Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Cardiovascular Surgery, Chamran Heart Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Trace Elem Med Biol. 2024 Jan;81:127331. doi: 10.1016/j.jtemb.2023.127331. Epub 2023 Oct 25.
Cardiac surgeries are known to induce an inflammatory response. Besides, dietary factors such as trace elements contribute to promoting cardiovascular health by maintaining oxidative balance. Here we systematically review the literature about alterations in serum concentrations of zinc (Zn), copper (Cu), and selenium (Se) in response to cardiac surgeries.
A systematic search was performed on databases until the end of December 2022. Studies assessing the changes of mentioned elements in adult patients undergoing cardiac surgery were included. Changes in the means and standard deviations of the elements before and after the cardiac surgery were utilized as desired effect sizes.
Among 1252 records found in the primary search, 23 and 21 articles were included in the systematic review and meta-analysis respectively. Seventeen studies evaluated the changes in serum Zn and Cu levels, and fifteen studies assessed Se levels. According to the results of quantitative analysis, Zn, Cu, and Se concentrations, one day after the surgery were significantly lower than preoperative values (WMD for Zn: 4.64 µmol/L [3.57-5.72], WMD for Cu: 1.62 µmol/L [0.52-2.72], and WMD for Se: 0.1 µmol/L [0.03-0.16]). The concentration of trace elements recovered gradually during the first-week post-operation and reached preoperative levels or even higher.
Serum trace elements dropped significantly soon after the cardiac surgery, but they reached their baseline levels mostly during the first week after the surgery. Future studies are warranted to elucidate the impact of alterations in serum concentration of trace elements on the outcomes and complications of open-heart surgeries.
心脏手术会引起炎症反应。此外，微量元素等饮食因素通过维持氧化平衡有助于促进心血管健康。在这里，我们系统地回顾了关于心脏手术后血清中锌（Zn）、铜（Cu）和硒（Se）浓度变化的文献。
我们在数据库中进行了系统搜索，直到 2022 年 12 月底。纳入评估接受心脏手术的成年患者上述元素变化的研究。将手术前后元素的平均值和标准差作为所需的效应量。
在初步搜索中发现的 1252 条记录中，有 23 篇和 21 篇文章分别被纳入系统评价和荟萃分析。17 项研究评估了血清 Zn 和 Cu 水平的变化，15 项研究评估了 Se 水平。根据定量分析的结果，手术后一天 Zn、Cu 和 Se 的浓度明显低于术前值（Zn 的 WMD：4.64µmol/L[3.57-5.72]，Cu 的 WMD：1.62µmol/L[0.52-2.72]，Se 的 WMD：0.1µmol/L[0.03-0.16]）。微量元素浓度在手术后第一周逐渐恢复，达到术前水平甚至更高。
心脏手术后血清微量元素明显下降，但在手术后第一周内大多恢复到基线水平。需要进一步研究阐明微量元素血清浓度变化对心脏手术结局和并发症的影响。
