Ethan J Anderson1,2, Jimmy T Efird3,4,5,6, Andy C Kiser4, Patricia B Crane5, Wesley T O'Neal7, T Bruce Ferguson4, Hazaim Alwair4, Kendal Carter3, J Mark Williams4, Anil K Gehi8, Alan P Kypson9. 1. Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa. 2. Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina. 3. Center for Epidemiology and Outcomes Research, East Carolina Heart Institute, Greenville, North Carolina. 4. Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina. 5. Office of the Dean of Research, College of Nursing, East Carolina University, Greenville, North Carolina. 6. Center for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia. 7. Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia. 8. Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 9. REX Cardiac Surgical Specialists, University of North Carolina Health Care, Raleigh, North Carolina.
Abstract
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute. The concentrations of norepinephrine (NE), dopamine (DA), epinephrine (EPI), and enzyme MAO-B were assessed in platelet-rich plasma. A log-binomial regression model was used to determine the association between quartiles of these variables and POAF. RESULTS: Levels of NE (p = 0.0006) and EPI (p = 0.047) in the 4th quartile [Formula: see text] were positively associated with POAF, whereas DA (p = 0.0034) levels in the 4th quartile [Formula: see text] were inversely associated with POAF. Adjusting for age, heart failure (HF), and history of atrial fibrillation, the composite pre-operative (adrenergic) plasma marker [Formula: see text] was associated with a 4-fold increased occurrence of POAF (adjusted p = 0.0001). No association between plasma MAO-B and POAF was observed. CONCLUSIONS: Our results suggest that pre-operative adrenergic tone is an important factor underlying POAF. This information provides evidence that assessment of plasma catecholamines may be a low-cost method that is easy to implement for predicting which patients are likely to develop POAF. More investigation in a multicentric setting is needed to validate our results.
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute. The concentrations of norepinephrine (NE), dopamine (DA), epinephrine (EPI), and enzyme MAO-B were assessed in platelet-rich plasma. A log-binomial regression model was used to determine the association between quartiles of these variables and POAF. RESULTS: Levels of NE (p = 0.0006) and EPI (p = 0.047) in the 4th quartile [Formula: see text] were positively associated with POAF, whereas DA (p = 0.0034) levels in the 4th quartile [Formula: see text] were inversely associated with POAF. Adjusting for age, heart failure (HF), and history of atrial fibrillation, the composite pre-operative (adrenergic) plasma marker [Formula: see text] was associated with a 4-fold increased occurrence of POAF (adjusted p = 0.0001). No association between plasma MAO-B and POAF was observed. CONCLUSIONS: Our results suggest that pre-operative adrenergic tone is an important factor underlying POAF. This information provides evidence that assessment of plasma catecholamines may be a low-cost method that is easy to implement for predicting which patients are likely to develop POAF. More investigation in a multicentric setting is needed to validate our results.
Authors: G Eisenhofer; P Friberg; B Rundqvist; A A Quyyumi; G Lambert; D M Kaye; I J Kopin; D S Goldstein; M D Esler Journal: Circulation Date: 1996-05-01 Impact factor: 29.690
Authors: Craig T January; L Samuel Wann; Joseph S Alpert; Hugh Calkins; Joaquin E Cigarroa; Joseph C Cleveland; Jamie B Conti; Patrick T Ellinor; Michael D Ezekowitz; Michael E Field; Katherine T Murray; Ralph L Sacco; William G Stevenson; Patrick J Tchou; Cynthia M Tracy; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2014-03-28 Impact factor: 24.094
Authors: Adil H Haider; Irene Dankwa-Mullan; Allysha C Maragh-Bass; Maya Torain; Cheryl K Zogg; Elizabeth J Lilley; Lisa M Kodadek; Navin R Changoor; Peter Najjar; John A Rose; Henri R Ford; Ali Salim; Steven C Stain; Shahid Shafi; Beth Sutton; David Hoyt; Yvonne T Maddox; L D Britt Journal: JAMA Surg Date: 2016-06-01 Impact factor: 14.766
Authors: Arthur R Menezes; Carl J Lavie; James J DiNicolantonio; James O'Keefe; Daniel P Morin; Sammy Khatib; Richard V Milani Journal: Mayo Clin Proc Date: 2013-04 Impact factor: 7.616
Authors: Gregory A Fleming; Katherine T Murray; Chang Yu; John G Byrne; James P Greelish; Michael R Petracek; Steven J Hoff; Stephen K Ball; Nancy J Brown; Mias Pretorius Journal: Circulation Date: 2008-09-29 Impact factor: 29.690
Authors: Basel Ramlawi; Hasan Otu; Shigetoshi Mieno; Munir Boodhwani; Neel R Sodha; Richard T Clements; Cesario Bianchi; Frank W Sellke Journal: Ann Thorac Surg Date: 2007-10 Impact factor: 4.330
Authors: Rosa M Agra-Bermejo; Carla Cacho-Antonio; Adriana Rozados-Luis; Marinela Couselo-Seijas; Angel L Fernandez; J M Martinez-Cereijo; S B Bravo; Jose R Gonzalez-Juanatey; Sonia Eiras Journal: Front Physiol Date: 2020-06-30 Impact factor: 4.566
Authors: Jimmy T Efird; Charulata Jindal; Andy C Kiser; Shahab A Akhter; Patricia B Crane; Alan P Kypson; Aaron L Sverdlov; Stephen W Davies; Linda C Kindell; Ethan J Anderson Journal: J Int Med Res Date: 2018-05-29 Impact factor: 1.671