La concentración de calcio iónico se asocia a la presencia de fibrilación auricular post operatoria en pacientes llevados a revascularización miocardica
| Contribuinte(s) |
Montes Romero, Felix Ramón Rincón Franco, Ismael |
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| Data(s) |
10/06/2016
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| Resumo |
Objetivo. Determinar en un grupo de pacientes llevados a revascularización miocárdica si existió asociación entre la presencia de niveles de calcio iónico inferiores a 1,1 en las 24 horas del post operatorio y la ocurrencia de fibrilación auricular post operatoria. Metodología. Estudio observacional, analítico de casos y controles, en donde de manera consecutiva se incluyeron 110 sujetos (57 en el grupo de casos con presencia de fibrilación auricular post operatoria y 54 en el grupo de controles sin evidencia de fibrilación auricular) estos sujetos fueron llevados a revascularización miocárdica en la Fundación Cardioinfantil en los años 2010 a 2015. Resultados. Hubo 13 casos de fibrilación auricular post operatoria en pacientes con niveles de calcio iónico inferiores a 1,1 mmol/l en las primeras 24 horas del post operatorio OR: 0,5, IC (0,2-1,2) p: 0,1. Sin determinarse asociación por limitaciones del estudio, sin embargo un 29% de los pacientes con fibrilación auricular tuvieron niveles de calcio inferiores a 1,1 mmol/l en las primeras 24 horas del post operatorio, este valor aumenta a 31% cuando se analizan por separado los valores de calcio obtenidos a las 12 horas. Conclusiones. Aunque no se logró determinar asociación entre la fibrilación auricular post operatoria y las concentraciones de calcio iónico, de manera exploratoria se pudo establecer que un 29% de los pacientes con fibrilación auricular tuvieron concentraciones de calcio iónico inferiores a 1,1 mmol/l, este valor aumenta a 31% cuando se analizan los niveles de calcio iónico por separado. Objective. Determined in a group of patients undergoing coronary artery bypass graft if there was significant association between the presence of ionized calcium levels below 1.1 at 24 hours postoperative and the occurrence of postoperative atrial fibrillation. Methodology. Observational, analytical study of cases and controls, consecutive 110 subjects were included (57 in the group of cases with postoperative atrial fibrillation and 54 in the control group without evidence of atrial fibrillation) these subjects were taken to CABG in Fundación Cardioinfantil – IC in the years 2010-2015. Results. There were 13 cases of postoperative atrial fibrillation in patients with ionized calcium levels below 1.1 mmol / l in the first 24 hours of postoperative OR 0.5, CI (0.2-1.2) p: 0 ,1. There was no association for study limitations, however 29% of patients with atrial fibrillation had calcium levels below 1.1 mmol / l in the first 24 hours postoperative, this value increases to 31% when analyzed by separate calcium values obtained at 12 hours. Conclusions. Although it was not possible to determine association between postoperative atrial fibrillation and the concentrations of ionized calcium, exploratory way it was established that 29% of patients with atrial fibrillation had concentrations below 1.1 mmol / l calcium ion, this value increases to 31% when ionized calcium levels are analyzed separately. |
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application/pdf |
| Identificador | |
| Idioma(s) |
spa |
| Publicador |
Facultad de Medicina |
| Direitos |
info:eu-repo/semantics/openAccess |
| Fonte |
instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Horwich P1, Buth KJ, Légaré JF. New onset postoperative atrial fibrillation is associated with a long-term risk for stroke and death following cardiac surgery. J Card Surg. 2013 Jan;28(1):8-13, 2012 Nov 27 Ahlsson A1, Fengsrud E, Bodin L, Englund A. Postoperative atrial fibrillation in patients undergoing aortocoronary bypass surgery carries an eightfold risk of future atrial fibrillation and a doubled cardiovascular mortality. Eur J Cardiothorac Surg. 2010 Jun;37(6):1353-9 Hogue CW Jr1, Murphy SF, Schechtman KB, Dávila-Román VG. Risk factors for early or delayed stroke after cardiac surgery. Circulation. 1999 Aug 10;100(6):642-7 Van Wagoner DR1. Oxidative stress and inflammation in atrial fibrillation: role in pathogenesis and potential as a therapeutic target. Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio, USA. J Cardiovasc Pharmacol. 2008 Oct;52(4):306-13 Prielipp R, Butterworth J. Con: calcium is not routinely indicated during separation from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997 Dec;11(7):908-12. DiNardo JA. Pro: calcium is routinely indicated during separation from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997 Dec;11(7):905-7 DeHert SG1, Ten Broecke PW, De Mulder PA, Rodrigus IE, Haenen LR, Boeckxstaens CJ, Vermeyen KM, Gillebert TC, Moulijn AC. Effects of calcium on left ventricular 65 function early after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997 Dec;11(7):864-9 Gialdini G1, Nearing K2, Bhave PD3, Bonuccelli U4, Iadecola C5, Healey JS6, Kamel H JAMA. Perioperative atrial fibrillation and the long-term risk of ischemic stroke. 2014 Aug 13;312(6):616-22 Saxena A1, Dinh DT, Smith JA, Shardey GC, Reid CM, Newcomb AE. Usefulness of postoperative atrial fibrillation as an independent predictor for worse early and late outcomes after isolated coronary artery bypass grafting (multicenter Australian study of 19,497 patients). . Am J Cardiol. 2012 Jan 15;109(2):219-25 Barbara DW, Rehfeldt KH, Pulido JN, Li Z, White RD, Schaff HV, Mauermann WJ. Diastolic function and new-onset atrial fibrillation following cardiac surgery. Ann Card Anaesth. 2015 Jan-Mar;18(1):8-14 Ishii Y1, Schuessler RB, Gaynor SL, Yamada K, Fu AS, Boineau JP, Damiano RJ Jr . Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial con duction and atrialfibrillation. Circulation. 2005 Jun 7;111(22):2881-8 Ramlawi B1, Otu H, Mieno S, Boodhwani M, Sodha NR, Clements RT, Bianchi C, Sellke FW. Oxidative stress and atrial fibrillation after cardiac surgery: a case-control study. Ann Thorac Surg. 2007 Oct;84(4):1166-72; discussion 1172-3 Maesen B, Nijs J, Maessen J, Allessie M, Schotten U. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2012;14(2):159-174. Anselmi A, Possati G, Gaudino M. Postoperative inflammatory reaction and atrial fibrillation: simple correlation or causation? Ann Thorac Surg 2009;88:326 –33 Hak Ł, Mys´liwska J, Wickiewicz J, Szyndler K, Siebert J, Rogowski J. Interleukin-2 as a predictor of early postoperative atrial fibrillation after cardiopulmonary bypass graft (CABG). J Interferon Cytokine Res 2009;29:327 – 32 S, Izzat MB, Lee TW, Wan IYP, Tang NLS, Yim APC. Avoiding cardiopulmonarybypass in multivessel CABG reduces cytokine response and myocardial injury. Ann Thorac Surg 1999;68:52–5 Panesar SS, Athanasiou T, Nair S, Rao C, Jones C, Nicolaou M et al. Early outcomes in the elderly: a meta-analysis of 4921 patients undergoing coronary artery bypass grafting— comparison between off-pump and on-pump techniques. Heart 2006;92:1808–16 Workman A. Cardiac adrenergic control and atrial fibrillation. Naunyn-Schmiedeberg’s Arch Pharmacol 2010;381:235–49 Hoeldtke RD, Cilmi KM. Effects of aging on catecholamine metabolism. J Clin Endocrinol Metab 1985;60:479–84 Kalman JM, Munawar M, Howes LG, Louis WJ, Buxton BF, Gutteridge G et al.Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic activation. Ann Thorac Surg 1995;60:1709–15. Fleming GA, Murray KT, Yu C, Byrne JG, Greelish JP, Petracek MR et al. Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery. Circulation 2008;118:1619–25 Feneck RO, Sherry KM, Withington PS, Oduro-Dominah A. Comparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2001;15:306–15 El-Armouche A, Boknik P, Eschenhagen T, Carrier L, Knaut M, Ravens U et al. Molecular determinants of altered Ca2+ handling in human chronic atrial fibrillation. Circulation 2006;114:670–80 Ali IM, Sanalla AA, Clark V. Beta-blocker effects on postoperative atrial fibrillation.Eur J Cardio-Thorac Surg 1997;11:1154–57 Carmeliet E. Cardiac ionic currents and acute ischemia: from channels to arrhythmias. Physiol Rev 1999;79:917–1017 Ramlawi B, Otu H, Mieno S, Boodhwani M, Sodha NR, Clements RT et al. Oxidative stress and atrial fibrillation after cardiac surgery: a case-control study. Ann Thorac Surg 2007;84:1166–73. Kim YM, Guzik TJ, Zhang YH, Zhang MH, Kattach H, Ratnatunga C et al. A myocardial Nox2 containing NAD(P)H oxidase contributes to oxidative stress in human atrial fibrillation. Circ Res 2005;97:629–36 Kim YM, Kattach H, Ratnatunga C, Pillai R, Channon KM, Casadei B. Association of atrial nicotinamide adenine dinucleotide phosphate oxidase activity with the development of atrial fibrillation after cardiac surgery. J Am Coll Cardiol 2008; 51:68–74 Lesnefsky EJ, Lundergan CF, Hodgson JM, Nair R, Reiner JS, Greenhouse SW et al. Increased left ventricular dysfunction in elderly patients despite successful thrombolysis: the GUSTO-I angiographic experience. J Am Coll Cardiol 1996;28: 331–37 Spach MS, Dolber PC. Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res 1986;58:356–71. Ad N, Snir E, Vidne BA, Golomb E. Histologic atrial myolysis is associated with atrial fibrillation after cardiac operation. Ann Thorac Surg 2001;72:688–93. Goette A, Juenemann G, Peters B, Klein HU, Roessner A, Huth C et al. Determinants and consequences of atrial fibrosis in patients undergoing open heart surgery. Cardiovasc Res 2002;54:390–6 Lowe JE, Hendry PJ, Hendrickson SC, Wells R. Intraoperative identification of cardiac patients at risk to develop postoperative atrial fibrillation. Ann Surg 1991;213:388–91, discussion 91–2 Kanagaratnam P, Kojodjojo P, Peters NS. Electrophysiological abnormalities occur prior to the development of clinical episodes of atrial fibrillation: observations from human epicardial mapping. Pacing Clin Electrophysiol 2008;31 443–53 Yue L, Feng J, Gaspo R, Li G-R, Wang Z, Nattel S. Ionic remodeling underlying action potential changes in a canine model of atrial fibrillation. Circ Res 1997;81: 512–25 Workman AJ Cardiac adrenergic control and atrial fibrillation Naunyn Schmiedebergs Arch Pharmacol. 2010 Mar;381(3):235-49 Bers DM. Cardiac excitation-contraction coupling. Nature. 2002; 415:198–205 Walden AP, Dibb KM, Trafford AW. Differences in intracellular calcium homeostasis between atrial and ventricular myocytes. J Mol Cell Cardiol. 2009; 46:463–473 Bers DM. Calcium cycling and signaling in cardiac myocytes. Annu Rev Physiol. 2008; 70:23–49 Polderman KH Severe electrolyte disorders following cardiac surgery: a prospective controlled observational study. Crit Care. 2004 Dec;8(6):R459-66 Svagzdiene M1, Sirvinskas E. Changes in serum electrolyte levels and their influence on the incidence of atrial fibrillation after coronary artery bypass grafting surgery. Medicina (Kaunas). 2006;42(3):208-14. Svagzdiene M Atrial fibrillation and changes in serum and urinary electrolyte levels after coronary artery bypass grafting surgery Medicina (Kaunas). 2009;45(12):960-70 Kaw R, Hernandez AV, Masood I, Gillinov AM, Saliba W, Blackstone EH. Short- and long-term mortality associated with new-onset atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2011 May;141(5):1305-12 Gialdini G, Nearing K, Bhave PD, Bonuccelli U, Iadecola C, Healey JS, Kamel H. Perioperative atrial fibrillation and the long-term risk of ischemic stroke. JAMA. 2014 Aug 13;312(6):616-22 Mathew JP1, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, Barash PG, Hsu PH, Mangano DT. A multicenter risk index for atrial fibrillation after cardiac surgery; Investigators of the Ischemia Research and Education Foundation; Multicenter Study of Perioperative Ischemia Research Group. JAMA. 2004 Apr 14;291(14):1720-9. Tran DT, Perry JJ, Dupuis JY, Elmestekawy E, Wells GA. Predicting New-Onset Postoperative Atrial Fibrillation in Cardiac Surgery Patients. J Cardiothorac Vasc Anesth. 2015 Oct;29(5):1117-26 Wong JK, Maxwell BG, Kushida CA, Sainani KL, Lobato RL, Joseph Woo Y, Pearl RG. J Cardiothorac Vasc Anesth. 2015 Oct;29(5):1140-7. Obstructive Sleep Apnea Is an Independent Predictor of Postoperative Atrial Fibrillation in Cardiac Surgery. Najmeddine Echahidi, MD, Philippe Pibarot, Gilles O’Hara, Patrick Mathieu. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery . J Am Coll Cardiol. 2008 Feb 26;51(8):793-801 Arsenault KA, Yusuf AM, Crystal E, Healey JS, Morillo CA, Nair GM, Whitlock RP Cochrane Database Syst Rev. 2013 Jan 31;1. Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery TEME |
| Palavras-Chave | #616.128 #Canales de Calcio #Fibrilación Atrial #Revascularización Miocárdica #Calcium #Atrial fibrillation #Myocardial bypass grafting |
| Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |
