Henningsen Kristoffer Mads Aaris, Therkelsen Susette Krohn, Bruunsgaard Helle, Krabbe Karen S, Pedersen Bente Klarlund, Svendsen Jesper Hastrup
Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Scand J Clin Lab Invest. 2009;69(3):425-32. doi: 10.1080/00365510802676848.
The aim of this study was to assess the role of inflammatory processes in the development of atrial fibrillation (AF) and the prognostic impact of inflammatory markers in predicting long-term risk of AF recurrence after electrical cardioversion (CV).
High-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured in 56 patients with persistent AF (lasting mean 128 days (range 14-960), mean age 65 years (34-84)), 19 healthy volunteers and 19 patients with permanent AF. Patients with persistent AF underwent CV. Blood samples were taken prior to CV and after 1, 30 and 180 days.
The immediate success rate of CV was 88%, while the total recurrence rate after 180 days was 68%. Patients with permanent AF had significantly higher levels of hs-CRP and IL-6 than patients with persistent AF (p = 0.0011, p<0.001). Patients in sinus rhythm (SR) after 180 days had significantly lower baseline hs-CRP (1.25 mg/L (0.5-2.4) versus 2.0 mg/L (0.9-3.3), p<0.001) and IL-6 (1.96 pg/mL (1.35-2.7) versus 2.75 pg/mL (1.55-3.62), p<0.001) than patients with recurrent AF. Baseline IL-6 was the only independent predictor of recurrent AF (p = 0.04) in a multivariate Cox analysis. Patients in the lowest hs-CRP quartile (<0.8 mg/L) had significantly lower AF recurrence rates after 180 days (50% versus 74% in the other three quartiles combined; p = 0.0069).
Patients with AF had elevated levels of inflammatory markers. Low hs-CRP and IL-6 prior to CV are associated with a lower risk of AF recurrence after CV.
本研究旨在评估炎症过程在心房颤动（AF）发生发展中的作用，以及炎症标志物对预测电复律（CV）后AF长期复发风险的预后影响。
对56例持续性AF患者（平均持续时间128天（范围14 - 960天），平均年龄65岁（34 - 84岁））、19名健康志愿者和19例永久性AF患者测定高敏C反应蛋白（hs-CRP）和白细胞介素-6（IL-6）。持续性AF患者接受CV。在CV前以及CV后1天、30天和180天采集血样。
CV的即刻成功率为88%，而180天后的总复发率为68%。永久性AF患者的hs-CRP和IL-6水平显著高于持续性AF患者（p = 0.0011，p<0.001）。180天后处于窦性心律（SR）的患者基线hs-CRP（1.25 mg/L（0.5 - 2.4）对比2.0 mg/L（0.9 - 3.3），p<0.001）和IL-6（1.96 pg/mL（1.35 - 2.7）对比2.75 pg/mL（1.55 - 3.62），p<0.001）显著低于复发AF的患者。在多变量Cox分析中，基线IL-6是AF复发的唯一独立预测因素（p = 0.04）。hs-CRP处于最低四分位数（<0.8 mg/L）的患者180天后的AF复发率显著更低（50%对比其他三个四分位数总和的74%；p = 0.0069）。
AF患者的炎症标志物水平升高。CV前低hs-CRP和IL-6与CV后AF复发风险较低相关。
