Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, The Netherlands; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Heart Rhythm. 2021 Oct;18(10):1790-1798. doi: 10.1016/j.hrthm.2021.06.1194. Epub 2021 Jun 26.
Early detection and staging of atrial fibrillation (AF) is of importance for clinical management. Serum (bio)markers, such as heat shock proteins (HSP), may enable AF staging and identify patients at risk for AF recurrence and postoperative AF (PoAF).
This study evaluates the relation between serum and atrial tissue HSP levels, stages of AF, AF recurrence after treatment, and PoAF from patients undergoing cardiothoracic surgery.
Patients without (control) and with paroxysmal, persistent (PerAF), or longstanding persistent (LSPerAF) AF were included. HSPB1, HSPA1, HSPB7, and HSPD1 levels were measured in serum obtained prior to and post intervention. HSPB1, HSPA1, HSPA5, HSPD1, HSPB5, and pHSF1 levels were measured in left and/or right atrial appendages (respectively, LAA and RAA).
In RAA, HSPA5 levels were significantly lower in LSPerAF and HSPD1 levels significantly higher in PerAF patients compared to controls. In RAA of controls who developed PoAF, HSPA1 and HSPA5 levels were significantly higher compared to those without PoAF. Also, HSPB1 RAA levels were lower and HSPA5 LAA levels higher in patients undergoing arrhythmia surgery who developed AF recurrence within 1 week after surgery compared to patients who did not.
HSPA5 RAA and HSPD1 RAA and LAA levels are altered in persistent stages of AF. RAA HSPA1 and HSPA5 levels associate with development of PoAF. Additionally, HSPB1 RAA and HSPA5 LAA levels can predict AF recurrence in patients who underwent arrhythmia surgery. Nevertheless, HSP levels in serum cannot discriminate AF stages from controls, nor predict PoAF or AF recurrence after treatment.
心房颤动（AF）的早期检测和分期对于临床管理很重要。血清（生物）标志物，如热休克蛋白（HSP），可用于 AF 分期，并识别 AF 复发和术后 AF（PoAF）的风险患者。
本研究评估了接受心胸外科手术的患者血清和心房组织 HSP 水平、AF 分期、治疗后 AF 复发以及 PoAF 之间的关系。
纳入无阵发性、持续性（PerAF）或长期持续性（LSPerAF）AF 的患者（对照组）和有阵发性、持续性（PerAF）或长期持续性（LSPerAF）AF 的患者。在干预前后采集血清，测量 HSPB1、HSPA1、HSPB7 和 HSPD1 水平。分别在左心房和/或右心房附件（分别为 LAA 和 RAA）中测量 HSPB1、HSPA1、HSPA5、HSPD1、HSPB5 和 pHSF1 水平。
在 RAA 中，与对照组相比，LSPerAF 患者的 HSPA5 水平显著降低，PerAF 患者的 HSPD1 水平显著升高。在对照组中发生 PoAF 的患者的 RAA 中，与无 PoAF 的患者相比，HSPA1 和 HSPA5 水平显著升高。此外，在术后 1 周内发生 AF 复发的心律失常手术患者的 RAA HSPB1 水平较低，LAA HSPA5 水平较高。
RAA 的 HSPA5 和 HSPD1 以及 LAA 的水平在持续性 AF 阶段发生改变。RAA 的 HSPA1 和 HSPA5 水平与 PoAF 的发生相关。此外，RAA 的 HSPB1 和 LAA 的 HSPA5 水平可预测接受心律失常手术的患者 AF 复发。然而，血清中的 HSP 水平不能区分 AF 分期与对照组，也不能预测 PoAF 或治疗后 AF 复发。
