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循环中间单核细胞与心房结构重构与导管消融后心房颤动复发相关。

Circulating intermediate monocytes and atrial structural remodeling associated with atrial fibrillation recurrence after catheter ablation.

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

J Cardiovasc Electrophysiol. 2021 Apr;32(4):1035-1043. doi: 10.1111/jce.14929. Epub 2021 Feb 10.

Abstract

BACKGROUND

Inflammation, such as that associated with intermediate CD14 CD16 monocytes and atrial structural remodeling (SRM), may be important in the recurrence of atrial fibrillation (AF) after catheter ablation. However, the relationship between the intermediate CD14 CD16 monocytes, SRM, and AF recurrence is unclear.

METHODS

Twenty-four patients with AF were enrolled. The proportion of intermediate monocytes (PIM) was assessed before ablation by flow cytometry. As a surrogate marker of SRM, the volume ratio (VR) of signal intensity greater than 1 standard deviation on late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) was calculated. We investigated whether PIM correlated with SRM on LGE-MRI and determined the optimal cutoff value for predicting AF recurrence.

RESULTS

Univariate analysis revealed positive correlations between PIM and BNP with SRM (PIM: r = .593, p = .002; BNP: r = .567, p = .004). Multivariable analysis revealed that PIM was independently associated with VR on LGE-MRI (β = .522; p = .033). The finding of an area under the receiver operating characteristic curve of 0.750 revealed that a VR ≥ 13.3% on LGE-MRI as the optimal cutoff value to predict AF recurrence with 80% sensitivity and 71% specificity, which was associated with PIM ≥ 10.0%.

CONCLUSION

Intermediate monocytes were significantly positively correlated with SRM. PIM ≥ 10% was associated with a VR ≥ 13.3% on LGE-MRI, which predicted AF recurrence after catheter ablation.

摘要

背景

炎症,如与中间型 CD14 CD16 单核细胞和心房结构重构(SRM)相关的炎症,可能在导管消融后心房颤动(AF)的复发中起重要作用。然而,中间型 CD14 CD16 单核细胞、SRM 和 AF 复发之间的关系尚不清楚。

方法

纳入 24 例 AF 患者。通过流式细胞术在消融前评估中间型单核细胞的比例(PIM)。作为 SRM 的替代标志物,计算晚期钆增强磁共振成像(LGE-MRI)上信号强度大于 1 个标准差的容积比(VR)。我们研究了 PIM 是否与 LGE-MRI 上的 SRM 相关,并确定了预测 AF 复发的最佳截断值。

结果

单因素分析显示 PIM 与 SRM 与 BNP 呈正相关(PIM:r = .593,p = .002;BNP:r = .567,p = .004)。多变量分析显示 PIM 与 LGE-MRI 上的 VR 独立相关(β = .522;p = .033)。受试者工作特征曲线下面积为 0.750,表明 LGE-MRI 上的 VR ≥ 13.3%为预测 AF 复发的最佳截断值,灵敏度为 80%,特异性为 71%,与 PIM ≥ 10.0%相关。

结论

中间型单核细胞与 SRM 呈显著正相关。PIM ≥ 10%与 LGE-MRI 上的 VR ≥ 13.3%相关,预测导管消融后 AF 复发。

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