Inflammatory cytokines and atrial fibrillation: current and prospective views

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia and a challenging clinical problem encountered in daily clinical practice. There is an increasing body of evidence linking inflammation to a broad spectrum of cardiovascular conditions including AF. Historical evidence supports an association between AF and inflammation and is consistent with the association of AF with inflammatory conditions of the heart, such as myocarditis and pericarditis. AF has been associated with myocardial oxidative stress, and antioxidant agents have demonstrated antiarrhythmic benefit in humans. Increased plasma interleukin (IL)-6, C-reactive protein (CRP), and plasma viscosity support the existence of an inflammatory state among “typical” populations with chronic AF. These indexes of inflammation are related to the prothrombotic state and may be linked to the clinical characteristics of the patients (underlying vascular disease and comorbidities), rather than simply to the presence of AF itself. It has been suggested that inflammation may have a role in the development of atrial arrhythmias after cardiac surgery, and that a genetic predisposition to develop postoperative complications exists. Cytokines can have a prognostic significance; IL-6 levels, CRP, and other cytokines may have prognostic value in AF. Cytokine lowering therapies, statins, angiotensin converting enzyme inhibitors and other anti-inflammatory agents may have a role in the treatment of AF. The present article provides an overview of the evidence linking inflammatory cytokines to AF and their therapeutic and prognostic implications.

Polymorphisms in Genes Encoding Metalloproteinase 9 and Lymphotoxin- Alpha can Influence Warfarin Treatment

“…non-random mating, mutation, selection, genetic drift, gene flow and meiotic drive [15]. We also have noticed that ethnics, gender, target INR and use of medications that interfere with warfarin treatment, did not have different distribution among the genotypes of all polymorphisms studied (data not shown).…”

Clinical Analysis of Association of Cystatin C and Atrial Fibrillation

“…Then fibrous tissue repairs the local tissue damage. As a result, the pathological process leads to the atrial remodelling [6][7][8]. It is worth mentioning that Targoński et al found the serum concentration of hsCRP is closely positive correlation with the diameter size of left atrium [16].…”

Clinical Analysis of Association of Cystatin C and Atrial Fibrillation

“…In atrial tissue of the patients with atrial fibrillation, inflammation results in inflammatory cell infiltration, oxidative stress and damage, this is followed by repair of the local tissue damage by fibrous tissue. As a result of this pathological process, atrial remodeling ensues [6][7][8]. It is worth mentioning that Targoński et al found that the serum concentration of hsCRP is closely, positively correlated with the diameter size of left atrium [16].…”

“…At the same time, correlation analysis showed that cystatin C is closely related to hsCRP and left atrial diameter of patients with atrial fibrillation. Therefore it follows that the inflammatory cytokines such as cystatin C and hsCRP should modulate process of inflammatory, participate in the hypertrophic degeneration of atrial muscle fiber, induce atrial structural abnormalities in patients with atrial fibrillation and thus lead to atrial electrical remodeling [6][7][8]. Inflammation is closely associated to atrial fibrillation [6] and may be the important medium which links atrial fibrillation with known risk factors (such as high blood pressure and obesity, etc.)…”

“…Recent evidence is accumulating that AF may be closely interrelated with inflammation and inflammatory biomarkers [2,[4][5][6]. Some studies confirmed that diverse inflammatory factors participate in pathogenesis and development of AF [6][7][8].…”