Can TNF-α be a predictor for atrial fibrillation after cardiac surgery? TNF-α kalp cerrahisi sonrasi{dotless} görülen atriyal fibrilasyon İçin bir prediktör olabilir mi?
Turkiye Klinikleri Journal of Medical Sciences, cilt.33, sa.4, ss.987-994, 2013 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 4
- Basım Tarihi: 2013
- Doi Numarası: 10.5336/medsci.2012-31597
- Dergi Adı: Turkiye Klinikleri Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.987-994
- Anahtar Kelimeler: Atrial fibrillation, Thoracic surgery, Tumor necrosis factor alpha (36-68)
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: It has been thought that systemic inflammatory response is one of the most important factors on the etiology of atrial fibrillation after cardiac surgery. In this study, we investigated the relationship between atrial fibrillation after cardiac surgery and TNF-α, which plays an important role in systemic inflammatory response. Material and Methods: Fifty patients who underwent revascularization surgery with more than three target vessels were enrolled to the study. TNF-α level was measured in the blood samples collected intraoperatively from coronary sinus at basal, ischemia and reperfusion periods. The patients with postoperative atrial fibrillation were compared with the other enrolled patients for demographic and surgical data and for TNF-α level. Results: Seven patients (14%) developed postoperative atrial fibrillation. Patients with postoperative atrial fibrillation were older (70.6±5.3 vs 58.6±9.5 years, p=0.001); however there were no statistically significant differences in the other parameters. There were no statistically significant differences in the operational parameters either. TNF-α level during extracorporeal circulation showed variability. There was no statistical differences according to TNF-α levels between patients with atrial fibrillation and the other patients on baseline (8.15 (7.59-9.84) and 8.30 (7.80-10.33) pg/ml, respectively, p=0.806) and ischemia and reperfusion period [Percentile change of ischemia period: 0.10 (-0.03-0.45) vs 0.01 (-0.07-0.37) pg/ml, p=0.106, and percentile change of reperfusion period: 0.03 (-0.02;0.24) vs 0.01 (-0.11-0.18) pg/ml, p=0.246]. There were no correlations between TNF-α level and the other postoperative variables of the patients. Conclusion: Advanced age was an important risk factor for postoperative atrial fibrillation. Higher TNF-α levels evaluated intraoperatively can be a predictor for postoperative atrial fibrillation, especially in the high risk patient groups. © 2013 by Türkiye Klinikleri.