Journal of Cardiothoracic Surgery最新文献

{"title":"Expression level and clinical significance of IL-29 in serum of patients with coronary heart disease.","authors":"Ping Ni, Liming Dai, Hai Li, Jun Sun, Yicheng Zhu, Xiaolei Lv","doi":"10.1186/s13019-025-03490-y","DOIUrl":"10.1186/s13019-025-03490-y","url":null,"abstract":"<p><strong>Background: </strong>Coronary heart disease (CHD) is a chronic inflammatory disease carrying high morbidity and mortality. Interleukin (IL)-29 may be used as a biomarker for autoimmune diseases. This paper investigates the diagnostic value of serum IL-29 in CHD patients.</p><p><strong>Methods: </strong>A total of 90 CHD patients (39 mild and 51 severe patients) and 90 controls were included. Serum IL-29 levels were detected by ELISA, and the diagnostic value of IL-29 in CHD was analyzed by ROC curve. According to the median value of serum IL-29 level, CHD patients were categorized into IL-29 low-level group and high-level group. The correlation between IL-29 and pathological indexes of CHD patients was analyzed by chi-square test. SYNTAX score was used to classify CHD patients into mild CHD and moderate/severe CHD. Pearson coefficient analyzed the correlation between IL-29 and CHD severity. Multivariate logistic regression analyzed the risk factors for CHD exacerbation.</p><p><strong>Results: </strong>IL-29 serum levels were elevated in CHD patients. The AUC for CHD diagnosis by serum IL-29 was 0.789 (65.6% sensitivity and 76.7% specificity). IL-29 was correlated with BMI, PHASE score, and CRP. IL-29 serum level was positively correlated with CHD severity. The AUC for differentiating mild and moderate/severe CHD patients by IL-29 level was 0.739 (70.6% sensitivity and 66.7% specificity). IL-29 was an independent risk factor for CHD exacerbation, and each one-unit increase in IL-29 increased the risk of exacerbation in CHD patients by 1.065-fold.</p><p><strong>Conclusion: </strong>IL-29 is highly expressed in CHD patients and has auxiliary diagnostic value for CHD.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"249"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elucidating the role of KLRD1 in coronary atherosclerosis: harnessing bioinformatics and machine learning to advance understanding.","authors":"Huan Liang, Xiao Liang, Man Zheng, Shoudong Wang","doi":"10.1186/s13019-025-03473-z","DOIUrl":"10.1186/s13019-025-03473-z","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis (AS) is increasingly recognized as a chronic inflammatory disease that significantly compromises vascular health and serves as a major contributor to cardiovascular diseases. KLRD1 is a gene that encodes a protein involved in the immune system, specifically in the function of natural killer (NK) cells.</p><p><strong>Methods: </strong>KLRD1 was identified as a focal point through an integrative analysis of DEGs across multiple datasets (GSE43292 and GSE9820) from the GEO database, aligned with immune-related gene sets from the ImmPort database. Advanced analytical tools, including Lasso regression and SVM-RFE, were employed to refine our gene selection. We further applied GSEA and GSVA to these gene sets, revealing significant enrichment in immune-related pathways. The relationship between KLRD1 expression and immune processes was examined using CIBERSORT and ESTIMATE algorithms to assess tumor microenvironment characteristics, suggesting increased immune cell infiltration associated with higher KLRD1 expression. Validation of these findings was conducted using data from the GSE9820 dataset.</p><p><strong>Results: </strong>Among 340 DEGs linked with KLRD1, 13 were identified as hub genes through LASSO and SVM-RFE analyses. Functional assays highlighted KLRD1's role in mononuclear cell differentiation, regulation of cell-cell adhesion, regulation of T cell activation. A Lollipop was created to display the expression patterns of Correlation Coefficient. T cells CD8, Plasma cells, Dendritic cells activated, T cells CD4 memory resting, T cells CD4 memory activated, T cells gamma delta.</p><p><strong>Conclusions: </strong>This research elucidates the complex relationship between KLRD1 and AS, underscoring its potential as a novel biomarker for diagnosing and monitoring the disease.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"248"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the impact of minimally invasive esophagectomy on quality of life and functional prognosis in patients with esophageal squamous cell carcinoma: A retrospective comparative study.","authors":"Bo Liu, Kebing Wang, Wei Wang, Si Ye","doi":"10.1186/s13019-025-03485-9","DOIUrl":"10.1186/s13019-025-03485-9","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive esophagectomy (MIE) has shown potential benefits in reducing postoperative complications and improving recovery for patients with esophageal squamous cell carcinoma (ESCC). This study aims to assess the effects of MIE on preoperative and postoperative quality of life and functional outcomes in ESCC patients.</p><p><strong>Methods: </strong>Clinical data from 57 ESCC patients who underwent MIE were retrospectively analyzed. Baseline characteristics, including age, gender, BMI, TNM stage, smoking history, alcohol consumption, comorbidities, tumor location, differentiation, and lymph node metastasis, were collected. Postoperative quality of life scores, nutritional status, and functional outcomes were assessed. Paired t-tests and chi-square tests were used to compare preoperative and postoperative variables, while correlation analysis was conducted to evaluate associations between functional outcomes and quality of life.</p><p><strong>Results: </strong>A total of 57 patients (41 males, 16 females; mean age: 67.61 ± 7.72 years) who underwent MIE were analyzed. Postoperative evaluation demonstrated significant improvements in quality of life scores across multiple dimensions, including physical symptoms (P = 0.006), emotional management (P = 0.013), role function (P = 0.013), cognitive function (P = 0.042), and social function (P = 0.021). Additionally, nutritional status improved postoperatively, with higher albumin levels (4.12 ± 0.34 g/dL vs. 3.78 ± 0.25 g/dL, P < 0.001) and reduced weight loss (1.98 ± 1.02 kg vs. 2.44 ± 1.12 kg, P = 0.026). Functional outcomes also showed significant improvements, including decreased dysphagia scores (3.45 ± 1.56 vs. 4.04 ± 0.31, P = 0.008), while cardiac physical activity and respiratory function remained stable (P > 0.05). Correlation analysis indicated significant associations between specific functional outcomes and quality of life (P < 0.05).</p><p><strong>Conclusion: </strong>MIE improves quality of life, nutritional status, and functional outcomes in patients with esophageal squamous cell carcinoma, highlighting its potential benefits in postoperative recovery and patient well-being.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"250"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of circ_0050908 in acute myocardial infarction (AMI) and its predictive value for AMI.","authors":"Quan Song, Li Fang, Zheyi Rong, Jingyi Yan, Junbo Wei, Jie Luan","doi":"10.1186/s13019-025-03478-8","DOIUrl":"10.1186/s13019-025-03478-8","url":null,"abstract":"<p><strong>Objective: </strong>Acute myocardial infarction (AMI) is a serious condition that significantly affects human health and is classified as an Acute Coronary Syndrome (ACS). Timely diagnosis of AMI is currently paramount for guiding its treatment. The objective of this research is to examine the influence of circ_0050908 in AMI and its potential as a predictive marker for the condition.</p><p><strong>Methods: </strong>The study included 110 patients with AMI, along with 82 healthy volunteers. The expression levels of circ_0050908 in the healthy control group, AMI patients, and AC16 cells were validated using the qRT-PCR method. The diagnostic value of circ_0050908 for AMI was assessed through binary logistic regression analysis and ROC curve analysis. An AMI cell model was constructed by subjecting AC16 cells to hypoxia-reoxygenation treatment. To assess cell viability and apoptosis, the researchers utilized the CCK-8 assay and flow cytometry techniques. The relationship between circ_0050908 and miR-338-3p was validated through dual-luciferase reporter assays and RNA immunoprecipitation (RIP) tests.</p><p><strong>Results: </strong>circ_0050908 was found to be significantly elevated in AMI patients, while the levels of its target, miR-338-3p, were significantly reduced. Furthermore, circ_0050908 demonstrated strong predictive ability for AMI. Silencing circ_0050908 showed protective effects against H/R-induced damage to myocardial cells, leading to enhanced cell survival and decreased inflammatory responses, along with decreased myocardial injury markers CK-MB and cTnT. However, transfection with miR-338-3p inhibitor suppressed these protective effects.</p><p><strong>Conclusion: </strong>This study indicated that circ_0050908 has potential value as a diagnostic biomarker for AMI and explored the function of the circ_0050908/miR-338-3p axis in the mechanism underlying AMI.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"247"},"PeriodicalIF":1.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot.","authors":"Vitor Mendes, Abdelkhalek Mouloudi, Jalal Jolou, Tomasz Nalecz, Ana Abecasis, Telmo Pereira, Tornike Sologashvili","doi":"10.1186/s13019-025-03475-x","DOIUrl":"10.1186/s13019-025-03475-x","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal surgical approach for right ventricular outflow tract obstruction in Tetralogy of Fallot aims to preserve the native pulmonary valve annulus, as this is associated with better long-term outcomes. Pediatric humanitarian patients often present with a delayed diagnosis and lack access to preoperative palliative treatments, reducing the likelihood of pulmonary valve annulus preservation and potentially compromising long-term outcomes. This study aims to identify independent predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients undergoing corrective surgery for Tetralogy of Fallot.</p><p><strong>Methods: </strong>Between January 2019 and May 2023, pediatric humanitarian patients with Tetralogy of Fallot underwent surgical correction at our center. We performed a comparative analysis of preoperative, intraoperative, and postoperative variables, followed by univariate and multivariate logistic regression to identify independent predictors of pulmonary valve-sparing repair.</p><p><strong>Results: </strong>A lower body mass index (OR = 0.711; p = 0.021; 95% CI = 0.533-0.949), a larger pulmonary valve annulus measured in centimeters (OR = 28.653; p = 0.008; 95% CI = 2.360-347.890) and a higher Z-score of pulmonary valve annulus (OR = 1.606; p = 0.023; 95% CI = 1.067-2.418) were identified as independent predictors of pulmonary valve-sparing repair.</p><p><strong>Conclusion: </strong>Successful pulmonary valve-sparing repair was associated with lower BMI and a larger pulmonary valve annulus (both measurements in centimeters and Z-score). These findings may help guide clinical and policy strategies to promote more equitable and effective surgical care in resource-limited settings.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"243"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of diagnosis and treatment of mediastinal Langerhans cytosis.","authors":"Yumeng Niu, Lei Xian, Yi Wang, Yourong Chen, Yifei Lu, Daying Liang","doi":"10.1186/s13019-025-03489-5","DOIUrl":"10.1186/s13019-025-03489-5","url":null,"abstract":"<p><strong>Background: </strong>Langerhans cell histiocytosis (LCH) is a rare disease. It mainly involves abnormal proliferation and aggregation of Langerhans cells, a type of cell of the immune system.Langerhans cytosis is more common in the bone, but it has rarely been reported in the mediastinum.</p><p><strong>Case presentation: </strong>We present a case of mediastinal thymus tumor presented with Langerhans cell histiocytosis. A 40-year-old female patient presented with left chest and back pain in April 2024. Imaging revealed abnormal signal lesions on the patient's left rib and anterior superior mediastinum. The clinical diagnosis was bone destruction and mediastinal space occupation, and the postoperative pathological diagnosis was Langerhans cell histiocytosis.</p><p><strong>Conclusions: </strong>Langerhans cytosis is characterized by mediastinal and thymus occupation and is relatively rare in clinical practice. For patients who tolerate surgery for a single or local lesion, surgical removal of the primary lesion should be considered. However, for patients with multiple lesions or distant metastases, clinicians should evaluate whether surgery will benefit the patient. After surgical treatment, targeted therapy or immunotherapy should be performed.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"245"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning radiomics fusion model to predict visceral pleural invasion of clinical stage IA lung adenocarcinoma: a multicenter study.","authors":"Jiabi Zhao, Tingting Wang, Bin Wang, Bhuva Maheshkumar Satishkumar, Lumin Ding, Xiwen Sun, Caizhong Chen","doi":"10.1186/s13019-025-03488-6","DOIUrl":"10.1186/s13019-025-03488-6","url":null,"abstract":"<p><strong>Aim: </strong>To assess the predictive performance, risk stratification capabilities, and auxiliary diagnostic utility of radiomics, deep learning, and fusion models in identifying visceral pleural invasion (VPI) in lung adenocarcinoma.</p><p><strong>Materials and methods: </strong>A total of 449 patients (female:male, 263:186; 59.8 ± 10.5 years) diagnosed with clinical IA stage lung adenocarcinoma (LAC) from two distinct hospitals were enrolled in the study and divided into a training cohort (n = 289) and an external test cohort (n = 160). The fusion models were constructed from the feature level and the decision level respectively. A comprehensive analysis was conducted to assess the prediction ability and prognostic value of radiomics, deep learning, and fusion models. The diagnostic performance of radiologists of varying seniority with and without the assistance of the optimal model was compared.</p><p><strong>Results: </strong>The late fusion model demonstrated superior diagnostic performance (AUC = 0.812) compared to clinical (AUC = 0.650), radiomics (AUC = 0.710), deep learning (AUC = 0.770), and the early fusion models (AUC = 0.586) in the external test cohort. The multivariate Cox regression analysis showed that the VPI status predicted by the late fusion model were independently associated with patient disease-free survival (DFS) (p = 0.044). Furthermore, model assistance significantly improved radiologist performance, particularly for junior radiologists; the AUC increased by 0.133 (p < 0.001) reaching levels comparable to the senior radiologist without model assistance (AUC: 0.745 vs. 0.730, p = 0.790).</p><p><strong>Conclusions: </strong>The proposed decision-level (late fusion) model significantly reducing the risk of overfitting and demonstrating excellent robustness in multicenter external validation, which can predict VPI status in LAC, aid in prognostic stratification, and assist radiologists in achieving higher diagnostic performance.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"246"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcription factor E2F1 promotes non-small cell lung cancer progression by activating the PI3K/AKT pathway through MCM4.","authors":"Yuyin Cai, Xinyan Lu, Tingting Li, Jia Liu, Lifeng Jiang","doi":"10.1186/s13019-025-03481-z","DOIUrl":"10.1186/s13019-025-03481-z","url":null,"abstract":"<p><strong>Purpose: </strong>Among malignant tumors, non-small cell lung cancer (NSCLC) remains a major threat to human life and health. Studies have illustrated that minichromosome maintenance protein 4 (MCM4) has complex interactions with the progression of many cancers, yet the role and mechanism of MCM4 in NSCLC remain to be elucidated.</p><p><strong>Methods: </strong>MCM4 expression in NSCLC tissues was assessed using the TCGA database. MCM4 levels in NSCLC cells and tissues was validated utilizing qRT-PCR and western blot. Cell proliferation, metastasis and EMT were measured by CCK-8, transwell, and western blot assays. Subsequently, E2F1 bound with the promoter of MCM4 was predicted via JASPAR database. Luciferase assay and chromatin immunoprecipitation (ChIP) were utilized to evaluate the binding relationship between the two. Finally, rescue experiments were performed to demonstrate the mechanism of MCM4 regulating NSCLC progression. Xenograft model was utilized to prove the role of MCM4 and E2F1 in NSCLC in vivo.</p><p><strong>Results: </strong>MCM4 was markedly elevated in NSCLC tumor samples and intimately linked to poor patient prognosis. Silencing of MCM4 repressed growth, migration, invasion, and EMT of cells. In vivo test findings displayed that knockdown of MCM4 suppressed changes in tumor volume and weight in mice. Moreover, E2F1 bound with the promoter of MCM4 was predicted by JASPAR database. E2F1 was heightened in NSCLC tissues and cells. Then, the outcome of rescue assays confirmed that E2F1 introduction attenuated the depressing influence of MCM4 knockdown on NSCLC. Moreover, E2F1/MCM4 promoted the progression of NSCLC by activating the PI3K/AKT signaling pathway.</p><p><strong>Conclusions: </strong>E2F1 accelerated NSCLC progression by activating the PI3K/AKT pathway through MCM4. Our outcomes confirmed that MCM4 is a potential target for the treatment of NSCLC patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"244"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of debranching technique with zone 1 thoracic endovascular aortic repair in high-risk patients with distal aortic arch lesions.","authors":"Xiaotian Gao, Xin Li, Shandong Liu, Chunhui Yu","doi":"10.1186/s13019-025-03469-9","DOIUrl":"10.1186/s13019-025-03469-9","url":null,"abstract":"<p><strong>Background: </strong>To share the results of the debranching technique with zone 1 thoracic endovascular aortic repair (TEVAR) in high-risk patients chosen based on older age, cardiopulmonary comorbidities, and unfit for open surgical procedures, who have distal arch lesions.</p><p><strong>Methods: </strong>Between January 2020 and August 2022, 15 patients treated in our practice were treated with the debranching technique TEVAR (d-TEVAR) for distal aortic arch lesions requiring a stent-graft landing in zone 1. We retrospectively reviewed clinical data and significant outcomes for prognostic analyses. Lesion types included chronic Stanford type B aortic dissections (n = 10), distal arch aneurysms (n = 4), and one pseudoaneurysm. All lesions were chronic, with no involvement of visceral vessels. These patients were considered high-risk in a multidisciplinary fashion.</p><p><strong>Results: </strong>All procedures were completed with a technical success rate of 100%. The mean operative time was 317 ± 48 min. No in-hospital mortality or major complications were recorded. One patient had a type I endoleak at 3 months that was treated conservatively due to no symptoms during follow-up (median 16 months, (range 12-20)), and in one patient, this was associated with fatal cerebral infarction at 4 months following the procedure, yielding a stroke rate of 6.7%. Graft survival for all patients, via a Kaplan-Meier analysis, was 89.3%.</p><p><strong>Conclusions: </strong>For distal aortic arch lesions requiring a zone 1 stent-graft landing, d-TEVAR is an effective and safe alternative treatment option with promising short-term results in well-selected high-risk patients and can be applied when open surgery constitutes a significant surgical risk.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"239"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consciousness in deep hypothermic circulatory arrest: a feasibility study.","authors":"Joshua Ross, Thomas Jan, Deane Smith, Anelly Gonzales, Aubrey Galloway, Natalia Leontovich, Tara Keshavarz, Analise Dickinson, David Friedman, Emmeline Koopman, Elise Huppert, Ian Jaffe, Christopher Burke, John Kern, Paul Stelzer, Ashraf Sabe, Rebecca Spiegel, Andrew Klein, Arvind Rajagopal, Gage Parr, Charles Deakin, Sam Parnia","doi":"10.1186/s13019-025-03484-w","DOIUrl":"10.1186/s13019-025-03484-w","url":null,"abstract":"<p><strong>Background: </strong>Studies have not explored consciousness during deep hypothermic circulatory arrest (DHCA). However, as studies in cardiac arrest have identified a spectrum of consciousness, we sought to establish the feasibility of studying consciousness during DHCA.</p><p><strong>Methods: </strong>This was a prospective study across 10 hospitals with 36 DHCA patients undergoing thoracic aortic aneurysm repair or pulmonary endarterectomy. A tablet computer delivered audiovisual stimuli (images and names of three fruits) using headphones during each procedure as a potential test of implicit learning and explicit recall. We also established electroencephalography (EEG) and near-infrared spectroscopy (NIRS) to measure electrocortical markers of consciousness and cerebral oxygenation. Post-procedure interviews were carried out to test patients' ability to recall the audiovisual stimuli as well other explicit memories.</p><p><strong>Primary outcomes: </strong>1) Feasibility of establishing tests of explicit recall and implicit learning, 2) Electroencephalography testing during DHCA.</p><p><strong>Secondary outcomes: </strong>1) Signs of explicit recall of memories or implicit learning, and 2) identification of electrocortical biomarkers of consciousness during DHCA.</p><p><strong>Results: </strong>Overall, 29/36 (81%) had the tablet set up. All 36 had NIRS and EEG set up, but 9 (25%) had useable EEG data, and 23 (66%) NIRS data. Delta EEG waves were observed during circulatory arrest in 3/9 (33%) patients, while 1/9 (11%) had theta waves just prior to circulatory arrest. All others showed isoelectric pattern. 35/36 (97%) agreed to follow up interviews. None had explicit recall of the names of the three fruits, but 3/36 (9%) correctly guessed them as a potential sign of implicit learning and 3 (9%) recalled other memories including events around the procedure and themes consistent with a recalled experience of death.</p><p><strong>Conclusions: </strong>A spectrum of consciousness and awareness, including signs of implicit learning and electrocortical biomarkers of consciousness may be present during DHCA, despite absence of visible signs of consciousness. This can be further used to help explain the negative psychological outcomes that cardiac arrest survivors face.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"242"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}