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October 11, 2014
8:00 AM - 9:30 AM
Room Room 244
Altered Gene Expression Following Cardiopulmonary Bypass May Lead to Post Operative Atrial Fibrillation
Jeffrey Hubbard, M.D., M.S., Thomas Huang, B.A., Khurram Owais, M.D., Vwaire Orhurhu, B.A., M.P.H., Anam Pal, M.D., Mario Montealegre, M.D., Kamal Khabbaz, M.D., Feroze Mahmood, M.D., Robina Matyal, M.D.
Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Altered Gene Expression following Cardiopulmonary Bypass May Lead to Post Operative Atrial Fibrillation


Post-operative atrial fibrillation (AF) is a common cause of morbidity following cardiac surgery. Patients with post-operative AF have increased duration of hospitalization, an increased propensity for adverse coronary events, a greater incidence of cerebrovascular accidents, and a higher long-term mortality. Previous studies have shown increased oxidative stress markers in patients with post-operative AF but this remains incompletely understood. In this study we sought to investigate genes associated with increased oxidative stress in patients with post-operative AF.


Thirty-four patients were consented and tissue from the right atrial appendage was collected pre- and post-cardiopulmonary bypass (CPB). Samples were collected from patients undergoing isolated CABG surgery. Tissue samples were subsequently assessed using microarray.


Patient demographics are listed in Table 1. Microarray analysis identified 57 genes that were significantly deranged in patients who developed post-operative AF, compared to those who did not develop AF post-CPB. Nine of the 57 genes were found to be linked to inflammatory response (Table 2). Of the 9 genes, CXCR4, SYK, and CYP1B1 are markers for oxidative stress. In patients who developed AF, CXCR4 expression was increased while it was decreased in patients without AF (p=0.0445). Spleen Tyrosine Kinase was greatly increased in AF patients but only slightly elevated in non-AF patients (p=0.0064). The expression of CYP1B1 followed a similar pattern to the previous two. In non-AF patients, expression between pre and post bypass increased 6.07-fold while the expression in patients with AF pre and post bypass increased 10.36-fold.


Our results suggest that the gene expression pattern of right atrial appendage cardiomyocytes of patients that develop AF can be linked to oxidative stress associated with CPB, resulting in cellular damage leading to AF.
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