Wu Gang, Cheng Mian, Huang He, Yang Bo, Jiang Hong, Huang Congxin
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
PLoS One. 2014 Jun 18;9(6):e99623. doi: 10.1371/journal.pone.0099623. eCollection 2014.
Recent studies have identified a variant, rs4845625, in the interleukin-6 receptor (IL6R) gene associated with Atrial Fibrillation (AF). Levels of circulating interleukin-6 and other proinflammatory molecules have consistently been associated with a risk for AF and its recurrence after catheter ablation. This study tested the hypothesis that variant rs4845625 is associated with AF recurrence after catheter ablation in a Chinese Han population.
A total of 278 consecutive patients (mean age 59.4±11.5 years, 43% female) with paroxysmal (36.0%), persistent (59.7%), and permanent (4.3%) AF who underwent catheterablation from 2007-2011, were included in this study. Patients were monitored for 12 months for a recurrence of AF. The SNP rs4845625 was genotyped using high resolution melting analysis.
In our study cohort, an early recurrence of AF (ERAF), defined as a recurrence within the first 4 weeks, was observed in 42.8% of the patients, whereas late recurrence of AF (LRAF) (between 3 and 12 months) occurred in 25.9% of the patients. No significant differences in baseline clinical or echocardiographic characteristics were observed between patients with ERAF and LRAF. In contrast, the presence of the T allele of rs4845625 was associated with an increase in the risk for both ERAF (odds ratio [OR]: 1.84, 95% confidence interval [CI]: 1.31-2.59, p = 4.10×10-4) and LRAF (OR: 1.92, 95% CI: 1.30-2.81, p = 0.001). Furthermore, this association was significant after adjustments for age, sex, hypertension, diabetes and other risk factors. No significant relationship between rs4845625 and serum levels of IL6 was observed.
In this study, a variant of the IL6R gene, rs4845625, was found confer risk to AF recurrence after catheter ablation in a Chinese Han population. Our findings indicated that the IL6R pathway or inflammation may play important rols in the recurrence of AF after catheter ablation.
最近的研究已确定白细胞介素6受体（IL6R）基因中的一个变体rs4845625与心房颤动（AF）相关。循环白细胞介素6和其他促炎分子的水平一直与AF风险及其导管消融术后复发相关。本研究检验了rs4845625变体与中国汉族人群导管消融术后AF复发相关的假设。
本研究纳入了2007年至2011年期间连续接受导管消融的278例阵发性（36.0%）、持续性（59.7%）和永久性（4.3%）AF患者（平均年龄59.4±11.5岁，43%为女性）。对患者进行12个月的AF复发监测。使用高分辨率熔解分析对单核苷酸多态性rs4845625进行基因分型。
在我们的研究队列中，42.8%的患者观察到AF早期复发（ERAF），定义为在最初4周内复发，而25.9%的患者发生AF晚期复发（LRAF）（3至12个月之间）。ERAF和LRAF患者之间在基线临床或超声心动图特征方面未观察到显著差异。相比之下，rs4845625的T等位基因的存在与ERAF（比值比[OR]：1.84，95%置信区间[CI]：1.31 - 2.59，p = 4.10×10 - 4）和LRAF（OR：1.92，95% CI：1.30 - 2.81，p = 0.001）的风险增加相关。此外，在对年龄、性别、高血压、糖尿病和其他风险因素进行调整后，这种关联仍然显著。未观察到rs4845625与IL6血清水平之间存在显著关系。
在本研究中，发现IL6R基因的一个变体rs4845625会增加中国汉族人群导管消融术后AF复发的风险。我们的研究结果表明，IL6R途径或炎症可能在导管消融术后AF复发中起重要作用。
