Nam Jong-Ho, Park Kyu-Hwan, Lee Jung-Hee, Lee Chan-Hee, Son Jang-Won, Kim Ung, Park Jong-Seon, Shin Dong-Gu
Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Korean Circ J. 2017 Sep;47(5):752-761. doi: 10.4070/kcj.2017.0024. Epub 2017 Aug 14.
Oxidative stress (OS) plays an important role in the pathophysiology of atrial fibrillation (AF) by amplifying the inflammatory cascade, wherein augmented inflammation facilitates the atrial electrical remodeling process. Few studies have investigated the possible link between systemic inflammation and OS in AF.
A total of 220 consecutive patients with AF (117 patients) or healthy controls (103 patients) were enrolled. Among the 117 AF patients, 65 paroxysmal AF (PaAF) and 52 persistent AF (PeAF) patients were included. The level of 8-iso-prostaglandin F2α (8-iso-PGF2α) was measured as a marker of OS burden. We evaluated the correlations between 3 systemic inflammatory markers, high-sensitivity C-reactive protein (hsCRP), neutrophil to lymphocyte ratio (NLR), and red cell distribution width (RDW), and 8-iso-PGF2α.
The 8-iso-PGF2α concentration in both PaAF and PeAF patients was higher than that of controls (p<0.001 and p=0.024, respectively). The NLR and RDW of PeAF patients were higher than those of both control and PaAF patients (p=0.041 and p=0.031 for NLR, p=0.057 and p=0.031 for RDW, respectively). There were no correlations between specific inflammatory markers and the 8-iso-PGF2α in AF. The 8-iso-PGF2α level decreased gradually with an increase in AF duration (p=0.008), contrary to the graded increase in hsCRP. Multiple regression analysis indicated that AF duration persisted as a significant determinant of 8-iso-PGF2α (β=-0.249, p=0.044).
Systemic inflammatory marker levels were not proportional to the levels of 8-iso-PGF2α, an OS marker, in AF.
氧化应激（OS）通过放大炎症级联反应在心房颤动（AF）的病理生理学中发挥重要作用，其中炎症加剧促进了心房电重构过程。很少有研究调查AF中全身炎症与OS之间的可能联系。
连续纳入220例AF患者（117例）或健康对照者（103例）。在117例AF患者中，包括65例阵发性AF（PaAF）患者和52例持续性AF（PeAF）患者。测量8-异前列腺素F2α（8-iso-PGF2α）水平作为OS负担的标志物。我们评估了3种全身炎症标志物，即高敏C反应蛋白（hsCRP）、中性粒细胞与淋巴细胞比值（NLR）和红细胞分布宽度（RDW）与8-iso-PGF2α之间的相关性。
PaAF和PeAF患者的8-iso-PGF2α浓度均高于对照组（分别为p<0.001和p=0.024）。PeAF患者的NLR和RDW高于对照组和PaAF患者（NLR分别为p=0.041和p=0.031，RDW分别为p=0.057和p=0.031）。AF中特定炎症标志物与8-iso-PGF2α之间无相关性。8-iso-PGF2α水平随AF病程延长逐渐降低（p=0.008），与hsCRP的分级升高相反。多元回归分析表明，AF病程仍然是8-iso-PGF2α的重要决定因素（β=-0.249，p=0.044）。
在AF中，全身炎症标志物水平与OS标志物8-iso-PGF2α的水平不成正比。
