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Basel Ramlawi, MD, Hasan Otu, PhD, James L

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1 Genomic expression pathways associated with brain injury after cardiopulmonary bypass 
Basel Ramlawi, MD, Hasan Otu, PhD, James L. Rudolph, MD, Shigetoshi Mieno, MD, Isaac S. Kohane, MD, PhD, Handan Can, PhD, Towia A. Libermann, PhD, Edward R. Marcantonio, MD, Cesario Bianchi, MD, PhD, Frank W. Sellke, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 134, Issue 4, Pages e4 (October 2007) DOI: /j.jtcvs Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Genes that were differentially expressed after cardiopulmonary bypass (CPB) in patients with (NCD group) and without (NORM group) neurocognitive decline: A, upregulated genes; B, downregulated genes. 6H, Six hours postoperatively in the cardiovascular intensive care unit; PRE, preoperatively after induction of anesthesia and before skin incision. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Heat maps with hierarchic clustering of genes in pathways showing differential expression in patients with neurocognitive decline (NCD) versus those without neurocognitive decline (NORM group). The cell-cell adhesion (A) and immune response (B) pathways were both downregulated postoperatively uniquely in the NCD group. The blood coagulation pathway (C) was upregulated uniquely in the NCD group. Also, the response-to-stress pathway (D) was uniquely upregulated in the NORM group. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Significantly different expression of genes involved in the antigen presentation pathway in patients with neurocognitive decline (NCD; A) in contract to patients without neurocognitive decline (NORM; B). Red, Upregulation; green, downregulation. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Confirmation of microarray gene-expression data by means of SYBR Green real-time polymerase chain reaction in 6 differentially expressed genes. Human 18S ribosomal RNA (18SrRNA) was used to normalize mRNA levels between samples. Values are shown for each gene as fold change (FC) in mRNA expression at 6 hours postoperatively (6H) compared with preoperative expression (PRE). Mean fold change ± standard error of the mean is shown. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions


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