Evidence for Inflammation as a Driver of Atrial Fibrillation

Zhou, Xiaoxu; Dudley, Samuel C.

doi:10.3389/fcvm.2020.00062

Cited by 72 publications

(86 citation statements)

References 106 publications

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“…Роли хронического субклинического воспаления в развитии и прогрессировании ФП в последние годы посвящено большое число исследований [3,6,11]. Убедительным доказательством наличия патогенетической связи между хроническим воспалением и ФП является то, что частота ФП при таких заболеваниях, как ревматоидный артрит, системная красная волчанка, псориаз и других, значительно выше, чем в популяции [6]. Системное воспаление относится и к молекулярным механизмам развития ФП при ожирении.…”

Section: Discussionunclassified

“…Воспаление играет существенную роль в развитии и прогрессировании сердечно-сосудистых заболеваний, в т.ч. ФП [5,6]. При ФП также установлена значимая роль воспаления, о чем свидетельствуют данные метаанализа, проведенного Wu ZK, et al [7].…”

Section: Biomarkers Of Inflammation Parameters Characterizing Obesitunclassified

“…При ФП наиболее изучена роль двух биомаркеров воспаления -С-реактивного белка (СРБ) и интерлейкина-6 (ИЛ-6) [9,10]. Кроме этих параметров исследовалась ассоциация между ФП и фактором некроза опухоли-α (ФНО-α), интерлейкином-8 (ИЛ-8) и интерлейкином-2 (ИЛ-2) [6,11]. Лейкоцитоз и нарушение соотношения между нейтрофилами и лимфоцитами также является индикатором системного воспаления и оксидативного статуса, что, в свою очередь, способствует развитию ФП [11].…”

Section: Biomarkers Of Inflammation Parameters Characterizing Obesitunclassified

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Biomarkers of inflammation, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation and metabolic syndrome

et al. 2021

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Aim. To determine the blood level of inflammatory markers, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation (AF) in combination with metabolic syndrome (MS).Material and methods. This single-stage case-control study included 677 subjects aged 35 to 65 years: patients with MS (n=407), of which 128 patients with AF; comparison group — patients with AF without MS (n=75); control group — practically healthy subjects without cardiovascular diseases and metabolic disorders (n=195).Results. It was found that the blood concentration of circulating pro-inflammatory biomarkers in patients with AF and MS is higher than in patients with AF without MS: C-reactive protein (CRP) (4,43 (2,68-4,98) and 2,33 (1,08-4,7) mg/L, p<0,0001), interleukin-6 (IL-6) (2,5 (1,28-5,13) and 1,27 (0,68-2,7) pg/ml, p<0,0001) and tumor necrosis factor-α (TNF-α) (5,18 (2,63-7,32) and 3,42 (2,115,48) pg/ml, p<0,0001). The serum CRP concentration positively correlates with left (ρ=0,451, p<0,0001) and right atrial (ρ=0,412, p<0,000) volumes, as well as with the waist circumference (ρ=0,503, p<0,001) and epicardial fat thickness (ρ=0,550, p<0,001). Plasma IL-6 and serum TNF-α levels correlated to a lesser extent with parameters characterizing atrial remodeling, but had a strong positive relationship with epicardial fat thickness. According to multivariate analysis, it was found that an increase in the epicardial fat thickness had a greater effect on an increase in blood concentration of CRP, IL-6 and TNF-α, in contrast to other parameters characterizing obesity, such as body mass index and waist circumference.Conclusion. An increase in the blood concentration of proinflammatory biomarkers CRP, IL-6, and TNF-α is associated with cardiac remodeling and epicardial fat thickness in patients with MS and probably has a pathogenetic role in increasing the AF risk in this cohort of patients.

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Section: Discussionunclassified

Section: Biomarkers Of Inflammation Parameters Characterizing Obesitunclassified

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Biomarkers of inflammation, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation and metabolic syndrome

et al. 2021

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“… 13 – 15 Interleukin-6, a cytokine highly expressed in individuals with severe COVID-19 infection and a biomarker target for these patients, has been related to a greater risk of AF. 13 , 16 – 18 In addition, leukocyte infiltration in the atrial tissue of patients with AF has been described. 13 , 16 – 18 Moreover, reactive oxygen species, direct oxidized Ca 2+ /calmodulin-dependent protein kinase II, and enhanced cardiomyocyte NLRP3 inflammasome signaling pathways have been recognized as potential triggers for developing AF.…”

Section: Risk Of Af and Covid-19 Infectionmentioning

confidence: 99%

“… 13 , 16 – 18 In addition, leukocyte infiltration in the atrial tissue of patients with AF has been described. 13 , 16 – 18 Moreover, reactive oxygen species, direct oxidized Ca 2+ /calmodulin-dependent protein kinase II, and enhanced cardiomyocyte NLRP3 inflammasome signaling pathways have been recognized as potential triggers for developing AF. 19 – 21 …”

Section: Risk Of Af and Covid-19 Infectionmentioning

confidence: 99%

Dabigatran, the oral anticoagulant of choice at discharge in patients with non-valvular atrial fibrillation and COVID-19 infection: the ANIBAL* protocol

Iturbe-Hernandez¹,

Romualdo²,

Ortega³

et al. 2020

DIC

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Atrial fibrillation is a frequent complication among patients with severe coronavirus disease-2019 (COVID-19) infection. Both direct and indirect mechanisms through COVID-19 have been described to explain this relationship. COVID-19 infection increases the risk of developing both arterial and venous thrombotic complications through systemic coagulation activation, leading to increased mortality. Chronic oral anticoagulation is essential to reduce the thromboembolic risk among AF patients. Switching to low-molecular-weight heparin has been recommended during hospitalization for COVID-19 infection. Of note, at discharge, the prescription of direct oral anticoagulants may offer some advantages over vitamin K antagonists. However, oral anticoagulants should only be prescribed after the consideration of drug–drug interactions with antiviral therapies as well as of the risk of hepatotoxicity, which is common among individuals with severe COVID-19 pneumonia. Not all anticoagulants have the same risk of hepatotoxicity; dabigatran has shown a good efficacy and safety profile and could have a lower risk of hepatotoxicity. Furthermore, its metabolism by cytochrome P450 is absent and it has a specific reversal agent. Therefore, dabigatran may be considered as a first-line choice for oral anticoagulation at discharge after COVID-19 infection. In this review, the available information on the antithrombotic management of AF patients at discharge after COVID-19 infection is updated. In addition, a practical algorithm, considering renal and liver function, which facilitates the anticoagulation choice at discharge is presented.

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Predictive value of HMGB1 for atrial fibrillation recurrence after cryoballoon ablation in paroxysmal atrial fibrillation patients

Zhao

et al. 2022

Clinical Cardiology

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Background Cryoballoon ablation (CBA) is recommended for patients with symptomatic drug refractory paroxysmal atrial fibrillation (pAF). However, substantial atrial fibrillation (AF) recurrence is common during follow‐up. Searching for a potential biomarker representing both myocardial injury and inflammation to identify patients at high risk of AF recurrence after CBA is very meaningful for postoperative management of AF patients. Hypothesis To evaluate the clinical efficacy of high‐mobility group box 1 (HMGB1) protein released from the left atrium to predict AF recurrence in pAF patients after CBA at 1‐year follow‐up. Methods We included 72 pAF patients who underwent CBA. To determine the expression levels of HMGB1, left atrial blood samples were collected from the patients before CBA and after the procedure through the transseptal sheath. Patients were followed up for AF recurrence for 1 year. Results A total of 19 patients of the 72 experienced AF recurrence. The level of postoperative HMGB1 (HMGB1post) was higher in the AF recurrence group than in the AF non recurrence group (p = .03). However, no differences were noted in the levels of other biomarkers such as preoperative high‐sensitivity C‐reactive protein (hs‐CRP), postoperativehs‐CRP, and preoperative HMGB1 between the two groups. Multiple logistic regression analysis revealed that a higher level of serum HMGB1post was associated with AF recurrence (odds ratio: 5.29 [1.17–23.92], p = .04). Receiver operating characteristic analysis revealed that HMGB1post had a moderate predictive power for AF recurrence (area under the curve: 0.68; sensitivity: 72%; and specificity: 68%). The 1‐year AF‐free survival was significantly lower in patients with a high HMGB1post level than in those with a low HMGB1post level (hazard ratio: 3.81 [1.49–9.75], p = .005). Conclusion In pAF patients who under went CBA, the level of HMGB1 after CBA was associated with AF recurrence and demonstrated a moderate predictive power. Thus, we offer a potential biomarker to identify pAF patients at high risk of AF recurrence.

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Evidence for Inflammation as a Driver of Atrial Fibrillation

Cited by 72 publications

References 106 publications

Biomarkers of inflammation, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation and metabolic syndrome

Biomarkers of inflammation, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation and metabolic syndrome

Dabigatran, the oral anticoagulant of choice at discharge in patients with non-valvular atrial fibrillation and COVID-19 infection: the ANIBAL* protocol

Predictive value of HMGB1 for atrial fibrillation recurrence after cryoballoon ablation in paroxysmal atrial fibrillation patients

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