Abstract
Inflammation is associated with atrial fibrillation (AF), but little is known about the association of AF with the inflammatory serum cytokines after the acute postoperative phase. Thus, we aimed to explore how plasma cytokines concentrations modify during a 3-week cardiac rehabilitation after heart surgery, comparing patients who developed postoperative AF (POAF) and those with permanent AF with patients free from AF (NoAF group). We enrolled 100 consecutive patients and 40 healthy volunteers as a control group. At the beginning of cardiac rehabilitation, 11 days after surgery, serum levels of MPO, PTX3, ADAM17, sST2, IL-25, and IL-33 were dramatically higher, whereas TNFα and IL-37 levels were much lower in NoAF, POAF, and permanent AF patients than in the healthy volunteers. After rehabilitation, most of the cytokines changed tending towards normalization. POAF patients (35% of the total) had higher body mass index and abdominal adiposity than NoAF patients, but similar general characteristics and risk factors for POAF. However, ADAM-17 and IL-25 were always lower in POAF than in NoAF patients, suggesting a protective role of IL-25 and ADAM 17 against POAF occurrence. This finding could impact on therapeutic strategies focusing on the postoperative prophylactic antiarrhythmic interventions.
Highlights
Previous studies have demonstrated that inflammation is closely related to the pathogenesis of atrial fibrillation (AF)[6] and there is strong evidence supporting an association between inflammation and AF
The patients were admitted to our Rehabilitative Unit 10.8 (5.7) days after surgery, mean (SD), and the T0-T1 observation period, i.e. from admission to discharge from the Rehabilitative Unit, lasted 21.7 (6.2) days
Other 14 patients were affected by permanent AF (AF group) and 4 patients had a previously implanted pacemaker (PM group)
Summary
Previous studies have demonstrated that inflammation is closely related to the pathogenesis of atrial fibrillation (AF)[6] and there is strong evidence supporting an association between inflammation and AF. To the best of our knowledge, no data are available on the patients’ inflammatory profile at the end of rehabilitation, in POAF and AF patients. This information is important 1) to evaluate the effect of a standard rehabilitation period on the patients’ inflammatory profile and 2) to understand whether the presence of some cytokines is due to an acute response www.nature.com/scientificreports to the surgical stress or if is more intrinsically related to the inflammatory profile of the patients with POAF or permanent AF
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