Increased Inflammation in Pericardial Fluid Persists 48 Hours After Cardiac Surgery
| Autor: | Lee A. Goeddel, James E. Davies, Louis J. Dell’Italia, Jasmina Varagic, Spencer J. Melby, Carlos M. Ferrario, Chad Steele, James F. George, Chih Chang Wei, David J. George, Brittany Butts |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Time Factors medicine.medical_treatment Article 03 medical and health sciences Valve replacement Risk Factors Physiology (medical) medicine.artery Atrial Fibrillation medicine Thoracic aorta Pericardium Humans Cardiac Surgical Procedures business.industry Pericardial fluid Atrial fibrillation Middle Aged medicine.disease Surgery Cardiac surgery Up-Regulation 030104 developmental biology medicine.anatomical_structure Cardiothoracic surgery cardiovascular system Pericardial Fluid Drainage Female Inflammation Mediators Cardiology and Cardiovascular Medicine business Biomarkers Artery |
| Zdroj: | Circulation. 136(23) |
| ISSN: | 1524-4539 |
| Popis: | Cardiac surgery causes direct trauma to cardiac tissue, breaches the pericardium, and disrupts the normal composition of the fluid largely produced from the myocardial interstitium and epicardial and visceral pericardium. This leaves the heart exposed to pericardial fluid (PCF) and mediastinal contents comprising inflammatory cells and their products that now bathe the heart. This can potentially have adverse effects on the thin-walled atria leading to postoperative atrial fibrillation (AF).1 After cardiac surgery, the pericardium remains open, and chest drains are routinely placed to prevent fluid accumulation around the heart. Here, we describe the concentration and trajectory of blood proinflammatory factors in the PCF after cardiac surgery over time. The study protocol was approved by the University of Alabama at Birmingham. Institutional Review Board approval and informed consent were obtained from all patients. PCF (n=19) was collected immediately after pericardiotomy (time 0) and from the pericardial drains at times 4, 12, 24, and 48 hours after surgery. The patient population (mean age, 60±3 years) included 26.3% women and 26.3% blacks undergoing cardiac surgery (coronary artery bypass graft, n=14; coronary artery bypass graft+valve procedure, n=3; valve procedure alone, n=2). Patients with ventricular assist devices, AF surgery, thoracic aorta surgery, and AF within 6 months prior were excluded. All participants who had valve replacement (with or without coronary artery bypass graft) underwent on-pump surgeries. Of the patients undergoing coronary artery bypass … |
| Databáze: | OpenAIRE |
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