| Abstract [eng] |
The aim of present study was to investigate the prognostic value of plasma and atrial tissue expression of prothrombotic, proinflammatory and extracellular matrix turnover indices for the development of atrial fibrillation (AF) after on-pump coronary artery bypass grafting (CABG) surgery and to describe atrial ultrastructural changes in patients suffering from severe coronary artery disease. Methods: Blood samples were obtained from peripheral vein (PV) and from intracardiac chambers (right atrium (RA), right atrial appendage (RAA), left atrium (LA) and left atrial appendage (LAA)) amongst 100 consecutive patients undergoing elective on-pump CABG. Biomarker (high sensitivity C reactive protein (hs-CRP), interleukin 6 (IL-6), von Willebrand factor (vWF), tissue factor (TF), matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1)) concentrations were related to incident AF (in 30 days after CABG). The RAA and LAA tissues were tested for expression of vWF, TF, IL-6, MMP-9 and TIMP-1 using immunohistochemistry. The ultrastructure of the RAA and LAA in 20 patients was examined by electron microscopy. Results: Levels of plasma vWF, TF, hs-CRP, MMP-9 and TIMP-1 differ in-between various intracardiac sampling sites. Higher plasma hs-CRP levels in the PV, RAA and LA, higher plasma IL-6 levels in the RAA, LA and LAA and higher plasma MMP-9 levels in the LAA are associated with postoperative AF. An increased expression of vWF by the LAA is a risk factor for the development of AF after on-pump CABG. We found pronounced ultrastructural changes in both atrial appendages of all 20 selected patients. |
