Related Experiment Video
Updated: Jan 11, 2026
A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
Association of Plasma BDNF Concentration and Val66Met Polymorphism with Postoperative Delirium After Cardiac Surgery
Kacper Lechowicz1, Aleksandra Szylińska2, Elżbieta Cecerska-Heryć3
1Department of Anesthesiology, Intensive Care and Pain Management, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Insights
Postoperative delirium (POD) in cardiac surgery patients was not linked to brain-derived neurotrophic factor (BDNF) levels or its Val66Met polymorphism. However, POD was associated with longer hospital stays and reoperations, highlighting the need for better neurological complication management.
Area of Science:
- Neuroscience
- Cardiology
- Genetics
Background:
- Cardiac surgery with cardiopulmonary bypass (CPB) poses a high risk of neurological complications, notably postoperative delirium (POD).
- Brain-derived neurotrophic factor (BDNF) and its Val66Met polymorphism are investigated for their potential role in predicting POD.
- Understanding these factors is crucial for improving patient outcomes after cardiac procedures.
Purpose of the Study:
- To investigate the association between perioperative plasma BDNF levels, the BDNF Val66Met polymorphism, and the incidence of POD.
- To evaluate the impact of these factors on cognitive function and neurological complications in patients undergoing elective cardiac surgery with CPB.
Main Methods:
- Prospective observational study of 287 adults undergoing elective coronary artery bypass grafting (CABG) with CPB.
- Preoperative assessment included cognitive tests (MoCA), laboratory analysis, and BDNF Val66Met genotyping.
- Postoperative assessment utilized CAM-ICU for POD and follow-up evaluations for cognitive function and neurological complications.
Main Results:
- Postoperative delirium (POD) occurred in 19.6% of patients, associated with older age, higher EuroSCORE II, and comorbidities.
- POD was significantly linked to prolonged hospital stay, need for renal replacement therapy, and reoperation.
- The BDNF Val66Met polymorphism was not associated with POD, though carriers had higher plasma BDNF levels.
Conclusions:
- Perioperative plasma BDNF concentrations and the BDNF Val66Met polymorphism were not independent predictors of POD in elective CABG patients.
- POD remains a significant complication associated with prolonged hospitalization and reoperations.
- Further research is needed for early identification and management strategies for neurological complications in cardiac surgery.
Abstract:
Background/Objectives: Cardiac surgery, particularly procedures performed with cardiopulmonary bypass (CPB), carries a high risk of neurological complications, including postoperative delirium (POD), which affects 16-73% of patients and increases the likelihood of long-term cognitive impairment. Brain-derived neurotrophic factor (BDNF), a neurotrophin involved in neuronal function, synaptic plasticity, and inflammatory regulation processes, including its Val66Met polymorphism, has been implicated as a potential predictor of POD. This study aimed to evaluate the relationship between perioperative plasma BDNF levels, the BDNF Val66Met polymorphism, and the incidence of POD in patients undergoing elective cardiac surgery with CPB. Methods: This prospective observational single-center study enrolled 287 adults scheduled for elective isolated coronary artery bypass grafting (CABG) with CPB, of whom 107 met all inclusion criteria for final analysis. Exclusion criteria included urgent surgery and pre-existing cognitive or psychiatric disorders. Preoperative evaluation included cognitive testing (MoCA), laboratory and biochemical analysis, and genotyping for BDNF Val66Met. Postoperatively, patients were assessed for POD using the CAM-ICU scale for the first three consecutive days. Cognitive function (using MoCA) and other neurological complications were evaluated during hospitalization, at 30-day and 12-month follow-up. Associations between biomarkers, genetic factors, and clinical outcomes were analyzed. Results: POD occurred in 19.6% of patients who were older, had higher EuroSCORE II, greater coronary disease burden, more frequent prior stroke and chronic kidney disease, and lower neutrophil counts. POD was significantly associated with prolonged hospital stay, need for continuous renal replacement therapy, and reoperation. The BDNF Val66Met polymorphism was present in 31.8% of patients but was not associated with POD, although carriers exhibited higher plasma BDNF concentrations across all time points. Conclusions: Perioperative plasma BDNF concentrations and the BDNF Val66Met polymorphism were not independently associated with the occurrence of POD in elective CABG patients. However, POD was significantly linked to prolonged hospitalization and reoperations. Neurological complications remain an important challenge in cardiac surgery, emphasizing the need for further research and early identification strategies to improve postoperative outcomes.
