Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy.
Department of Medicine, University of Milano-Bicocca, Milan, Italy.
Nutr Metab Cardiovasc Dis. 2023 Jul;33(7):1323-1329. doi: 10.1016/j.numecd.2023.05.002. Epub 2023 May 6.
Interest in the role of atrial substrate in maintaining Atrial Fibrillation (AF) is growing. Fibrosis is the culprit in the electrical derangement of the myocytes. Many cardiovascular risk factors are known to be linked to atrial scarring; among them Uric Acid (UA) is emerging. The purpose of our study is to find whether UA is associated with Left Atrium (LA) with pathological substrate.
81 patients who underwent radiofrequency transcatheter ablation for nonvalvular AF at the cardiological department of the Niguarda Hospital were enrolled in an observational, cross-sectional, single-center study. UA levels were analysed before the procedure. High density electroanatomic mapping of the LA was performed and patients were divided according to the presence or not of areas of pathological substrate (bipolar voltage <0.5 mV in sinus rhythm). 19 patients showed a LA with pathological substrate. These subjects showed a significant higher prevalence of persistent phenotype of AF (84.2 vs. 25.8%, p < 0.001). UA levels were significantly higher in the group of patients with LA with pathological substrate (6.8 ± 1.9 vs 5.3 ± 1.4 mg/dL, p < 0.001) as well as the prevalence of hyperuricemia (26.5 vs. 6.5%, p = 0.021). The association between uric acid LA with pathological substrate remains significant even after correction for confounding factors (age, left ventricular dysfunction, valvular disease, arrythmia phenotype and furosemide use) and also when the ratio UA/creatinine was evaluated.
In a population of patients who underwent AF ablation, higher UA levels were significantly associated with pathological LA substrate at electro-anatomical mapping.
人们对心房基质在维持心房颤动（AF）中的作用越来越感兴趣。纤维化是心肌电紊乱的罪魁祸首。许多心血管危险因素与心房瘢痕有关；其中尿酸（UA）正在出现。我们的研究目的是确定 UA 是否与具有病理性基质的左心房（LA）相关。
在 Niguarda 医院心内科接受射频导管消融治疗非瓣膜性 AF 的 81 名患者入组了一项观察性、横断面、单中心研究。在手术前分析了 UA 水平。对 LA 进行高密度电解剖标测，并根据是否存在病理性基质（窦性节律下双极电压<0.5 mV）区域将患者分为两组。19 名患者的 LA 存在病理性基质。这些患者的 AF 持续表型的患病率显著更高（84.2% vs. 25.8%，p < 0.001）。LA 存在病理性基质的患者 UA 水平明显更高（6.8 ± 1.9 比 5.3 ± 1.4 mg/dL，p < 0.001），高尿酸血症的患病率也更高（26.5% vs. 6.5%，p = 0.021）。即使在校正混杂因素（年龄、左心室功能障碍、瓣膜疾病、心律失常表型和呋塞米使用）后，UA 与 LA 病理性基质之间的关联仍然显著，当评估 UA/肌酐比值时也是如此。
在接受 AF 消融的患者人群中，较高的 UA 水平与电解剖标测时的病理性 LA 基质显著相关。
