Electromecánica auricular como predictora de inflamación, estrés oxidativo y arritmias auriculares
Arrhythmias are frequent during the postoperative period of cardiovascular surgery. The arrhythmic risk increases in pathologies with greater inflammatory load, such as obesity, arterial hypertension, and coronary heart disease. Inflammation leads to electrophysiological remodeling of the Na channel...
Guardado en:
| Autores principales: | , , , , |
|---|---|
| Publicado: |
2019
|
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=14586 |
| Sumario: | Arrhythmias are frequent during the postoperative period of cardiovascular surgery. The arrhythmic risk increases in pathologies with greater inflammatory load, such as obesity, arterial hypertension, and coronary heart disease. Inflammation leads to electrophysiological remodeling of the Na channel, connexins, and structural remodeling by fibrosis. The inflammatory pathway that triggers IL-6 and activates STAT3 / NF-Kβ is involved in atrial remodeling. Changes in driving facilitate the onset of atrial fibrillation (AF). P waves greater than 120 ms on the ECG suggest atrial conduction disorder and is called Bayes syndrome. Atrial dilatation also prolongs the P wave. The new echocardiographic techniques that determine regional myocardial deformation (strain) would allow elucidating whether there is dilatation or whether intra and interatrial dyschromia occur. The general objective is to improve the prediction of risk of developing arrhythmias in the surgical postoperative with non-invasive techniques that are sensitive to detect disychronia related to local atrial inflammation. Specific objectives 1) Identify intra and inter atrial activation dyssynchrony by strain. 2) Demonstrate that Bayes syndrome with mechanical atrial dyssynchrony is a non-invasive indicator of tissue electrical inflammation and remodeling. 3) Determine that dyssynchrony increases the risk of AF in the postoperative period. ECG will be performed to diagnose Sd. of Bayes and echocardiogram with evaluation of atrial strain in patients undergoing non-valvular mitral cardiovascular surgery. We will try to demonstrate intra and interauricular dyssynchrony. Markers of systemic inflammation such as IL-6 and CRP will be determined. In right atrial samples, the following tests will be performed: action potentials; determination of inflammation, fibrosis, electrical remodeling, electron microscopy, and oxidative state. During the hospital stay, there will be continuous ECG monitoring during the first 5 days after surgery to detect the incidence of AF. A sample size of 90 patients was calculated to detect a difference in the incidence of AF among those who presented electromechanical alteration assessed by atrial strain, who developed AF in the postoperative period in 50% of the cases in contrast to 20% with that that do not present these alterations. It will be considered a significance level of p 0.05 and a power of 80%. |
|---|
