NR2 antibody is associated with quality of life in aortic valve replacement.
BACKGROUND
The relationship between the potential brain injury biomarker N-methyl-D-aspartate receptor antibody and quality of life has never been assessed.


METHODS
We measured serum N-methyl-D-aspartate receptor antibody levels preoperatively in patients undergoing aortic valve replacement. Quality of life was scored using the Short Form-36 and European Quality of Life 5-Dimensions questionnaires pre- and postoperatively. We analyzed the antibody levels as a continuous variable and as a dichotomous variable with 1.8 ng mL(-1) as the cutoff.


RESULTS
Fifty-two patients (15 females) with a mean age of 71 ± 8.4 years were recruited for this study. Forty-eight (92%) patients attended the follow-up visit (405 ± 161 days). No mortality or severe neurological event was recorded. In both quality-of-life instruments, the low antibody level group (n = 35) had significantly better scores than the high antibody level group (n = 17) preoperatively. Postoperatively, the scores for both groups improved; however, the low antibody level group continued to score significantly better in most of the physical and mental health domains (p = 0.04 to <0.001). Multiple regression analyses revealed that antibody level and the 1.8 ng mL(-1) cutoff were independently related to quality of life (pre- and postoperatively).


CONCLUSIONS
Higher N-methyl-D-aspartate receptor antibody levels in aortic valve replacement patients are independently related to poorer quality of life pre- and postoperatively.
Department of Surgery & Cancer, St. Mary's Hospital, London, UK e.kidher@imperial.ac.uk.
Emaddin
E
Kidher
Department of Surgery & Cancer, St. Mary's Hospital, London, UK.
Omar A
OA
Jarral
Department of Surgery & Cancer, St. Mary's Hospital, London, UK.
Leanne
L
Harling
Departments of Cardiac Surgery and Cardiology, Hammersmith Hospital, London, UK.
Jon R
JR
Anderson
Departments of Cardiac Surgery and Cardiology, Hammersmith Hospital, London, UK.
Andrew
A
Chukwuemeka
Department of Surgery & Cancer, St. Mary's Hospital, London, UK.
Hutan
H
Ashrafian
Department of Cardiovascular Science, University of Sheffield, Sheffield, UK.
Paul C
PC
Evans
Department of Surgery & Cancer, St. Mary's Hospital, London, UK Departments of Cardiac Surgery and Cardiology, Hammersmith Hospital, London, UK.
Thanos
T
Athanasiou
D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood*; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D011788:Quality of Life; D016194:Receptors, N-Methyl-D-Aspartate / Q000097:blood*; D011795:Surveys and Questionnaires
D000906:Antibodies; D016194:Receptors, N-Methyl-D-Aspartate
Aortic valve; Biological markers; Heart valve prosthesis implantation; N-methyl-D-aspartate; Outcome assessment (health care); Quality of life; Receptors