Cardiac surgery elicited profound alterations in the pericardial immune cell profile, with neutrophils constituting almost 80% of immune cells present and peaking at 24 hours post-surgery.
Observational (n=43)
Does cardiac surgery alter the immune cell profile and inflammatory mediators in the pericardial space?
Cardiac surgery induces a profound local inflammatory response in the pericardial space, characterized by a massive influx of neutrophils and altered MMP/TIMP ratios, which may influence postoperative remodeling and complications.
Objective: There is a paucity of data on the inflammatory response that takes place in the pericardial space after cardiac surgery. This study provides a comprehensive assessment of the local postoperative inflammatory response. Methods: Forty-three patients underwent cardiotomy, where native pericardial fluid was aspirated and compared with postoperative pericardial effluent collected at 4, 24, and 48 hours' postcardiopulmonary bypass. Flow cytometry was used to define the levels and proportions of specific immune cells. Samples were also probed for concentrations of inflammatory cytokines, matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs). Results: Preoperatively, the pericardial space mainly contains macrophages and T cells. However, the postsurgical pericardial space was populated predominately by neutrophils, which constituted almost 80% of immune cells present, and peaked at 24 hours. When surgical approaches were compared, minimally invasive surgery was associated with fewer neutrophils in the pericardial space at 4 hours' postsurgery. Analysis of the intrapericardial concentrations of inflammatory mediators showed interleukin-6, MMP-9, and TIMP-1 to be highest postsurgery. Over time, MMP-9 concentrations decreased significantly, whereas TIMP-1 levels increased, resulting in a significant reduction of the ratio of MMP:TIMP after surgery, suggesting that active inflammatory processes may influence extracellular matrix remodeling. Conclusions: These results show that cardiac surgery elicits profound alterations in the immune cell profile in the pericardial space. Defining the cellular and molecular mediators that drive pericardial-specific postoperative inflammatory processes may allow for targeted therapies to reduce immune-mediated complications.
Hassanabad et al. (Mon,) conducted a observational in Patients undergoing cardiac surgery (n=43). Cardiac surgery (cardiotomy) vs. Preoperative state (native pericardial fluid) was evaluated on Pericardial inflammatory response (immune cell profile and inflammatory mediators). Cardiac surgery elicited profound alterations in the pericardial immune cell profile, with neutrophils constituting almost 80% of immune cells present and peaking at 24 hours post-surgery.