Phd in ANGIO-CARDIO-THORACIC PATHOPHYSIOLOGY AND IMAGING

Thesis title: Serum NOX2 predict post-operative atrial fibrillation after pulmonary resection: prospective observational study of 100 patients

Introduction: Inflammatory mediators and cardiovascular parameters have a role in predicting atrial fibrillation (AF). Despite several risk factors have been identified, AF cannot be prevented after pulmonary resection to date. The aim of the study is test serum NOX2, NO, H2O2 and clinical parameters as a possible predictor of post lung resection AF. Materials and Methods: A series of 100 consecutive prospectively collected patients undergoing pulmonary resections were reviewed. Pre- and post-operative clinical data are analyzed. Demographics and perioperative events are recorded. Statistical analysis is performed to determine possible correlations between post operative atrial fibrillation (POAF) and oxidative stress mediators. Serum NOX2, NO, H2O2 were sampled preoperative and 1 month after surgery. Patients with previous AF or diagnosed cardiac disease were excluded from the study. Results: AF occurred in 6 out of 100 patients. Preoperative NOX2 is higher in patients developing post-operative AF compared to the others (p<0,001). NOX2 remains higher throughout the control period in patients with AF (p<0,001). Preoperative low respiratory function is significant risk factor for POAF (p=0,05). H2O2 follows NOX2 trends but less evidently (p= 0,271 preoperatively, p= 0,020 1-month post-surgery). Atrial area has a close correlation with POAF occurrence (p=0,048). Conclusions: The study confirms NOX2 interaction in POAF mechanism. Serum NOX2 represents a possible predictive factor for post-lung resection AF, in association with clinical data. However, these results must be confirmed by further studies with larger patients’ cohorts.