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Heat shock proteins HSP70 and HSP27 in the cerebral spinal fluid of patients undergoing thoracic aneurysm repair correlate with the probability of postoperative paralysis

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Cell Stress and Chaperones Aims and scope


An understanding of the time course and correlation with injury of heat shock proteins (HSPs) released during brain and/or spinal cord cellular stress (ischemia) is critical in understanding the role of the HSPs in cellular survival, and may provide a clinically useful biomarker of severe cellular stress. We have analyzed the levels of HSPs in the cerebrospinal fluid (CSF) from patients who are undergoing thoracic aneurysm repair. Blood and CSF samples were collected at regular intervals, and CSF was analyzed by enzyme-linked immunosorbent assay for HSP70 and HSP27. These results were correlated with intraoperative somatosensory-evoked potentials measurements and postoperative paralysis. We find that the levels of these proteins in many patients are elevated and that the degree of elevation correlates with the risk of permanent paralysis. We hypothesize that sequential measurement intraoperatively of the levels of the heat shock proteins HSP70 and HSP27 in the CSF can predict those patients who are at greatest risk for paralysis during thoracic aneurysm surgery and will allow us to develop means of preventing or attenuating this severe and often fatal complication.

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thoracic aortic aneurysm


thoraco-abdominal aortic aneurysm


deep hypothermic circulatory arrest


left atrial femoral artery bypass


coronary artery bypass graft


heat shock protein


somato sensory-evoked potentials


motor-evoked potential, EEG


thoracic aortic endovascular repair


mean arterial pressure


central nervous system


cerebral spinal fluid


intracerebral pressure


American Spinal Injury Association


NIH Stroke Scale


residual squared error


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We would like to express our gratitude for the valuable expertise of, skillful intraoperative management by, and discussions with our cardiac anesthesia colleagues, Drs. Augostides, Cheung, Floyd, Hanson, Horak, Levy, Savino, and Weiss. We also gratefully acknowledge the cooperation of the Aortic Surgery Group of Drs. Acker, Bavaria, Pochettino, Szeto, and Woo. We also thank Dr. Andrew Ochroch for preliminary statistical analysis.

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Correspondence to James G. Hecker.

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M.L. McGarvey and J.G. Hecker contributed equally to this work.

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Hecker, J.G., Sundram, H., Zou, S. et al. Heat shock proteins HSP70 and HSP27 in the cerebral spinal fluid of patients undergoing thoracic aneurysm repair correlate with the probability of postoperative paralysis. Cell Stress and Chaperones 13, 435–446 (2008).

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