期刊
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
卷 23, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/ijms23031355
关键词
atrial fibrillation; cardiac surgery; pathophysiology; echocardiography; atrial strain
Postoperative atrial fibrillation (POAF) is a complication of cardiovascular surgeries that increases the risk of embolic stroke, prolonged hospital stay, and cardiovascular mortality. While many pathophysiological mechanisms are known, predicting POAF remains a hot topic. Doppler echocardiogram and strain echocardiography have shown significant predictive capacity for POAF.
Postoperative atrial fibrillation (POAF) complicates 15% to 40% of cardiovascular surgeries. Its incidence progressively increases with aging, reaching 50% in octogenarians. This arrhythmia is usually transient but it increases the risk of embolic stroke, prolonged hospital stay, and cardiovascular mortality. Though many pathophysiological mechanisms are known, POAF prediction is still a hot topic of discussion. Doppler echocardiogram and, lately, strain echocardiography have shown significant capacity to predict POAF. Alterations in oxidative stress, calcium handling, mitochondrial dysfunction, inflammation, fibrosis, and tissue aging are among the mechanisms that predispose patients to the perfect atrial storm. Manifestations of these mechanisms have been related to enlarged atria and impaired function, which can be detected prior to surgery. Specific alterations in the atrial reservoir and pump function, as well as atrial dyssynchrony determined by echocardiographic atrial strain, can predict POAF and help to shed light on which patients could benefit from preventive therapy.
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