Pericardial Inflammatory Mediators in Patients Undergoing Cardiac Surgery: Towards a Biomarker-Informed Clinical Practice

Postoperative atrial fibrillation, heart failure, and pericardial effusion remain frequent complications after cardiac surgery. Pericardial fluid is a localized inflammatory compartment in close contact with the myocardium and may provide information that complements systemic biomarkers. This narrative review summarizes inflammatory mediators identified in pericardial fluid after cardiac surgery and their associations with postoperative outcomes. We discuss potential mechanistic links between pericardial inflammation and pericardial fluid markers, as well as practical limitations related to sampling, timing, and standardization. Although pericardial fluid biomarkers may augment existing clinical risk models, prospective studies are needed to determine their incremental value and clarify their role in perioperative management.