Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery.

Abstract:

:Postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery that occurs in up to 60% of patients. POAF is associated with increased risk of cardiovascular mortality, stroke and other arrhythmias that can impact on early and long term clinical outcomes and health economics. Many factors such as disease-induced cardiac remodelling, operative trauma, changes in atrial pressure and chemical stimulation and reflex sympathetic/parasympathetic activation have been implicated in the development of POAF. There is mounting evidence to support a major role for inflammation and oxidative stress in the pathogenesis of POAF. Both are consequences of using cardiopulmonary bypass and reperfusion following ischaemic cardioplegic arrest. Subsequently, several anti-inflammatory and antioxidant drugs have been tested in an attempt to reduce the incidence of POAF. However, prevention remains suboptimal and thus far none of the tested drugs has provided sufficient efficacy to be widely introduced in clinical practice. A better understanding of the cellular and molecular mechanisms responsible for the onset and persistence of POAF is needed to develop more effective prediction and interventions.

journal_name

Pharmacol Ther

authors

Zakkar M,Ascione R,James AF,Angelini GD,Suleiman MS

doi

10.1016/j.pharmthera.2015.06.009

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

13-20

eissn

0163-7258

issn

1879-016X

pii

S0163-7258(15)00124-2

journal_volume

154

pub_type

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