó estímulos y comportamientos que pueden ayudar a los enfermeros a identificar los motivos por los cuales se diagnostica el Patrón de Respiración Ineficiente y cómo se manifiesta en niños con cardiopatías congénitas, mejorando así la comprensión de las relaciones entre las causas y su temporalidad.
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Souza NMGD, Silva VMD, Lopes MVDO, Guedes NG, Pascoal LM, Beltrão BA. Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. Rev Bras Enferm 2021; 74:e20190844. [PMID: 33909807 DOI: 10.1590/0034-7167-2019-0844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/01/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. METHOD Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05. RESULTS The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy. CONCLUSION The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.
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Affiliation(s)
| | | | | | | | | | - Beatriz Amorim Beltrão
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio. Fortaleza, Ceará, Brazil
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Zhu S, Sai X, Lin J, Deng G, Zhao M, Nasser MI, Zhu P. Mechanisms of perioperative brain damage in children with congenital heart disease. Biomed Pharmacother 2020; 132:110957. [PMID: 33254442 DOI: 10.1016/j.biopha.2020.110957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/15/2022] Open
Abstract
Congenital heart disease, particularly cyanotic congenital heart disease (CCHD), may lead to a neurodevelopmental delay through central nervous system injury, more unstable central nervous system development, and increased vulnerability of the nervous system. Neurodevelopmental disease is the most serious disorder of childhood, affecting the quality of life of children and their families. Therefore, the monitoring and optimization of nerve damage treatments are important. The factors contributing to neurodevelopmental disease are primarily related to preoperative, intraoperative, postoperative, genetic, and environmental causes, with intraoperative causes being the most influential. Nevertheless, few studies have examined these factors, particularly the influencing factors during early postoperative care. Children with congenital heart disease may experience brain damage during early heart intensive care due to unstable haemodynamics and total body oxygen transfer, particularly early postoperative inflammatory reactions in the brain, blood glucose levels, and other factors that potentially influence long-term neural development. This study analyses the forms of structural and functional brain damage in the early postoperative period, along with the recent evolution of research on its contributing factors.
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Affiliation(s)
- Shuoji Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Xiyalatu Sai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianxin Lin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Gang Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Mingyi Zhao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
| | - M I Nasser
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
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Manuel V, Miana LA, Guerreiro GP, Tenório DF, Turquetto A, Penha JG, Massoti MR, Tanamati C, Junior APF, Caneo LF, Jatene FB, Jatene MB. Prognostic value of the preoperative neutrophil‐lymphocyte ratio in patients undergoing the bidirectional Glenn procedure. J Card Surg 2019; 35:328-334. [DOI: 10.1111/jocs.14381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Valdano Manuel
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
- Cardio‐Thoracic CenterClínica GirassolLuanda Angola
| | - Leonardo A. Miana
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Gustavo P. Guerreiro
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Davi F. Tenório
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Aida Turquetto
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Juliano G. Penha
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Maria R. Massoti
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Carla Tanamati
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | | | - Luiz F. Caneo
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Fábio B. Jatene
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
| | - Marcelo B. Jatene
- Division of Cardiovascular SurgeryHeart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloPinheiros São Paulo Brazil
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