Research Progress On Relationship Between Vitamin D Deficiency And Postoperative Atrial Fibrillation In Coronary Artery Bypass Graft Surgery

In recent years,many studies have shown that vitamin D deficiency is not only closely related to musculoskeletal diseases but also cardiovascular diseases,such as atrial fibrillation,coronary heart disease,heart failure and hypertension etc.Coronary artery bypass graft surgery(CABG)is an important surgical treatment for patients with coronary heart disease.CABG surgery is the procedure using autologous blood vessels to build up bypasses between the narrowed coronary arteries and aorta,and redirecting aortic blood to the distal ends of stenosed coronary arteries,thereby restoring myocardial blood supply.Atrial fibrillation is the most common one among postoperative complications after CABG.Most studies have shown that atrial fibrillation after CABG surgery is a benign,transient and self-limited complication,but some studies have suggested that postoperative atrial fibrillation(POAF)is one of the independent predictors of poor prognoses after surgery.Vitamin D deficiency could easily lead to the occurrence of atrialfibrillation after CABG.The possible mechanism may mainly be the activation of renin-angiotensin-aldosterone system,and others may include enhanced inflammatory response,heightened oxidative stress,preoperative use of adrenaline drugs,intraoperative myocardial traction and incision and extracorporeal circulation,postoperative sympathetic and parasympathetic activation and elevated atrial pressure caused by left ventricular dysfunction,etc.Some researches reported the correlation between vitamin D deficiency and occurrence of postoperative atrial fibrillation in coronary artery bypass graft surgery.Gode,et al conducted a study on patients who underwent CABG.The results showed that serum 25-OHD levels in POAF group were significantly lower than those in the non-POAF,suggesting serum 25-OHD levels may be an independent predictor of the occurrence of atrial fibrillation after CABG.However,Shadvar,et al reported there was no significant difference in serum 25-OHD levels between atrial fibrillation group and control group(P=0.803).At present,there are few related literatures on the relationship between vitamin D supplementation and the incidence of atrial fibrillation after CABG.Besides,the sample size is small and the follow-up time is not long.Furthermore,there is also no consensus on the dosage form and dosage of vitamin D supplementation.Cerit,et al supplemented vitamin D to patients before CABG surgery.The number of cases in atrial fibrillation afteroperation was significantly reduced(P= 0.02).However,large-scale,multi-center,long-term clinical trials are still needed.