Kishima Hideyuki, Mine Takanao, Takahashi Satoshi, Ashida Kenki, Ishihara Masaharu, Masuyama Tohru
Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
J Cardiovasc Electrophysiol. 2017 Apr;28(4):402-409. doi: 10.1111/jce.13169. Epub 2017 Mar 7.
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.
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).
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.
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。
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)。
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。