Fibrosis independent atrial fibrillation in older patients is driven by substrate leukocyte infiltration: diagnostic and prognostic implications to patients undergoing cardiac surgery

Autor: Petra C. Kienesberger, Kareem Gawdat, Jean S. Marshall, Stephanie Legere, Jean-Francois Légaré, Keith R. Brunt, Thomas Pulinilkunnil, Christie Aguiar, Mathieu Castonguay, Ansar Hassan
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Neutrophils
Cardiac fibrosis
medicine.medical_treatment
lcsh:Medicine
Cell Count
030204 cardiovascular system & hematology
Gastroenterology
Cohort Studies
0302 clinical medicine
Fibrosis
Leukocytes
Lymphocytes
Sinoatrial Node
Aged
80 and over
education.field_of_study
Age Factors
Atrial fibrillation
General Medicine
Middle Aged
Cardiac surgery
Prognosis
Cytokine
Macrophages (MoΦ)
Matrix Metalloproteinase 9
Cytokines
Female
medicine.symptom
Blood Platelets
medicine.medical_specialty
Population
Inflammation
General Biochemistry
Genetics and Molecular Biology
NLR
03 medical and health sciences
Internal medicine
Human atrium
medicine
Humans
Heart Atria
Cardiac Surgical Procedures
education
Aged
Surrogate endpoint
business.industry
Research
Leucocyte infiltration
lcsh:R
Length of Stay
medicine.disease
030104 developmental biology
Leukocyte Common Antigens
business
Zdroj: Journal of Translational Medicine, Vol 17, Iss 1, Pp 1-14 (2019)
Journal of Translational Medicine
ISSN: 1479-5876
Popis: Background The objectives of the study were to characterize and quantify cellular inflammation and structural remodeling of human atria and correlate findings with molecular markers of inflammation and patient surrogate outcome. Methods Voluntary participants undergoing heart surgery were enrolled in the study and blood samples were collected prior to surgery, and right atrium samples were harvested intraoperatively. Blood samples were analyzed by flow cytometry and complete blood counts. Atrial samples were divided for fixed fibrosis analysis, homogenized for cytokine analysis and digested for single cell suspension flow cytometry. Results A total of 18 patients were enrolled and samples assessed. Isolated cells from the atria revealed a CD45+ population of ~ 20%, confirming a large number of leukocytes. Further characterization revealed this population as 57% lymphocytes and 26% monocyte/macrophages (MoΦ), with the majority of the latter cells being classical (CD14++/CD16−). Interstitial fibrosis was present in 87% of samples and correlated significantly with patient age. Older patients (> 65) had significantly more atrial fibrosis and cellular inflammation. AFib patients had no distinguishing feature of atrial fibrosis and had significantly greater CD45+ MoΦ, increased expression of MMP9 and presented with a significant correlation in length of stay to CCL-2/MCP-1 and NLR (neutrophil-to-lymphocyte ratio). Conclusion Atrial fibrosis is correlated with age and not determinate to AFib. However, severity of atrial leukocyte infiltration and markers of matrix degradation are determinant to AFib. This also correlated with CCL2 (or MCP-1) and NLR-indicative of marked inflammation. These data show the potential importance of diagnostic and prognostic assessments that could inform clinical decision making in regard to the intensity of AFib patient management.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje