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抵抗素作为预测药物难治性心房颤动患者导管消融术后左心房基质及复发情况的生物标志物

Resistin as a Biomarker for the Prediction of Left Atrial Substrate and Recurrence in Patients with Drug-Refractory Atrial Fibrillation Undergoing Catheter Ablation.

作者信息

Chang Ting-Yung, Hsiao Ya-Wen, Guo Shu-Mei, Chang Shih-Lin, Lin Yenn-Jiang, Lo Li-Wei, Hu Yu-Feng, Chung Fa-Po, Chao Tze-Fan, Liao Jo-Nan, Tuan Ta-Chuan, Lin Chin-Yu, Higa Satoshi, Chen Shih-Ann

机构信息

Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital.

Division of Cardiology, Taipei Veterans General Hospital.

出版信息

Int Heart J. 2020 May 30;61(3):517-523. doi: 10.1536/ihj.19-680. Epub 2020 May 15.

Abstract

Resistin is an adipocytokine that is abundantly secreted from lipid cells and is related to the inflammatory process and cardiometabolic diseases. This study aimed to examine the role of resistin on inflammation and its effect on the clinical outcome of patients with atrial fibrillation (AF) following catheter ablation.A total of 108 patients (56.9 ± 12.0 years, 76.8% male) with symptomatic and drug-refractory AF undergoing catheter ablation were enrolled. Inflammatory biomarkers and epicardial fat volume by contrast computed tomography (CT) images were assessed in all patients before the procedure. Baseline resistin correlated with epicardial fat volume, tumor necrosis factor-α (TNF-α), and left atrial (LA) scar area. After the index procedure, the univariate analysis revealed that hypertension, persistent AF, LA diameter, and plasma resistin level were related to recurrent atrial arrhythmia. Multivariate regression analysis revealed that persistent AF, LA diameter, and plasma resistin level all independently predicted recurrent atrial arrhythmia after ablation. Plasma resistin with a level higher than 777 (pg/mL) could predict recurrence following catheter ablation of AF.High plasma resistin level is associated with poor left atrial substrate, high epicardial fat volume, and elevated TNF-α level in patients with AF. Plasma resistin may predict the recurrence of atrial arrhythmia after ablation.

摘要

抵抗素是一种由脂肪细胞大量分泌的脂肪细胞因子,与炎症过程和心脏代谢疾病有关。本研究旨在探讨抵抗素在炎症中的作用及其对房颤(AF)患者导管消融术后临床结局的影响。共纳入108例有症状且药物难治性AF并接受导管消融的患者(年龄56.9±12.0岁,男性占76.8%)。在手术前对所有患者评估炎症生物标志物以及通过对比计算机断层扫描(CT)图像测量的心外膜脂肪体积。基线抵抗素与心外膜脂肪体积、肿瘤坏死因子-α(TNF-α)和左心房(LA)瘢痕面积相关。在首次手术后,单因素分析显示高血压、持续性AF、LA直径和血浆抵抗素水平与房性心律失常复发有关。多因素回归分析显示,持续性AF、LA直径和血浆抵抗素水平均独立预测消融术后房性心律失常复发。血浆抵抗素水平高于777(pg/mL)可预测AF导管消融术后的复发。高血浆抵抗素水平与AF患者左心房基质不良、心外膜脂肪体积高和TNF-α水平升高有关。血浆抵抗素可能预测消融术后房性心律失常的复发。

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