Echocardiographically measured epicardial fat predicts new-onset atrial fibrillation after cardiac surgery

Abstract Objective: The current study aims to investigate the role of echocardiographically measured epicardial adipose tissue (EAT) thickness in the prediction of new-onset atrial fibrillation (AF) following coronary artery bypass grafting (CABG) surgery. Methods: One hundred and twenty-four patients scheduled to undergo isolated on-pump CABG due to coronary artery disease were enrolled to the current study. Patient characteristics, medical history and perioperative variables were prospectively collected. EAT thickness was measured using transthoracic echocardiography (TTE). Any documented episode of new-onset postoperative AF (POAF) until discharge was defined as the study endpoint. Fortyfour participants with POAF served as AF group and 80 patients without AF served as Non-AF group. Results: Two groups were similar in terms of baseline echocardiographic and laboratory findings. In laboratory findings, the groups were similar in terms of the studied parameters, except N-terminal pro-brain natriuretic peptide (NT Pro-BNP), which was higher in AF group than in Non-AF group (P=0.035). The number of left internal mammary artery (LIMA) grafts was not different in both groups. AF group had higher cross-clamp (CC) and cardiopulmonary bypass (CPB) times than Non-AF group (P=0.01 and P<0.001). In multivariate logistic regression analysis, EAT was found an independent predictor for the development of POAF (OR 4.47, 95% CI 3.07-5.87, P=0.001). Conclusion: We have shown that EAT thickness is associated with increased risk of AF development and can be used as a prognostic marker for this purpose.

The In vitro Effects on Platelet Functions and Coagulation of Different Prime Solutions Used in Cardiopulmonary by Pass.

Purpose: To investigate the in vitro effect of human albumin (HA) and fresh frozen plasma (FFP) added to prime solution on platelet functions and coagulation in patients undergoing cardiopulmonary bypass (CPB) surgery. Methods: Sixty consecutive patients receiving elective cardiopulmonary bypass with open heart surgery were enrolled in the study. Patients were divided into three equal groups. Group 1: with 2 units of fresh frozen plasma added to prime solution. Group 2: With 100 cc 25% human albumins added to prime solution. Group 3: (control group) with no FFP or HA added to prime solution. PFA-100 platelet function analyzer and platelet aggregation tests were investigated pre-induction, during and after CPB and on the 1st day postoperatively. Results: Postoperative drainage was significantly higher in groups 2 and 3 compared to Group 1 (p<0.01). The compromise in platelet functions in groups 1 and 2 improved, while in Group 3 preoperative values were not attained at the end of the 1st day postoperatively. There was a significant difference between groups 2 and 3 in terms of erythrocyte suspension (ES) used in intensive care (p<0.01). Greater hemorrhage occurred in the postoperative period in Group 3 and more ES was used. In addition, lengths of stay in intensive care differed significantly between groups 2 and 3 (p<0.01). Conclusion: FFP used in CPB causes reduced drainage in the postoperative period and necessitates less use of blood and blood products.