Time course of markers of tissue repair after ablation of atrial fibrillation and their relation to left atrial structural changes and clinical ablation outcome

Richter, Bernhard; Gwechenberger, Marianne; Socas, Ariel; Zorn, Gerlinde; Albinni, Sulaima; Marx, Manfred; Wolf, Florian; Bergler‐Klein, Jutta; Loewe, Christian; Bieglmayer, Christian; Binder, Thomas; Wojta, Johann; Gössinger, Heinz

doi:10.1016/j.ijcard.2010.07.021

Cited by 36 publications

(32 citation statements)

References 35 publications

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“…Recent studies of LA scars induced by RFCA as assessed by cardiac magnetic resonance imaging (MRI) and by a time course of markers of tissue repair after RFCA (matrix metalloproteinase-9 and transforming growth factor-β1) support reduction of LA volume by scarring, which would support the latter opinion 12,13. Our results, which identified reductions in LA volume in both the SR group and the AF group, favor the theory of scarring by RFCA.…”

Section: Discussionsupporting

confidence: 78%

The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

Chin

Youn

2014

Yonsei Med J

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PurposeThe effect of radiofrequency catheter ablation (RFCA) on left atrial (LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) has not been extensively studied. The aim of this study was to evaluate the long-term impact of RFCA on LA volume and function in patients with PAF.Materials and MethodsA total of 90 patients with drug-refractory PAF who had sinus rhythm on the initial echocardiogram were examined at baseline, 3 months and 1 year after ablation. We measured LA volume index, LA ejection fraction (LAEF; maximal-minimal LA volume/maximal LA volume), and LA active emptying fraction (LAAEF; mid-diastolic-minimal LA volume/mid-diastolic LA volume).ResultsAfter 12±1 months, 78 patients returned, and 61 patients (78%) had sinus rhythm. After 3 months, the LA maximal volume indices decreased (from 33±13 to 28±12 mL/m2; p<0.001). But, LAEF and LAAEF also decreased (from 48±13 to 39±12; p<0.001, from 27±13 to 19±11; p<0.001). After 1 year, LA volumes, LAEF, and LAAEF remained similar at 3 months. In patients without atrial fibrillation (AF) recurrence, LAEF and LAAEF decreased after 3 months (from 50±12 to 40±11; p<0.001, from 29±13 to 22±11; p<0.001) and did not change after 1 year. However, in patients with AF recurrence, those who did not have decreased levels after 3 months had significantly decreased after 1 year (from 43±14 to 34±11; p=0.026, from 22±12 to 15±10; p=0.012).ConclusionSuccessful RFCA of PAF decreased LA volume and function at 3 months. At one year, LA volume and function was remained unchanged in successfully ablated patients whereas LA function in patients with AF recurrence worsened.

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Section: Discussionsupporting

confidence: 78%

The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

Chin

Youn

2014

Yonsei Med J

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“…Structural alterations in atria in AF may be a consequence or predictor of this condition [18,19]. Plasma markers of this remodeling include matrix metalloproteinase (MMP) enzymes and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs); of these, MMP‐9 and TIMP‐1 may be important [20–23]. However, the place of these and allied markers is unclear, especially in predicting which patients are likely to go on to develop AF after CABG.…”

Section: Introductionmentioning

confidence: 99%

Intracardiac expression of markers of endothelial damage/dysfunction, inflammation, thrombosis, and tissue remodeling, and the development of postoperative atrial fibrillation

Kairevičiūtė

Lip

Balakrishnan

et al. 2011

Journal of Thrombosis and Haemostasis

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Summary. Background: Atrial fibrillation (AF) is a common complication of coronary artery bypass grafting (CABG), and may have an inflammatory and/or thrombotic etiology. We sought to determine the expression of inflammatory (interleukin [IL]-6), thrombotic (tissue factor and von Willebrand factor [VWF]) and remodeling (matrix metalloproteinase [MMP]-9 and tissue inhibitor of metalloproteinase [TIMP]-1) markers by left atrial appendage (LAA) and right atrial appendage (RAA) tissue in the prediction of postoperative AF. We determined whether the tissue expression of markers of certain different pathophysiologic mechanisms predicted the development of AF after CABG. Methods: LAA and RAA tissue was excised during CABG in 100 patients free of AF and inflammation. Tissue marker expression was quantified by immunohistochemistry and was related to 30-day postoperative AF. Results: Overall, there were no significant differences in staining intensity of any marker between LAA tissue and RAA tissue. However, more intense expression of VWF by LAA tissue predicted the 30 patients with postoperative AF as compared with those free of AF (P = 0.006). IL-6, MMP-9 and TIMP-1 expression by RAA and LAA epicardial tissue was stronger than expression by endocardium or cardiomyocytes (all P < 0.025) but failed to predict AF. Conclusion: In this study, one of the largest to investigate tissue expression of pathophysiologic markers in relation to postoperative AF, we show that more intense expression of VWF by LAA tissue is a significant predictor of postoperative AF. This points towards a possible role of endothelial damage/dysfunction (as reflected by VWF changes) in the pathogenesis of postoperative AF.

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“…These findings suggest that LAV reduction itself may be more affected by RFCA‐induced LA scarring, rather than LA reverse remodeling by SR restoration. Previous studies using cardiac magnetic resonance imaging or assessment of tissue healing biomarkers revealed that the extent of LAV reduction after AF ablation exhibited a strong positive correlation with the LA scar volume . In addition, several reports have demonstrated that extensive RFCA‐induced LA scarring is associated with deteriorated LA function; moreover, active LA function at 24 hours post‐RFCA is inversely correlated with the number of ablation lesions .…”

Section: Discussionmentioning

confidence: 99%

Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1‐Year Follow‐Up Multislice Computed Tomography Study

Kim

Shin

et al. 2016

Cardiovasc electrophysiol

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Time course of markers of tissue repair after ablation of atrial fibrillation and their relation to left atrial structural changes and clinical ablation outcome

Cited by 36 publications

References 35 publications

The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

Intracardiac expression of markers of endothelial damage/dysfunction, inflammation, thrombosis, and tissue remodeling, and the development of postoperative atrial fibrillation

Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1‐Year Follow‐Up Multislice Computed Tomography Study

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