EFFECT OF HORMONAL IMBALANCES IN THE PERIOPERATIVE PERIOD OF CARDIAC SURGICAL PROCEDURES
Szécsi Balázs
Szív-és Érgyógyászati Tagozat
Dr. Merkely Béla
Sebészeti, Transzplantációs és Gasztroenterológiai Klinika, Dollinger terem
2025-07-14 13:00:00
Szív és érrendszeri betegségek élettana és klinikuma
Dr. Merkely Béla
Dr. Székely Andrea
Dr. Székely László
Dr. Fülöp András
D. Szijártó Attila
Dr. Keltai Katalin
Dr. Hejjel László
Current thesis aimed to explore the hormonal trends, imbalances and their effects on adverse outcomes in the perioperative period of cardiac surgical procedures.
The objective of this thesis was to describe hormonal patterns and trends including TSH, T3, T4, PRL, TTE in the perioperative period of cardiac surgeries. In addition, we investigate the role of endocrine support and supplementation as a major part of donor management during HTx. Furthermore, the research aimed to expose deeper associations between thyroid status and adverse outcomes after HTx.
Our findings suggest that postoperative serum T3 levels may serve as a reliable indicator for evaluating NTIS after cardiac surgery. In contrast, changes in serum TSH and T4 levels demonstrate minimal correlation with postoperative adverse events, rendering the routine measurement of these parameters less useful. TH treatment can reduce complications and improve both short- and long-term survival. Administering thyroxine alongside methylprednisolone may decrease the risk of PGD. Central TH parameters, including TSH, fT3, and fT4, decreased post-HTx compared to preoperative levels, indicating the development of NTIS. Levothyroxine replacement therapy for both donors and recipients may offer post-HTx benefits, correlating with improved survival rates. The expression of Dio3 mRNA was influenced by different MCS devices. Additionally, higher Dio2 expression in the heart, which may be reduced by levothyroxine replacement, is associated with acute allograft rejection, a common complication following HTx. A significant decrease in serum testosterone levels may be more pronounced in male patients, indicating a disrupted endocrine response. Additionally, serum testosterone levels may be linked to preoperative conditions and altered MELD scores, suggesting hepatic dysfunction. PRL acts as a stress hormone, but this effect is observed only in female patients.
Our findings indicate that monitoring TH status during the perioperative period of cardiac surgery could facilitate appropriate TH treatment, reduce complications, and improve both short- and long-term survival outcomes.
