Cozac Dan-Alexandru, Somkereki Cristina, Huțanu Adina, Nicoara Tunde Renata, Scridon Alina
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Physiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Medicina (Kaunas). 2025 Aug 27;61(9):1545. doi: 10.3390/medicina61091545.
Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) commonly occur after coronary artery bypass grafting (CABG) surgery, with frequent ectopics linked to atrial fibrillation risk and reduced heart function. While CABG-induced inflammation causes arrhythmogenic changes, the connection between preoperative inflammatory markers and postoperative ectopic burden has not been studied. Therefore, the aim of the present study is to evaluate the association between preoperative inflammatory biomarkers and postoperative atrial and ventricular ectopic burden, and to determine their influence on clinical outcomes following elective CABG procedures. This study assessed preoperative plasma levels of highly sensitive C-reactive protein (hs-CRP), von Willebrand factor (vWF), transforming growth factor-β (TGF-β), interleukin (IL)-2, IL-1β, IL-6, IL-8, and vascular endothelial growth factor (VEGF) using the Multiplex technique in patients undergoing elective CABG. A continuous 24-h ECG Holter monitoring was performed one day before CABG, as well as on days 2, 3, and 4 post-CABG. The PACs and PVCs burdens were quantified, and correlations with clinical parameters were analyzed. Preoperative plasma concentrations of vWF, TGF-β, and IL-8 exhibited significant positive correlations with postoperative PACs ( < 0.001, = 0.03, and < 0.001, respectively). Preprocedural hs-CRP, TGF-β, IL-6, and IL-8 levels showed significant positive associations with PVCs ( < 0.0001, < 0.0001, = 0.02, and < 0.0001, respectively). However, none of the tested biomarkers could predict other postoperative outcomes, such as acute kidney injury, acute liver failure, duration of inotropic support, and days of hospitalization. Preoperative inflammatory biomarkers may serve as predictive tools for postoperative ectopic activity following CABG. Early identification of high-risk patients could enable prophylactic strategies and improve post-CABG outcomes.
冠状动脉旁路移植术（CABG）后常出现房性早搏（PACs）和室性早搏（PVCs），频发的异位心律与房颤风险及心功能降低有关。虽然CABG引发的炎症会导致致心律失常性改变，但术前炎症标志物与术后异位心律负荷之间的联系尚未得到研究。因此，本研究的目的是评估术前炎症生物标志物与术后房性和室性异位心律负荷之间的关联，并确定它们对择期CABG手术后临床结局的影响。本研究使用多重技术评估了择期CABG患者术前血浆中高敏C反应蛋白（hs-CRP）、血管性血友病因子（vWF）、转化生长因子-β（TGF-β）、白细胞介素（IL）-2、IL-1β、IL-6、IL-8和血管内皮生长因子（VEGF）的水平。在CABG手术前一天以及术后第2、3和4天进行连续24小时的心电图动态监测。对PACs和PVCs负荷进行量化，并分析其与临床参数的相关性。术前血浆中vWF、TGF-β和IL-8的浓度与术后PACs呈显著正相关（分别为P<0.001、P = 0.03和P<0.001）。术前hs-CRP、TGF-β、IL-6和IL-8水平与PVCs呈显著正相关（分别为P<0.0001、P<0.0001、P = 0.02和P<0.0001）。然而，所检测的生物标志物均无法预测其他术后结局，如急性肾损伤、急性肝衰竭、血管活性药物支持的持续时间和住院天数。术前炎症生物标志物可能作为CABG术后异位心律活动的预测工具。早期识别高危患者可制定预防策略并改善CABG术后结局。
