<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3><p>Due to its deleterious effects, early identification of patients at risk of postoperative AF (POAF) is of critical importance. Preexisting proarrhythmic atrial remodeling could contribute to this increased risk. Therefore, we aimed to evaluate the presence of preexisting proarrhythmic atrial remodeling and its impact on POAF occurrence in patients undergoing coronary artery bypass grafting (CABG).</p></sec>
<sec><h3>Methods</h3><p>Data regarding atrial structural (atrial size and histology), electrical (P-wave and atrial action potential parameters, mRNA expression of several AF-related genes), and autonomic (heart rate variability parameters) proarrhythmic remodeling were compared between patients with (AF; n=11) and without (no-AF; n=19) POAF. Impact of POAF on postoperative outcomes was also evaluated.</p></sec>
<sec><h3>Results</h3><p>No significant difference was observed in atrial electrical parameters between the two groups (all p>0.05). However, compared with no-AF, AF patients had more important subepicardial adipose infiltration (p=0.02) and higher markers of parasympathetic and sympathetic modulation (both p=0.03). Patients with POAF had longer hospital stay and more often presented postoperative renal dysfunction (both p=0.04).</p></sec>
<sec><h3>Conclusion</h3><p>These findings suggest that preexisting atrial structural (i.e., increased atrial subepicardial adiposity) and autonomic (i.e., sympatho-vagal coactivation) alterations could favor the occurrence of POAF. At its turn, POAF was associated with altered postoperative outcomes in CABG patients.</p></sec>
</abstract>

IntroductionDue to its deleterious effects, early identification of patients at risk of postoperative AF (POAF) is of critical importance. Preexisting proarrhythmic atrial remodeling could contribute to this increased risk. Therefore, we aimed to evaluate the presence of preexisting proarrhythmic atrial remodeling and its impact on POAF occurrence in patients undergoing coronary artery bypass grafting (CABG).
MethodsData regarding atrial structural (atrial size and histology), electrical (P-wave and atrial action potential parameters, mRNA expression of several AF-related genes), and autonomic (heart rate variability parameters) proarrhythmic remodeling were compared between patients with (AF; n=11) and without (no-AF; n=19) POAF. Impact of POAF on postoperative outcomes was also evaluated.
ResultsNo significant difference was observed in atrial electrical parameters between the two groups (all p>0.05). However, compared with no-AF, AF patients had more important subepicardial adipose infiltration (p=0.02) and higher markers of parasympathetic and sympathetic modulation (both p=0.03). Patients with POAF had longer hospital stay and more often presented postoperative renal dysfunction (both p=0.04).
ConclusionThese findings suggest that preexisting atrial structural (i.e., increased atrial subepicardial adiposity) and autonomic (i.e., sympatho-vagal coactivation) alterations could favor the occurrence of POAF. At its turn, POAF was associated with altered postoperative outcomes in CABG patients.

Role of Preexisting Proarrhythmic Atrial Remodeling in Post-Coronary Artery Bypass Grafting Atrial Fibrillation

„George Emil Palade” University of Medicine, Pharmacy, Science and Technology

Romanian Journal of Cardiology

This work is licensed under the Creative Commons Attribution 4.0 International License.

IntroductionDue to its deleterious effects, early identification of patients at risk of postoperative AF (POAF) is of critical importance. Preexisting...

Role of Preexisting Proarrhythmic Atrial Remodeling in Post-Coronary Artery Bypass Grafting Atrial Fibrillation

Article Category: Original Article

Publié en ligne: 05 mai 2022

Pages: 597 - 607

DOI: https://doi.org/10.47803/rjc.2021.31.3.597

Mots clés
adipose tissue, atrial remodeling, coronary artery bypass grafting, postoperative atrial fibrillation, sympatho-vagal coactivation

© 2021 Alkora Ioana Balan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Role of Preexisting Proarrhythmic Atrial Remodeling in Post-Coronary Artery Bypass Grafting Atrial Fibrillation

Article Category: Original Article

Publié en ligne: 05 mai 2022

Pages: 597 - 607

DOI: https://doi.org/10.47803/rjc.2021.31.3.597

Mots clésadipose tissue, atrial remodeling, coronary artery bypass grafting, postoperative atrial fibrillation, sympatho-vagal coactivation

© 2021 Alkora Ioana Balan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Mots clés
adipose tissue, atrial remodeling, coronary artery bypass grafting, postoperative atrial fibrillation, sympatho-vagal coactivation