Enhanced Levels of Adiposity, Stretch and Fibrosis Markers in Patients with Coexistent Heart Failure and Atrial Fibrillation.

The coexistence of heart failure (HF) and atrial fibrillation (AF) worsens the prognosis of patients. We aimed to study the inflammation, metabolism, adiposity, and fibrosis markers on epicardial and subcutaneous fat and blood, and their relationship with HF and AF. Samples from 185 patients undergoing cardiac surgery were collected. Levels of multi-markers on fat biopsies and plasma were analyzed. Patients were grouped by HF or AF presence. Plasma adiposity markers were increased in AF patients, while increased stretch markers correlated with HF. Patients with both AF and HF had higher ANP and GDF-15 levels. After excluding AF patients, plasma FABP4 was identified as the main HF predictor. Fat biopsies from AF patients showed an enhanced inflammatory profile. Higher levels of adiposity markers are associated with AF or HF, and higher stretch and fibrosis markers with combined AF and HF, suggesting a role of adiposity-fibrosis pathway in HF and AF coexistence.

Relation of Skin Flora of Hands with Glove Perforation and Contamination in Cardiac Surgery.

BACKGROUND AND OBJECTIVES: Surgical scrub reduces the number of microorganisms, but fails to sterilize hands, and therefore the use of sterile gloves is recommended. Glove perforation allows bacteria passage from the surgeons´ hands to the patient´s tissues. We analyze the relationship between skin flora of hands, glove perforation and contamination. METHODS: A prospective study comprising 139 patients undergoing open heart surgery through a median sternotomy was conducted. Surgeons´hands were studied. Gloved and ungloved fingertips were placed on culture plates after scrubbing and before sternal closure. Removed gloves were evaluated for perforations. Samples from the surgical wound were taken for culture. Identification of isolated microorganisms was performed by conventional biochemical tests. RESULTS: Culture of fingertips after scrubbing resulted positive in 29.13% of the samples and increased to 34.53% at the end of the procedure. Culture of gloved fingertips before closing the sternum demonstrated contamination of the outer surface in 11.87% of samples. Gloves removed before sternal closure showed perforations in 23.02% of samples. Holes were observed in 33% of contaminated gloves. No relationship between perforation and contamination of gloves was observed. The culture of the sternal wound resulted positive in 7.91% of cases. A significant relationship between the presence of microorganisms in the wound and glove contamination was demonstrated. (P<0,001). CONCLUSIONS: Perforation does not cause significant contamination of the outer surface of surgical gloves. The statistical correlation between glove contamination and surgical wound colonization could be explained by the presence of other sources of contaminating microorganisms.