Serum Inflammation Markers Predicting Successful Initial Catheter Ablation for Atrial Fibrillation

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• 作者：Takehiro Kimura ; MD ; PhD ; ^{kimura@z7.keio.jp" class="auth_mail} ; Seiji Takatsuki ; MD ; PhD ; Kohei Inagawa ; MD ; PhD ; Yoshinori Katsumata ; MD ; PhD ; Takahiko Nishiyama ; MD ; PhD ; Nobuhiro Nishiyama ; MD ; PhD ; Kotaro Fukumoto ; MD ; PhD ; Yoshiyasu Aizawa ; MD ; PhD ; Yoko Tanimoto ; MD ; PhD ; Kojiro Tanimoto ; MD ; PhD ; Keiichi Fukuda ; MD ; PhD
• 关键词：AF ; atrial fibrillation ; BMI ; body mass index ; LA ; left atrium ; LAA ; left atrial appendage
• 刊名：Heart, Lung and Circulation
• 出版年：July 2014
• 年：2014
• 卷：23
• 期：7
• 页码：636-643
• 全文大小：793 K

文摘

We investigated various serum inflammatory markers to predict ablation responders who have no atrial fibrillation (AF) relapse after the initial ablation.

Methods

Forty-four consecutive AF patients (age: 59 ± 8 years, paroxysmal: 31, CHADS₂: 1.1 ± 1.1) who underwent an initial pulmonary vein isolation were investigated. Various serum inflammatory markers, such as adiponectin, ANP, BNP, 1CTP, F1+2, hs-CRP, IL-6, intact P1NP, MDA-LDL, MMP-2, TGF-尾, TIMP-2, and TNF-伪, were evaluated prior to ablation. AF relapse was defined as AF documented in telemonitoring electrocardiograms twice a day during 9.7 ± 2.4 months of follow-up with three months of a blanking-period.

Results

A total of 29 patients (paroxysmal: 21) maintained sinus rhythm after the initial catheter ablation. These ablation responders had significantly lower MMP-2 (Sinus vs. Relapsed: 748 ± 132.7 vs. 841.2 ± 152.4 ng/mL, P=0.042) and TNF-伪 (1.1 ± 0.4 vs. 1.8 ± 1.7 pg/mL, P=0.046) levels prior to ablation. A BNP-adjusted Cox multivariate regression analysis revealed that the independent predictive factor for AF recurrence was high MMP-2 levels (>766 ng/mL) accompanied by high TNF-伪 levels (>1.2 pg/mL).

Conclusions

The levels of MMP-2 and TNF-伪 might be useful for predicting initial AF catheter ablation responders.