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转化生长因子-β水平对心房颤动患者导管消融术后结局的影响

The Impact of Transforming Growth Factor-β Level on Outcome After Catheter Ablation in Patients With Atrial Fibrillation.

作者信息

Kishima Hideyuki, Mine Takanao, Takahashi Satoshi, Ashida Kenki, Ishihara Masaharu, Masuyama Tohru

机构信息

Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

J Cardiovasc Electrophysiol. 2017 Apr;28(4):402-409. doi: 10.1111/jce.13169. Epub 2017 Mar 7.

Abstract

INTRODUCTION

Transforming growth factor-β (TGF-β ) is an important factor that induces atrial fibrosis and atrial fibrillation (AF). The purpose of this study was to evaluate the association between TGF-β level and clinical factors before catheter ablation (CA), and to investigate the impact of TGF-β level on the outcome after CA for AF.

METHODS AND RESULTS

This prospective study included 151 patients (persistent AF group: n = 59, paroxysmal AF [PAF] group: n = 54, and control group: n = 38). All patients who underwent CA for AF were followed up for 12 months. The PAF group had the highest TGF-β levels in all patients. An early recurrence of AF (ERAF: defined as episodes of atrial tachyarrhythmia within a 3-month blanking period) was detected in 60 patients (53%). Recurrent AF after the blanking period was detected in 36 patients (32%). On multivariate analysis, low TGF-β level was the only independent factor associated with recurrent AF. Moreover, the AF recurrence ratio was higher in the low TGF-β group (< 12.56 ng/mL) than in the high TGF-β group (16 of 29 patients, 55% vs. 20 of 84 patients, 24%, P = 0.002 by log-rank test).

CONCLUSIONS

PAF was associated with a higher TGF-β level. Moreover, lower TGF-β level in AF patients could be a cause of recurrent AF after CA.

摘要

引言

转化生长因子-β(TGF-β)是诱导心房纤维化和心房颤动(AF)的重要因素。本研究旨在评估导管消融(CA)术前TGF-β水平与临床因素之间的关联,并探讨TGF-β水平对AF患者CA术后结局的影响。

方法与结果

这项前瞻性研究纳入了151例患者(持续性AF组:n = 59,阵发性AF [PAF]组:n = 54,对照组:n = 38)。所有接受AF-CA的患者均随访12个月。PAF组患者的TGF-β水平在所有患者中最高。60例患者(53%)检测到AF早期复发(ERAF:定义为3个月空白期内心房快速性心律失常发作)。空白期后复发性AF在36例患者(32%)中被检测到。多因素分析显示,低TGF-β水平是与复发性AF相关唯一独立因素。此外,低TGF-β组(< 12.56 ng/mL)的AF复发率高于高TGF-β组(29例患者中有16例,55% vs. 84例患者中有20例,24%,对数秩检验P = 0.002)。

结论

PAF与较高的TGF-β水平相关。此外,AF患者较低的TGF-β水平可能是CA术后复发性AF的一个原因。

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