Pericardial Inflammatory Mediators That Can Drive Postoperative Atrial Fibrillation in Cardiac Surgery Patients

Hassanabad, Ali Fatehi; Deniset, Justin; Fedak, Paul W.M.

doi:10.1016/j.cjca.2023.06.003

Cited by 5 publications

(1 citation statement)

References 97 publications

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“…Pathology showed lymphocyte cell infiltration and adjacent myocyte necrosis around the atrium in patients with AF [ 22 ]. Inflammatory mediators including TNF-α, IL-6, IL-1β, IL-8 and MPO by hematological indicators play an important role in the process of AF [ 23 ]. Chao TF et al showed that CRP levels were significantly higher in persistent or permanent AF patients than paroxysmal AF patients, indicating that higher levels of inflammatory factors may increase the load of PerAF [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Right atrial wall inflammation detected by 18F-FDG PET/CT may be significantly associated with persistent atrial fibrillation: a prospective case-control study

Wan,

Wang,

et al. 2023

BMC Cardiovasc Disord

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Aim Atrial fibrillation (AF) is a progressive disease from paroxysmal to persistent, and persistent AF (PerAF) had worse prognosis. AF has potential link with inflammation, but it is not clear whether PerAF or paroxysmal AF (ParAF) is more closely related to inflammation. On the basis of inhibiting myocardial physiological uptake, 18F-fluorodeoxyglucosepositron emission tomography/computed tomography (18F-FDG PET/CT) is an established imaging modality to detect cardiac inflammation. We aimed to decipher the association between AF and atrial inflammatory activity by 18F-FDG PET/CT. Methods Thirty-five PerAF patients were compared to age and sex matched ParAF group with baseline 18F-FDG PET/CT scans prior to radiofrequency catheter ablation (RFCA) in the prospective case-control study. High-fat and low-carbohydrate diet and prolonged fast (HFLC+Fast) was applied to all AF patients before PET/CT. Then 22 AF patients with positive right atrial (RA) wall FDG uptake (HFLC+Fast) were randomly selected and underwent HFLC+Fast+heparin the next day. The CHA2DS2-VASc score was calculated to evaluate the risk of stroke. Clinical data, ECG, echocardiography, and atrial 18F-FDG uptake were compared. Results PerAF patients had significantly higher probability of RA wall positive FDG uptake and higher SUVmax than ParAF group [91.4% VS. 28.6%, P < 0.001; SUVmax: 4.10(3.20–4.90) VS. 2.60(2.40–3.10), P < 0.001]. Multivariate logistic regression analyses demonstrated that RA wall SUVmax was the independent influencing factor of PerAF (OR = 1.80, 95%CI 1.02–3.18, P = 0.04). In 22 AF patients with RA wall positive FDG uptake (HFLC+Fast), the “HFLC+Fast+Heparin” method did not significantly change RA wall FDG uptake evaluated by either quantitative analysis or visual analysis. High CHA2DS2-VASc score group had higher RA wall 18F-FDG uptake [3.35 (2.70, 4.50) vs, 2.8 (2.4, 3.1) P = 0.01]. Conclusions RA wall FDG positive uptake was present mainly in PerAF. A higher RA wall 18F-FDG uptake was an independent influencing factor of PerAF. RA wall FDG uptake based on 18F-FDG PET/CT may indicate pathological inflammation. Trial registration http://www.chictr.org.cn, ChiCTR2000038288.

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Section: Discussionmentioning

confidence: 99%