Biomarkers associated with rhythm status after cardioversion in patients with atrial fibrillation

Abstract

Biomarkers may help to improve our knowledge about the complex pathophysiology of atrial fibrillation (AF). In this study we sought to identify significant changes in biomarkers and clinical measures in patients with and without AF recurrence after electrical cardioversion. We measured 21 conventional and new biomarkers before and 30 days after electrical cardioversion and assessed the associations of changes in biomarker levels with rhythm status at follow-up. Significant between-group changes were observed for bone morphogenetic protein 10 (BMP10), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and total bilirubin. Their respective changes were − 10.4%, − 62.0% and − 25.6% in patients with sinus rhythm, and 3.1%, 1.1% and − 9.4% in patients with recurrent AF, for a between-group difference of − 13.5% (95% confidence interval [CI] − 19.3% to − 7.6%; P < 0.001), − 63.1% (95% CI − 76.6% to − 49.6%; P < 0.001) and − 16.3% (95% CI − 27.9% to − 4.7%; P = 0.007). In multivariable models, the reductions of BMP10 and NT-proBNP were significantly associated with follow-up rhythm status (β coefficient per 1 − SD decrease, − 3.85; 95% CI − 6.34 to − 1.35; P = 0.003 for BMP10 and − 5.84; 95% CI − 10.22 to − 1.47; P = 0.009 for NT-proBNP. In conclusion, changes in BMP10 und NT-proBNP levels were independently associated with rhythm status after cardioversion, suggesting that these markers may be dependent on the actual heart rhythm.

Serum Neurofilament Light Chain in Patients With Atrial Fibrillation

“… 42 , 43 In a recent study of 100 patients with AF undergoing electrical cardioversion, significant reductions in NT‐proBNP levels were associated with sinus rhythm at 30 days follow up. 44 The levels of NT‐proBNP were higher in the AF group compared with the control group in the present study. Similar to sNFL, the highest levels of NT‐proBNP were noticed in patients with ongoing AF rhythm (data not shown).…”

Decoding the PITX2-controlled genetic network in atrial fibrillation

“…In development and the adult, decreased Pitx2 is associated with increased LA Bmp10 and has been implicated in its repression (9,83). Furthermore, decreased levels of LA PITX2 and increased levels of BMP10 have been identified in human patients with AF, and increased BMP10 serum levels are correlated with relapse after cardiac ablation therapy and decreased levels with successful cardioversion (15,84,85). During development, increased levels of Bmp10 expression from the heart are known to have an adverse effect on the endothelial layer of blood vessels, including premature differentiation and decreased proliferation (72,86,87).…”

"Pathophysiology and Management of Atrial Fibrillation"

“…AF may also increase an individual's socioeconomic burden through increased healthcare costs [6][7][8]. smoking; chronic obstructive pulmonary disease; excessive alcohol intake and excessive exercise [11].…”