Heart Center Leipzig at University of Leipzig, Leipzig, Germany; Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center of Civilization Diseases, University of Leipzig, Leipzig, Germany.
Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center of Civilization Diseases, University of Leipzig, Leipzig, Germany.
Int J Cardiol. 2019 Dec 15;297:61-65. doi: 10.1016/j.ijcard.2019.09.006. Epub 2019 Sep 7.
Electro-anatomical remodeling in atrial fibrillation (AF) is associated with disease initiation and progression. Troponin T (TropT) - a specific biomarker for myocardial damage - is associated with AF incidence. However, its association with AF progression is understudied. The aim of the current analysis was to investigate the association between TropT and AF progression phenotypes: persistent AF and left atrial low voltage areas (LVAs).
Patients undergoing first AF ablation were included into analyses. LVAs were determined using high-density maps and defined as <0.5 mV. Blood samples from femoral vein were collected before catheter ablation. The analysis of TropT serum concentrations was performed using a high-sensitive assay from Roche Diagnostics. Biomarkers, clinical, anthropometric and echocardiographic data were compared with healthy individuals from the epidemiological cohort.
The study included 824 healthy individuals without overt cardiovascular disease (54 ± 10 years, 40% males) from epidemiological cohort and 241 AF patients (64 ± 11 years, 59% males, 59% persistent AF, 27% LVAs). Patients with AF had higher TropT levels and larger left atrium (LA), while healthy individuals had better renal function and ejection fraction (all p < 0.001). In clinical cohort, there were significant differences between TropT levels according to AF progression groups: paroxysmal AF without/with LVAs (n = 86/12), persistent AF without/with LVAs (n = 90/53): means 7.3, 12.9, 8.4, 11.3 pg/ml, p < 0.001, respectively. Similar findings were observed for LA and renal function (all p < 0.001). On ROC analysis, TropT significantly predicted LVAs (AUC 0.675, 95%CI 0.598-0.752, p < 0.001) in AF patients.
TropT may be useful to differentiate AF progression phenotypes.
心房颤动（AF）中的电解剖重构与疾病的发生和进展有关。肌钙蛋白 T（TropT）-一种心肌损伤的特异性生物标志物-与 AF 的发生率有关。然而，其与 AF 进展的关系研究较少。本分析的目的是研究 TropT 与 AF 进展表型的关系：持续性 AF 和左心房低电压区（LVAs）。
纳入首次接受 AF 消融的患者进行分析。LVAs 使用高密度图谱确定，定义为<0.5 mV。股静脉血样在导管消融前采集。罗氏诊断的高敏测定法用于分析 TropT 血清浓度。比较生物标志物、临床、人体测量学和超声心动图数据与流行病学队列中的健康个体。
该研究纳入了来自流行病学队列的 824 名无明显心血管疾病的健康个体（54±10 岁，40%为男性）和 241 名 AF 患者（64±11 岁，59%为男性，59%为持续性 AF，27%为 LVAs）。AF 患者的 TropT 水平较高，左心房（LA）较大，而健康个体的肾功能和射血分数较好（均 P<0.001）。在临床队列中，根据 AF 进展组，TropT 水平存在显著差异：无/有 LVAs 的阵发性 AF（n=86/12）、无/有 LVAs 的持续性 AF（n=90/53）：平均值分别为 7.3、12.9、8.4、11.3 pg/ml，P<0.001。LA 和肾功能也存在类似的发现（均 P<0.001）。在 ROC 分析中，TropT 对 AF 患者的 LVAs 具有显著预测价值（AUC 0.675，95%CI 0.598-0.752，P<0.001）。
TropT 可能有助于区分 AF 进展表型。
