Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT-pro ANP levels after coronary artery bypass surgery: A three-dimensional echocardiography study.

OBJECTIVE: Postoperative AF (POAF) is the most common cause of morbidity after coronary artery bypass surgery. In this study, we aimed to show the relationship between POAF and N-terminal pro-atrial natriuretic peptide (NT-pro ANP) levels and the relationship between mechanical functions and left atrial volume measured using preoperative three-dimensional echocardiography (3D ECHO) among patients that will undergo isolated coronary artery bypass grafting (CABG) in elective conditions. METHOD: Sixty-six consecutive patients (51 male, 15 female) who were decided to undergo CABG and had normal sinus rhythm were involved in the study. Patients were followed by continuous electrocardiography monitoring and daily electrocardiogram. LA volume and mechanical functions were calculated with 3D ECHO. In addition, for the analysis of plasma levels of NT-pro ANP, blood samples were collected before the surgery. RESULTS: During follow-up after the operation, 15 patients (22.7%) had postoperative atrial fibrillation. LA Vmax, Vmin, VpreA values were higher (P < .001, P = .004, P < .001 respectively) Also in POAF-developed group and SR group, LAVI values were 27.56 ± 4.2 and 20.7 ± 4.64 mL/m2 , respectively (P < .001). In POAF-developing group, NT-pro ANP levels were significantly higher (P < .001). In multiple logistic regression analysis, age (ß = 0.355, P = .007) and LAVI (ß = 0.668, P = .012) are independent predictors of POAF. CONCLUSION: It was found that 3D echocardiography can be used as a helping noninvasive method to show subclinical atrial volume and mechanical dysfunction in patients undergoing CABG. Also, blood levels of NT-pro ANP in POAF group were increased.

Association of serum prolidase activity in patients with isolated coronary artery ectasia.

OBJECTIVE: Coronary artery ectasia (CAE) is defined as an angiographic enlargement of a portion of the coronary artery between 1.5 and 2 times the diameter of the adjacent normal coronary artery. It has been demonstrated that increased serum prolidase activity (SPA) is associated with increased collagen turnover. We aimed to analyze the relationship between CAE and serum SPA levels. METHODS: This study used a prospective case protocol design. A total of 40 consecutive patients with isolated right CAE and normal coronary arteries (23 men, 17 women; mean age, 62.4±10.8 years) were evaluated. The control group included the same number of consecutive patients with angiographically normal coronary arteries (20 men, 20 women; mean age, 63.8±11.1 years). Clinical characteristics, laboratory results, cardiovascular risk factors, and medication use were recorded. SPA was measured using a spectrophotometer. Student's t-test, Mann-Whitney U test, chi-square test, Pearson's and Spearman's correlations, logistic regression analysis, and ROC curve analysis were used for statistical analysis. RESULTS: SPA was significantly higher in the CAE group compared with the control group (1635.2±492.0 U/L and 986.2±422.3 U/L, respectively; p<0.001). The relationship of SPA with CAE proved to be significant (r=0.512; p<0.001). SPA also served as an independent predictor of CAE (OR=1.003; 95% CI, 1.001-1.005; p=0.002). The SPA value of 1170 U/L was predictive of CAE, with a sensitivity of 85% and specificity of 60% (AUC=0.854; 95% CI, 0.763-0.944; p<0.001). CONCLUSION: The activity of this enzyme was significantly correlated with CAE.