Relationship between Angiotensin Converting Enzyme, Apelin, and New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting

Abstract

It has been shown that inflammation and oxidative stress are important factors in postoperative atrial fibrillation (POAF). Angiotensin converting enzyme (ACE) and apelin have a close relationship with inflammation and oxidative stress. The effect of ACE and apelin on POAF after off-pump coronary artery bypass grafting (OPCABG) remains a question. The concentrations of serum ACE, angiotensin II (Ang II), apelin, bradykinin (BK), malondialdehyde (MDA), and C reactive protein (CRP) were measured in the perioperative period of OPCABG. The levels of serum ACE in the POAF group were higher than in the no POAF group both preoperatively and postoperatively. Apelin in the POAF group was lower than in the no POAF group. There was a correlation between serum ACE and apelin. Postoperatively, CRP and MDA in the POAF group were higher than in the no POAF group; however, there was no difference before the operation. Preoperative ACE and apelin were both significant and independent risk factors for POAF. In conclusion, the high ACE and low apelin preoperatively led to CRP and MDA being increased postoperatively, which was probably associated with POAF after OPCABG. Apelin may be a new predictor for POAF.

Prevalence of Postoperative Atrial Fibrillation Following Off-Pump Coronary Artery Bypass Graft Surgery in Elderly Patients

“…We observed higher mean plasma BNP levels in the preoperative period, which might be associated with POAF, although other conditions may cause an elevation of plasma BNP. Xu and colleagues reported that increased LA size is related to POAF [11]. We found increased mean LA size among our study populations, and these findings have also been confirmed [7].…”

“…Systemic arterial hypertension, decreased left ventricular function, chronic obstructive pulmonary disease (COPD), chronic renal failure, diabetes, and withdrawal of β-blockers are also responsible for POAF [1]. Smoking, LDL, statins, LA diameter, and left ventricular ejection fraction (LVEF) are significant risk factors for POAF preoperatively [11]. Preoperative HbA1c independently predicts the occurrence of AF after isolated OPCAB [12].…”

Role of gut microbiota in post-operative atrial fibrillation: a randomized trial of berberine

“…In ammation and ROS are still the main reason for the occurrence of POAF. 2,3,4,15 Recently, several studies have shown that intestinal bacterial microbiota dysbiosis was associated with different types of AF and duration of AF. 7,8 In this study, we demonstrated the characteristics of gut microbiota in patients underwent CABG are prone to developing POAF.…”

“…1,2 Some studies indicated in ammation, oxidative stress, and electrical remodeling are the main reasons for POAF. 3,4 However, the detailed mechanisms underlying POAF are largely unknown. Uncovering the driving factors and identifying strategies to impede POAF have attracted considerable attention.…”

Clinical, echocardiographic parameters and markers of oxidative stress associated with atrial fibrillation in patients undergoing coronary artery bypass graft surgery

“…Rodrigo R, et al (2013) показали, что активность КАТ, СОД и ГПО в тканях предсердий была ниже у пациентов с ПОФП [13]. Кроме того, уровень плазменной концентрации МДА был выше в группе пациентов с ПОФП при проведении КШ на работающем сердце [14].…”