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心房颤动导管消融术后血清尿酸水平下降。

Declines in serum uric acid level after catheter ablation of atrial fibrillation.

机构信息

Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.

出版信息

Heart Vessels. 2022 Dec;37(12):2049-2058. doi: 10.1007/s00380-022-02108-w. Epub 2022 Jul 5.

Abstract

BACKGROUND

Few studies have examined whether catheter ablation for AF patients improves biomarkers other than serum levels of brain natriuretic peptide (BNP) and renal function. This study was to explore whether catheter ablation for atrial fibrillation (AF) patients affects uric acid (UA), glucose and lipid metabolism.

METHODS AND RESULTS

A total of 206 patients (66.6 ± 10.4 years; 132 men) who underwent initial AF ablation without changes to oral medications were included. Baseline BNP and UA levels significantly decreased at 1 year after ablation (p < 0.05 each). Changes in UA level correlated significantly with pre-procedural UA level (r = 0.57). In multivariable logistic regression modeling, pre-procedural UA level, persistent AF, and hemoglobin A1c (p < 0.05 each) were independent predictors of post-procedural UA level decline. Significant improvements in both persistent and paroxysmal AF patients were identified, and the magnitude of post-procedural serum UA level decline after ablation (ΔUA) was significantly greater in patients with persistent AF (0.8 ± 1.0 mg/dl) than in those with paroxysmal AF (0.2 ± 0.8 mg/dl, p < 0.001). Of the 48 patients with high UA level before procedure, 28 patients showed improvement in UA level to normal range.

CONCLUSIONS

Catheter ablation for AF patients significantly improved serum UA levels without obvious influences of heart failure, renal function, or inflammation, suggesting that AF ablation may be effective for AF patients with hyperuricemia. Trial registration The study was approved by the Research Ethics Committee of University of Fukui (no. 20210132) and clinical trial registration (UMIN000044669).

摘要

背景

很少有研究探讨房颤(AF)患者的导管消融治疗是否除了脑钠肽(BNP)和肾功能以外还能改善其他生物标志物。本研究旨在探讨导管消融治疗房颤(AF)患者是否会影响尿酸(UA)、葡萄糖和脂质代谢。

方法和结果

共纳入 206 例(66.6±10.4 岁;132 例男性)初始行 AF 消融治疗且未改变口服药物的患者。消融治疗后 1 年,BNP 和 UA 水平均显著降低(p<0.05)。UA 水平的变化与术前 UA 水平显著相关(r=0.57)。多变量逻辑回归模型显示,术前 UA 水平、持续性 AF 和糖化血红蛋白(HbA1c)(p<0.05)是术后 UA 水平下降的独立预测因素。持续性和阵发性 AF 患者均有显著改善,且持续性 AF 患者消融后血清 UA 水平下降幅度(ΔUA)明显大于阵发性 AF 患者(0.8±1.0 mg/dl 比 0.2±0.8 mg/dl,p<0.001)。在术前 UA 水平较高的 48 例患者中,28 例患者 UA 水平恢复正常。

结论

AF 患者的导管消融治疗可显著改善血清 UA 水平,而心力衰竭、肾功能或炎症无明显影响,提示 AF 消融可能对高尿酸血症的 AF 患者有效。

试验注册

本研究得到了福井大学研究伦理委员会的批准(编号:20210132),并在临床试验注册处(UMIN000044669)进行了注册。

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