Sikora Wiesław, Kanikowska Dominika, Budzianowski Jan, Kawka Edyta, Rutkowski Rafał, Korybalska Katarzyna
Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
Department of Cardiology with Internal Disease Subunit, Puszczykowo Hospital, 62-040 Puszczykowo, Poland.
Int J Mol Sci. 2025 Apr 11;26(8):3627. doi: 10.3390/ijms26083627.
Endothelial dysfunction (ED) promotes and maintains atrial fibrillation (AF). Using a CHA2DS2-VASc score in women and men with paroxysmal AF, we aimed to determine which patients' ED would be more pronounced. We recruited 47 females and 48 males (mean BMI 31 kg/m and 30 kg/m, respectively) with paroxysmal AF and abnormal body mass and divided them into those with low (F < 3; M < 2) and high (F ≥ 3; M ≥ 2) CHA2DS2-VASC score. The blood samples were taken before AF ablation. Using Elisa tests, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), vascular cell adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule (sICAM-1), von Willebrand factor (vWF), and thrombomodulin (sTM). ED was more pronounced in females, expressed by higher endothelial cell marker concentrations: sVCAM-1 and sTM in low scores and sICAM-1 in high scores, CHA2DS2-VASc. Females were characterized by postmenopausal status, higher risk of thrombosis, lower GFR, and more frequent treatment with antiarrhythmic drugs. In contrast, males have only higher suppression of tumorigenicity 2 (ST2). In conclusion, women with paroxysmal AF exhibited more pronounced ED compared to men, regardless of their CHA2DS2-VASc scores. The soluble pro-inflammatory adhesion molecules and thrombomodulin emerge as the most sensitive biomarkers of ED elevated in females.
内皮功能障碍（ED）促进并维持心房颤动（AF）。我们使用CHA2DS2-VASc评分对患有阵发性房颤的男性和女性进行评估，旨在确定哪些患者的内皮功能障碍更为明显。我们招募了47名女性和48名男性（平均BMI分别为31kg/m²和30kg/m²），他们患有阵发性房颤且体重异常，并将他们分为CHA2DS2-VASC评分低（女性<3；男性<2）和高（女性≥3；男性≥2）两组。在房颤消融术前采集血样。通过酶联免疫吸附测定（ELISA）试验，我们检测了组织型纤溶酶原激活剂（t-PA）、纤溶酶原激活剂抑制剂1（PAI-1）、血管细胞黏附分子1（sVCAM-1）、细胞间黏附分子（sICAM-1）、血管性血友病因子（vWF）和血栓调节蛋白（sTM）。女性的内皮功能障碍更为明显，表现为内皮细胞标志物浓度较高：低评分组中的sVCAM-1和sTM，以及高评分组（CHA2DS2-VASc）中的sICAM-1。女性的特征为绝经后状态、血栓形成风险较高、肾小球滤过率较低以及抗心律失常药物治疗更为频繁。相比之下，男性仅具有较高的抑瘤性2（ST2）。总之，无论CHA2DS2-VASc评分如何，患有阵发性房颤的女性与男性相比，内皮功能障碍更为明显。可溶性促炎黏附分子和血栓调节蛋白是女性中内皮功能障碍升高的最敏感生物标志物。
