Author/Authors :
Mihai V. Podgoreanu، نويسنده , , Debra A. Schwinn، نويسنده ,
Abstract :
Considerable progress has been made in understanding the pathophysiology of perioperative stress responses and their impact on the cardiovascular system; however, researchers are just beginning to unravel genetic and molecular determinants that predispose to increased risk for postoperative cardiovascular adverse events. A new field, coined perioperative genomics, aims to apply functional genomic approaches to uncover the biological reasons why similar patients can have dramatically different clinical outcomes after surgery. For the perioperative physician, such findings may soon translate into prospective risk assessment incorporating genomic profiling of markers important in inflammatory, thrombotic, vascular, and neurologic responses to perioperative stress, with implications ranging from individualized additional pre-operative testing and physiological optimization, to perioperative decision-making, choice of monitoring strategies, and critical care resource utilization. We review current knowledge regarding genomic technologies in perioperative cardiovascular disease characterization and outcome prediction, as well as discuss future trends/challenges for translating integrated “omic” information into daily clinical management of the surgical patient.
Keywords :
ACE , Interleukin , CAD , Atrial fibrillation , PAI-1 , cardiopulmonary bypass , factor V Leiden , coronary artery disease , angiotensin-converting enzyme , APOE , Heat shock protein , SNP , Single nucleotide polymorphism , apolipoprotein E , mace , Adrenergic receptor , AF , CABG , AR , coronary artery bypass grafting , HSP , IL , major adverse cardiac events , plasminogen activator inhibitor-1 , CPB , FVL , PMI , perioperative myocardial infarction , PoAF , postoperative atrial fibrillation
