Inflammatory biomarkers in atrial myxoma - a tertiary center perspective

Introduction Myxomas constitute most common type of primary heart tumors. Nevertheless, primary heart tumors are considered as rare disease with the prevalence of 0.05-0.17%. Accordingly, available data on clinical characteristics and changes in laboratory test in this group remains limited. Currently there are no specific biomarkers applicable to risk assessment and prognosis among patients undergoing surgical treatment for atrial myxoma. Purpose The aim of this study was to evaluate epidemiological characteristics and changes in inflammatory biomarkers among patients with left atrial myxoma referred for surgical treatment. Methods This was a single-center, retrospective study that included surgically treated patients with left atrial myxoma between January 2019 and December 2024. We analyzed demographic data of patients, laboratory test results with the focus on systemic inflammatory reaction biomarkers, hospital and intensive care unit hospitalization length and perioperative complications. Results A total of 18 patients were included. Operated patients were predominantly women (66,7%) with the median age of 65.5 years (minimum 35, maximum 79 years) at the time of surgery. The diagnosis was based on transthoracic echocardiography. The tumors were predominantly attached to interatrial septum (66.6%), whereas pediculus has been identified in 61.1%. Maximal dimension of mass was 53±12.2 mm. Significant obstruction of mitral valve has been found in 41.6% of cases, due to left ventricular mass protrusion. Lymphocyte-to-monocyte ratio significantly correlated with atrial mass dimensions (r= -0.59; p= 0.0018). Moreover, EuroScore II correlated with intensive care unit stay length (r= 0.61, p < 0.05). Conclusion Already published studies suggest potential involvement of immune system in atrial myxoma, as several changes in systemic inflammatory biomarkers have been found. Interestingly, correlation between lymphocyte-monocyte ratio and mass size may indicate potential role of immune system in pathogenesis and or clinical course of atrial myxomas, however further studies are required to evaluate these associations. Moreover, results of our study have shown the utility of EuroScore II in prediction of short-term complications and intensive care unit stay length.