A2 Adenosine Receptor Subtypes Overproduction in Atria of Perioperative Atrial Fibrillation Patients Undergoing Cardiac Surgery: A Pilot Study

Baptiste Maille; Julien Fromonot; Claire Guiol; Marion Marlinge; Florian Baptiste; Suzy Lim; Charlotte Colombani; Marie Charlotte Chaptal; Mohamed Chefrour; Marguerite Gastaldi; Frederic Franceschi; Jean-Claude Deharo; Vlad Gariboldi; Jean Ruf; Giovanna Mottola; Régis Guieu

doi:10.3389/fcvm.2021.761164

A₂ Adenosine Receptor Subtypes Overproduction in Atria of Perioperative Atrial Fibrillation Patients Undergoing Cardiac Surgery: A Pilot Study

Front Cardiovasc Med. 2021 Nov 3:8:761164. doi: 10.3389/fcvm.2021.761164. eCollection 2021.

Authors

Baptiste Maille^{1

2}, Julien Fromonot^{1

3}, Claire Guiol¹, Marion Marlinge^{1

3}, Florian Baptiste^{1

2

3}, Suzy Lim³, Charlotte Colombani³, Marie Charlotte Chaptal¹, Mohamed Chefrour³, Marguerite Gastaldi¹, Frederic Franceschi^{1

2}, Jean-Claude Deharo^{1

2}, Vlad Gariboldi^{1

4}, Jean Ruf¹, Giovanna Mottola¹, Régis Guieu^{1

3}

Affiliations

¹ Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.
² Department of Cardiology, Timone University Hospital, Marseille, France.
³ Laboratory of Biochemistry, Timone University Hospital, AP-HM, Marseille, France.
⁴ Department of Cardiac Surgery, Timone University Hospital, Marseille, France.

Abstract

Objective: Although atrial fibrillation is a common cardiac arrhythmia in humans, the mechanism that leads to the onset of this condition is poorly elucidated. Adenosine is suspected to be implicated in the trigger of atrial fibrillation (AF) through the activation of its membrane receptors, mainly adenosine receptor (AR) subtypes A₁R and A₂R. In this study, we compared blood adenosine concentration (BAC), and A₁R, A_2AR, and A_2BR production in right (RA) and left atrium (LA), and on peripheral blood mononuclear cells (PBMCs) in patients with underlying structural heart disease undergoing cardiac surgery with or without peri-operative AF (PeOpAF). Methods: The study group consisted of 39 patients (30 men and 9 women, mean age, range 65 [40-82] years) undergoing cardiac surgery and 20 healthy patients (8 women and 12 men; mean age, range 60 [39-72] years) as controls were included. Among patients, 15 exhibited PeOpAF. Results: Blood adenosine concentration was higher in patients with PeOpAF than others. A_2AR and A_2BR production was higher in PBMCs of patients compared with controls and was higher in PeOpAF patients than other patients. In LA and RA, the production of A_2AR and A_2BR was higher in patients with PeOpAF than in other patients. Both A_2AR and A_2BR production were higher in LA vs. RA. A₁R production was unchanged in all situations. Finally, we observed a correlation between A₁R, A_2AR, and A_2BR production evaluated on PBMCs and those evaluated in LA and RA. Conclusions: Perioperative AF was associated with high BAC and high A_2AR and A_2BR expression, especially in the LA, after cardiac surgery in patients with underlying structural heart disease. Whether these increases the favor in triggering the AF in this patient population needs further investigation.

Keywords: adenosine receptor; adenosine receptor 2A; adenosine receptor 2B; atrial fibrillation; cardiac surgery; perioperative atrial fibrillation.