循环生物标志物与电复律后持续性心房颤动的复发

Circulating Biomarkers and Recurrence of Persistent Atrial Fibrillation After Electrical Cardioversion.

作者信息

Andersen Elizabeth Lyster, Solberg Magnar Gangås, Enger Steve, Onarheim Sophia, Olufsen Mona, Berge Trygve, Åkra Sissel, Kleveland Maiken Kojen, Christophersen Ingrid Elisabeth, Ulimoen Sara Reinvik, Seljeflot Ingebjørg, Tveit Arnljot

机构信息

Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.

出版信息

Biomark Insights. 2025 Sep 11;20:11772719251361306. doi: 10.1177/11772719251361306. eCollection 2025.

DOI:10.1177/11772719251361306

PMID:40949791

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12432329/

Abstract

BACKGROUND

Rhythm control therapy is recommended for individuals with symptomatic atrial fibrillation (AF) to reduce symptoms and improve quality of life. Electrical cardioversion (ECV) is used to restore sinus rhythm (SR), but AF recurrence is common.

OBJECTIVE

We aimed to investigate if a selection of circulating biomarkers can predict rhythm outcomes in individuals with persistent AF treated with ECV.

DESIGN

This was an observational cohort study.

METHODS

We included 200 individuals aged ⩾ 18 years referred for ECV of AF from November 2017 to March 2022. We obtained blood samples 0 to 6 weeks before ECV. Plasminogen activator inhibitor type 1 (PAI-1) activity, soluble suppression of tumorigenicity 2 (sST2), galectin-3 (GAL-3), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), growth differentiation factor-15, (GDF-15), transforming growth factor-β-1 (TGF-β1), and fibroblast growth factor-23 (FGF-23) were analyzed by ELISA methods. The participants recorded thumb ECGs twice daily for 28 days after the ECV to detect AF recurrence.

RESULTS

A total of 188 individuals were eligible for the analyses. Twenty-four participants converted spontaneously to SR before ECV. Among the cardioverted, 74 maintained SR, whereas 90 experienced AF recurrence before hospital discharge (n = 15) or during the follow-up period of 28 days (n = 75). TIMP-1 was significantly higher in those with AF recurrence than in those who maintained SR, but overlapping distributions suggest limited predictive ability. PAI-1 activity, sST2, GAL-3, IL-6, MMP-9, GDF-15, TGF-β1, and FGF-23 did not differ among the participants who had ECV.

CONCLUSION

TIMP-1 was higher in participants with recurrence of AF after ECV, but its predictive ability was limited. None of the other biomarkers were associated with AF recurrence. We do not recommend using these biomarkers for candidate selection for ECV of persistent AF.

摘要

背景

对于有症状的心房颤动（AF）患者，推荐采用节律控制疗法以减轻症状并改善生活质量。电复律（ECV）用于恢复窦性心律（SR），但AF复发很常见。

目的

我们旨在研究一系列循环生物标志物能否预测接受ECV治疗的持续性AF患者的节律转归。

设计

这是一项观察性队列研究。

方法

我们纳入了2017年11月至2022年3月因AF接受ECV治疗的200名年龄≥18岁的个体。在ECV前0至6周采集血样。采用酶联免疫吸附测定（ELISA）方法分析纤溶酶原激活物抑制剂1（PAI-1）活性、可溶性肿瘤抑制因子2（sST2）、半乳糖凝集素-3（GAL-3）、白细胞介素-6（IL-6）、基质金属蛋白酶-9（MMP-9）、金属蛋白酶组织抑制剂-1（TIMP-1）、生长分化因子-15（GDF-15）、转化生长因子-β-1（TGF-β1）和成纤维细胞生长因子-23（FGF-23）。参与者在ECV后28天每天记录两次拇指心电图以检测AF复发。

结果

共有188名个体符合分析条件。24名参与者在ECV前自发转为SR。在接受复律的患者中，74名维持了SR，而90名在出院前（n = 15）或28天随访期内（n = 75）经历了AF复发。AF复发患者的TIMP-1显著高于维持SR的患者，但分布重叠表明预测能力有限。接受ECV治疗的参与者之间PAI-1活性、sST2、GAL-3、IL-6、MMP-9、GDF-15、TGF-β1和FGF-23没有差异。