Department of Physiology, Maastricht University, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.
Department of Physiology, Maastricht University, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands; Department of Cardiothoracic Surgery, Heart and Vascular Centre Maastricht University Medical Centre, Maastricht, the Netherlands.
JACC Clin Electrophysiol. 2024 Jul;10(7 Pt 1):1326-1340. doi: 10.1016/j.jacep.2024.03.003. Epub 2024 Apr 1.
Serum bone morphogenetic protein 10 (BMP10) blood levels are a marker for history of atrial fibrillation (AF) and for major adverse cardiovascular events in patients with AF, including stroke, AF recurrences after catheter ablations, and mortality. The predictive value of BMP10 in patients undergoing cardiac surgery and association with morphologic properties of atrial tissues are unknown.
This study sought to study the correlation between BMP10 levels and preoperative clinical traits, occurrence of early and late postoperative atrial fibrillation (POAF), and atrial fibrosis in patients undergoing cardiac surgery.
Patients with and without preoperative AF history undergoing first cardiac surgery were included (RACE V, n = 147). Preoperative blood biomarkers were analyzed, left (n = 114) and right (n = 125) atrial appendage biopsy specimens were histologically investigated after WGA staining, and postoperative rhythm was monitored continuously with implantable loop recorders (n = 133, 2.5 years).
Adjusted multinomial logistic regression indicated that BMP10 accurately reflected a history of persistent AF (OR: 1.24, 95% CI: 1.10-1.40, P = 0.001), similar to NT-pro-BNP. BMP10 levels were associated with increased late POAF occurrence after adjustment for age, sex, AF history, and early POAF occurrence (HR: 1.07 [per 0.1 ng/mL increase], 95% CI: 1.00-1.14, P = 0.041). Left atrial endomysial fibrosis (standardized β = 0.22, P = 0.041) but not overall fibrosis (standardized Β = 0.12, P = 0.261) correlated with circulating BMP10 after adjustment for age, sex, AF history, reduced LVF, and valvular surgery indication.
Increased BMP10 levels were associated with persistent AF history, increased late POAF incidence, and LAA endomysial fibrosis in a diverse sample of patients undergoing cardiac surgery.
血清骨形态发生蛋白 10（BMP10）水平是心房颤动（AF）病史和 AF 患者主要不良心血管事件（包括中风、导管消融后 AF 复发和死亡率）的标志物。BMP10 在接受心脏手术的患者中的预测价值以及与心房组织形态学特性的关系尚不清楚。
本研究旨在研究 BMP10 水平与心脏手术患者术前临床特征、早期和晚期术后心房颤动（POAF）的发生以及心房纤维化之间的相关性。
纳入有或无术前 AF 病史的首次心脏手术患者（RACE V，n=147）。分析术前血液生物标志物，对左心房（n=114）和右心房（n=125）心耳活检标本进行 WGA 染色后的组织学研究，并通过植入式环路记录器（n=133，随访 2.5 年）连续监测术后节律。
调整后的多项逻辑回归表明，BMP10 准确反映了持续性 AF 的病史（OR：1.24，95%CI：1.10-1.40，P=0.001），与 NT-pro-BNP 相似。调整年龄、性别、AF 病史和早期 POAF 发生后，BMP10 水平与晚期 POAF 发生增加相关（HR：1.07[每增加 0.1ng/mL]，95%CI：1.00-1.14，P=0.041）。左心房内膜纤维化（标准化β=0.22，P=0.041）而不是总纤维化（标准化Β=0.12，P=0.261）与循环 BMP10 相关，调整年龄、性别、AF 病史、左室射血分数降低和瓣膜手术指征后。
在接受心脏手术的不同患者样本中，BMP10 水平升高与持续性 AF 病史、晚期 POAF 发生率增加以及 LAA 内膜纤维化相关。
