Goudis Christos A, Kallergis Eleftherios M, Kanoupakis Emmanuel M, Mavrakis Hercules E, Malliaraki Niki E, Vardas Panos E
Department of Cardiology.
Laboratory of Biochemistry, Heraklion University Hospital, Crete, Greece.
Pacing Clin Electrophysiol. 2015 Sep;38(9):1039-48. doi: 10.1111/pace.12662. Epub 2015 Jun 12.
Atrial fibrillation (AF) is associated with abnormal atrial substrate. We investigated whether patients with persistent lone AF and patients with persistent AF and nonischemic dilated cardiomyopathy (NIDCM) exhibit any differences in electrophysiological and electroanatomical properties of right atrium (RA) and collagen turnover. We also investigated the relationship between mean RA bipolar voltage and collagen turnover.
Ten patients with a history of persistent lone AF and eight patients with a history of persistent AF and NIDCM were studied. Sinus node recovery times (SNRTs) and effective refractory periods (ERPs) at 600 ms, 500 ms, and 400 ms from the high (HLRA) and low (LLRA) lateral RA, proximal coronary sinus (pCS), and right atrial appendage (RAA) were evaluated, and RA electroanatomic mapping was created. Serum N-terminal propeptide of collagen type I (PINP), cross-linked C-terminal telopeptide of collagen type I (CTx), matrix metalloproteinase-1 (MMP-1), and tissue inhibitor of matrix metalloproteinases (TIMP-1) were measured as markers of collagen synthesis and degradation.
No differences were found in SNRTs, ERPs from the HLRA, LLRA at 600 ms, pCS and RAA, mean RA bipolar voltage, serum PINP, CTx, MMP-1, and TIMP-1 between the two groups. In persistent lone AF, serum levels of TIMP-1 were related with mean HLRA and HPRA bipolar voltage.
Persistent AF patients with or without NIDCM, demonstrate similar changes in electrophysiological and electroanatomical properties of the RA, as well as similar structural changes. Moreover, serum markers of collagen synthesis are correlated with bipolar voltage in specific regions of RA in persistent lone AF.
心房颤动（AF）与异常心房基质相关。我们研究了持续性孤立性AF患者以及持续性AF合并非缺血性扩张型心肌病（NIDCM）患者在右心房（RA）的电生理和电解剖特性以及胶原周转方面是否存在差异。我们还研究了RA平均双极电压与胶原周转之间的关系。
研究了10例有持续性孤立性AF病史的患者和8例有持续性AF合并NIDCM病史的患者。评估了来自高位（HLRA）和低位（LLRA）外侧RA、近端冠状窦（pCS）和右心耳（RAA）在600 ms、500 ms和400 ms时的窦房结恢复时间（SNRTs）和有效不应期（ERPs），并创建了RA电解剖图。测量血清I型胶原N端前肽（PINP）、I型胶原交联C端末肽（CTx）、基质金属蛋白酶-1（MMP-1）和基质金属蛋白酶组织抑制剂（TIMP-1）作为胶原合成和降解的标志物。
两组之间在SNRTs、HLRA、LLRA在600 ms时的ERPs、pCS和RAA、RA平均双极电压、血清PINP、CTx、MMP-1和TIMP-1方面均未发现差异。在持续性孤立性AF中，TIMP-1的血清水平与HLRA和HPRA平均双极电压相关。
有或无NIDCM的持续性AF患者在RA的电生理和电解剖特性方面表现出相似的变化，以及相似的结构变化。此外，在持续性孤立性AF中，胶原合成的血清标志物与RA特定区域的双极电压相关。
