Abstract
Non-cardiac surgery is associated with significant cardiovascular complications. Reported mortality rate ranges from 1.9% to 4% in unselected patients. A postoperative surge in pro-inflammatory cytokines is a well-known feature and putative contributor to these complications. Despite much clinical research, little is known about the biomolecular changes in cardiac tissue following non-cardiac surgery. In order to increase our understanding, we analyzed whole-transcriptional and metabolic profiling data sets from hearts of mice harvested two, four, and six weeks following isolated thoracotomy. Hearts from healthy litter-mates served as controls. Functional network enrichment analyses showed a distinct impact on cardiac transcription two weeks after surgery characterized by a downregulation of mitochondrial pathways in the absence of significant metabolic alterations. Transcriptional changes were not detectable four and six weeks following surgery. Our study shows distinct and reversible transcriptional changes within the first two weeks following isolated thoracotomy. This coincides with a time period, in which most cardiovascular events happen.
Highlights
Non-cardiac surgery is associated with significant cardiovascular complications
Transcriptional and metabolic changes following TAC surgery compared to isolated thoracotomy have been described previously[6]
As expected, isolated thoracotomy did not change left ventricular function compared to controls
Summary
Non-cardiac surgery is associated with significant cardiovascular complications. Reported mortality rate ranges from 1.9% to 4% in unselected patients. Our study shows distinct and reversible transcriptional changes within the first two weeks following isolated thoracotomy. This coincides with a time period, in which most cardiovascular events happen. Following surgery, increased levels of IL-1, IL-6 and TNF-alpha have been reported, and increased C-reactive protein levels and elevated white blood cell counts indicative of a systemic inflammatory response are frequently observed[4]. These findings prompted clinical trials investigating the effect of perioperative statin and betablocker-therapy in non-cardiac surgery[3,5]. Aim of this study was to improve our understanding of the effect of isolated thoracotomy (ITH) on the cardiac metabolome and transcriptome over time
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