Retinal biomarkers in relation to post-CABG delirium and cognition: Eyeing the link between heart and brain health
Description: Background One fifth of patients who undergo coronary artery bypass graft (CABG) surgery has cognitive impairment before surgery, and delirium occurs in roughly one fifth of patients after CABG surgery. Both post-CABG delirium and cognitive impairment have tremendous impact on quality of life, and both increase the risk for morbidity and mortality. However, current delirium prediction models rely on demographic and peripheral markers because, to date, no direct, efficient, non-invasive assessment of CNS vulnerability to delirium exists. Innovation We propose the novel application of retinal biomarkers to study not only delirium risk but also the underlying neural and neurovascular basis for delirium and its subsequent cognitive and functional outcomes. Retinal optical coherence tomography (OCT), OCT angiography (OCTA) at rest and during vascular reactivity, and flash electroretinography (ERG)—forms of retinal imaging and electrophysiology—can provide direct, efficient, non-invasive measures of neural and neurovascular structure and function in the CNS. Methods We will enroll 60 patients without dementia who are undergoing CABG surgery, characterize the sample before surgery including retinal assessment, obtain perioperative variables, assess for postoperative delirium daily, and follow up with patients over the following 3 months using phone assessments. We aim to assess the predictive validity of retinal biomarkers for post-CABG delirium, pre- and post-CABG cognition, and additional measures of mental and sleep health. Implications The study, which directly evaluates cardiovascular and neurovascular pathology in relation to brain health and well-being, aims to validate retinal biomarkers for (a) early identification of cognitive impairment and neuropathology, (b) characterizing cerebrovascular disease; and (c) risk stratification regarding real-world outcomes essential to overall well-being and quality of life.
Funder: American Heart Association
Amount: $200,000
Funding type: research
Funder scheme: Innovative Project Award
Start date: 2023-07-01
End date: 2025-06-30
Investigators: Mark Oldham, Mark Oldham
Institution: University of Rochester Medical Center (URMC), Rochester, NY
Field: Medicine
Domain: Health Sciences
Funded outputs count: 2
Funder award ID: 23IPA1047969
OpenAlex ID: G8459562014