Comprehensive characterization of the postoperative pericardial inflammatory response: Potential implications for clinical outcomes

Hassanabad, Ali Fatehi; Schoettler, Friederike I.; Kent, William; Adams, Corey; Holloway, Debra; Ali, Imtiaz S.; Novick, Richard J.; Ahsan, Muhammad R.; McClure, Robert Scott; Shanmugam, Ganesh; Kidd, William T.; Fedak, Paul W.M.; Deniset, Justin

doi:10.1016/j.xjon.2022.09.003

Cited by 14 publications

(5 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To do so, we included 12 patients undergoing CABG surgery, and compared the local post-operative inflammatory response to systemic inflammation and show that the local response is distinct when compared with systemic postsurgical inflammation. Given the present study is a subpopulation analysis of our recent work, 22 the enrolled patients had all presented with an ACS. Although we have previously shown that ACS alters the immune cell composition of the pericardial space, 21 the present study focuses on the postoperative changes that can be consistently analyzed because native PF was removed in entirety during each operation.…”

Section: Discussionmentioning

confidence: 99%

“…Our group and others have shown that inflammatory processes are active in the pericardial space after surgery. 22 , 23 , 24 , 25 We characterized the immune cells and inflammatory mediators, including cytokines, chemokines, matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs), that are present in the pericardial space after cardiac surgery. We described how the postoperative pericardial inflammatory profile evolves over 48-hours after surgery.…”

mentioning

confidence: 99%

“…An inflammatory response has been shown to be present in the pericardial space after surgery. 22 , 26 However, few studies have comprehensively compared the local versus systemic postoperative inflammatory response in patients undergoing cardiac surgery. Thus, most treatment strategies have focused on circulating immune mediators.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Cardiac surgery elicits pericardial inflammatory responses that are distinct compared with postcardiopulmonary bypass systemic inflammation

Hassanabad¹,

Schoettler²,

Kent³

et al. 2023

JTCVS Open

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Cardiac surgery elicits pericardial inflammatory responses that are distinct compared with postcardiopulmonary bypass systemic inflammation

Hassanabad¹,

Schoettler²,

Kent³

et al. 2023

JTCVS Open

View full text Add to dashboard Cite

“…Autonomic dysregulation has been established as a primary POAF cause ( 43 ). Not surprisingly, inflammatory signaling molecules are increased in the pericardial fluid after cardiac surgery ( 44 ), altering autonomic signaling of the atria ( 43 ). The four major atrial ganglionic plexi found in the epicardial fat pads act as the primary source of autonomic innervation ( 45 ).…”

Section: Summary Of Major Societal Guidelinesmentioning

confidence: 99%

Postoperative atrial fibrillation (POAF) after cardiac surgery: clinical practice review

Suero,

Ali,

Barron

et al. 2024

J Thorac Dis

View full text Add to dashboard Cite

Postoperative atrial fibrillation (POAF) after cardiac surgery is associated with elevated morbidity and mortality. Although current prediction models have limited efficacy, several perioperative interventions can reduce patients’ risk of POAF. These begin with preoperative medications, including beta-blockers and amiodarone. Moreover, patients should be screened for preexisting atrial fibrillation (AF) so that concomitant surgical ablation and left atrial appendage occlusion can be performed in appropriate candidates. Intraoperative interventions such as posterior pericardiectomy can reduce mediastinal fluid accumulation, which is a trigger for POAF. Furthermore, many preventive strategies for POAF are implemented in the immediate postoperative period. Initiating beta-blockers, amiodarone, or both is reasonable for most patients. Overdrive atrial pacing, colchicine, and steroids have been used by some, although the evidence base is less robust. For patients with POAF, rate-control and rhythm-control strategies have comparable outcomes. Decision-making regarding anticoagulation should recognize that the stroke risk associated with POAF appears to be lower than that for general nonvalvular AF. The evidence that oral anticoagulation reduces stroke risk is less clear for POAF patients than for patients with general nonvalvular AF. Given that POAF tends to be shorter-lived and is associated with greater bleeding risks in the perioperative period, decisions regarding anticoagulation should be individualized. Finally, wearable technology and machine learning algorithms for better predicting and managing POAF appear to be coming soon. These technologies and a comprehensive clinical program could meaningfully reduce the incidence of this common complication.

show abstract

“…Three weeks following surgery, when patients are released from the hospital and go home, they often see a quicker improvement in their health. It is possible that this change influenced their depression levels [24,25].…”

Section: Depression In Patients Undergoing Cabgmentioning

confidence: 99%

Psychological Discomfort in Patients Undergoing Coronary Artery Bypass Graft (CABG) in West Bank: A Cohort Study

Sawalha,

Ariza-Vega,

Alhalaiqa

et al. 2024

JCM

View full text Add to dashboard Cite

Background/Objetives: Cardiovascular disease (CVD) remains a significant contributor to global morbidity and mortality rates. Coronary artery bypass graft (CABG) surgery is a critical intervention for patients with coronary artery disease, yet it poses psychological challenges that can impact recovery. Methods: This prospective cohort study, conducted across six hospitals in the West Bank/Palestine, aimed to assess changes in depression, anxiety, and stress levels among CABG patients and identify associated factors. The Arabic version of the Depression Anxiety Stress Scales (DASS-21) was administered before (one week) and after surgery (two and three weeks). Results: Of the 200 participants, 116 were men (58%). High levels of depression, anxiety, and stress were observed both before and after surgery, with statistically significant reductions in all these variables after surgery (p < 0.001). Regarding demographic factors, age displayed a weak positive correlation with depression (r = 0.283; p < 0.001), anxiety (r = 0.221; p = 0.002), and stress (r = 0.251; p < 0.001). Sex showed a weak correlation with stress pre-surgery (r = −0.160; p = 0.024). Conclusions: Patient outcomes could be improved by early identification and the provision of efficient treatments such as psychosocial therapy both before and after surgery.

show abstract

Comprehensive characterization of the postoperative pericardial inflammatory response: Potential implications for clinical outcomes

Cited by 14 publications

References 50 publications

Cardiac surgery elicits pericardial inflammatory responses that are distinct compared with postcardiopulmonary bypass systemic inflammation

Cardiac surgery elicits pericardial inflammatory responses that are distinct compared with postcardiopulmonary bypass systemic inflammation

Postoperative atrial fibrillation (POAF) after cardiac surgery: clinical practice review

Psychological Discomfort in Patients Undergoing Coronary Artery Bypass Graft (CABG) in West Bank: A Cohort Study

Contact Info

Product

Resources

About