Hyslop Kieran, Ki Katrina K, Naidoo Rishendran, O'Brien Donalee, Prabhu Anil, Gill Denzil, Anstey Chris, Rapchuk Ivan L, McDonald Charles I, Marshall Lachlan, Pearse India, Fraser John F, Suen Jacky Y, Passmore Margaret R
Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Australia.
Sci Rep. 2025 May 6;15(1):15857. doi: 10.1038/s41598-025-00382-y.
Surgical aortic valve replacement (AVR) is the standard of care for severe aortic valve disease; however, post-operative complications continue to pose challenges. Inflammation caused by increased release of cell-free mitochondrial DNA (cf-mtDNA) during surgery may be a contributing factor. The aim of this pilot study was to investigate the relationship between cf-mtDNA release and the risk of inflammatory-mediated post-operative complications in adult AVR patients. Plasma was collected from patients undergoing an AVR with cardiopulmonary bypass (CPB) at baseline, intra-operatively and post ICU admission at 6, 12 and 18 h. Cf-mtDNA was quantified and inflammatory biomarker expression in leukocytes and plasma was assessed. Cf-mtDNA levels increased 16-fold at the end of CPB with a corresponding increase in average fragment size. Cf-mtDNA levels may be associated with post-operative bleeding, infection, hepatic failure and hospital length of stay. Gene expression and plasma analysis revealed altered levels of markers associated with inflammation and innate immune responses. Several markers were associated with post-operative complications and outcomes. Our results indicate that cf-mtDNA levels, including average fragment sizes, are increased following initiation of CPB in AVR patients, and may be associated with post-operative complications and outcomes. However, larger studies are needed to validate these findings.
外科主动脉瓣置换术（AVR）是治疗严重主动脉瓣疾病的标准治疗方法；然而，术后并发症仍然是一个挑战。手术期间无细胞线粒体DNA（cf-mtDNA）释放增加所引起的炎症可能是一个促成因素。这项初步研究的目的是调查成年AVR患者中cf-mtDNA释放与炎症介导的术后并发症风险之间的关系。在基线、手术期间以及入住重症监护病房后6、12和18小时，从接受体外循环（CPB）的AVR患者中采集血浆。对cf-mtDNA进行定量，并评估白细胞和血浆中的炎症生物标志物表达。CPB结束时，cf-mtDNA水平增加了16倍，平均片段大小相应增加。cf-mtDNA水平可能与术后出血、感染、肝衰竭和住院时间有关。基因表达和血浆分析显示与炎症和先天免疫反应相关的标志物水平发生了改变。一些标志物与术后并发症和结局有关。我们的结果表明，AVR患者在CPB开始后，cf-mtDNA水平（包括平均片段大小）会升高，并且可能与术后并发症和结局有关。然而，需要更大规模的研究来验证这些发现。
