Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

Abstract

Objective: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, and it remains a challenge for cardiac surgeons despite advances in medicine. A number of studies have been performed to examine various parameters to predict which patients will develop POAF. The present study was performed to investigate the roles of epicardial adipose tissue (EAT) volume and red blood cell distribution width (RDW) as predictors of POAF. Methods: The medical records of 350 patients undergoing coronary artery bypass grafting in one or more vessels at the Tertiary Cardiac Center, Cardiovascular Surgery Department, Mevlana (Rumi) University Private Hospital (Konya, Turkey), were screened between December 2011 and May 2015. The study population consisted of 149 patients fulfilling the inclusion criteria and undergoing a preoperative evaluation by computed chest tomography. All patient demographics and laboratory parameters were obtained from medical records. Results: Age, postoperative RDW, and tomography variables, including the left atrial (LA) volume, LA diameters, and EAT volume, were significantly higher while the hemoglobin level and hematocrit were significantly lower in patients developing atrial fibrillation after cardiopulmonary bypass. A logistic multivariate regression analysis was performed on age, postoperative RDW, and tomography variables, including LA volume, LA diameters and EAT volume. Only age (OR 1.0731, 95% CI 1.012-1.138; p = 0.018) was an independent predictor of the development of POAF. Conclusions: Although the EAT volume was high in patients developing atrial fibrillation after surgery, age was the only significant predictor of POAF on multivariate analysis. Additional studies regarding the predictive roles of epicardial fat and RDW in POAF are needed.

Is Epicardial Adipose Tissue Associated with Atrial Fibrillation Following Cardiac Surgery? A Systematic Review and Meta-Analysis

“…Since then, more than 10 studies have been performed on this topic. However, they have been done in different populations and included different procedures (coronary artery bypass grafting or valve replacement) with different EAT measurements (computed tomography [CT] and echocardiography) and diverse intervals of follow up [Rachwalik 2019;Drossos 2014;Wang 2019;Opolski 2015;Kogo 2019;Liu 2020;Gunturk 2020;Ozbek 2018]. This study is the first attempt to prove the association between AFACS and EAT in patients with and without AF following cardiac surgery, via systematic review, and meta-analysis.…”

“…After reading the full text of the 37 remaining articles, 29 articles were excluded because of a lack of EAT measurement (N = 11), cardiac surgery (N = 13), AF (N = 2), or comparisons (N = 3). Ultimately, the 10 studies published in eight articles [Rachwalik 2019;Drossos 2014;Wang 2019;Opolski 2015;Kogo 2019;Liu 2020;Gunturk 2020;Ozbek 2018] with three sub-groups were included in the study (Figure 1).…”

“…Patients with AF (N = 154) and those without AF (N = 392) postoperatively were labeled as AFACS and non-AFACS, respectively. Most [Rachwalik 2019;Drossos 2014;Wang 2019;Opolski 2015;Kogo 2019] of the studies included fulltext articles, while only one study [Ozbek 2018] was available as a conference abstract. EAT measurement involved EAT volume and LA-EAT volume, which were assessed using CT and EAT thickness assessed using echocardiography.…”

Is Epicardial Adipose Tissue Associated with Atrial Fibrillation after Cardiac Surgery? A Systematic Review and Meta-analysis

“…Patients with AF occurrence (n=154) and patients without AF occurrence (n=392) post operation were named as AFACS and non-AFACS respectively. Most 7,[16][17][18][19] of the studies were in the full text format, while only one 22 study was in the conference abstract. EAT measurement involved EAT volume and LA EAT volume, which were assessed by CT, as well as EAT thickness assessed by echocardiography.…”

“…The relationship between EAT and AFACS was firstly described by Charilaos et al 16 in 2014, while more than ten studies have been undergone investigation thus far. However, these studies have been conducted in different populations, operations (Coronary Artery Bypass Grafting or valve replacement), with a variety of EAT measurement methods [computed tomography (CT) or echocardiography], and diverse intervals of follow-up 7,[16][17][18][19][20][21][22] . This study was the first attempt to prove the association between AFACS and EAT, via conducting a systemic review and meta-analysis in patients with and without AF occurrence after cardiac surgery.…”