Big endothelin-1 as a predictor of atrial fibrillation recurrence after primary ablation only in patients with paroxysmal atrial fibrillation.

Abstract:

BACKGROUND:Atrial fibrillation (AF) recurrence after ablation is difficult to predict. The development of AF is associated with inflammation, and inflammatory markers such as big endothelin-1 (big ET-1) reflect inflammatory status. It is unknown, however, whether big ET-1 can be used as a predictor for AF recurrence. The aim of this study was to investigate the relationship between plasma levels of big ET-1 and AF recurrence. METHODS:A total of 158 patients who had undergone primary ablation for symptomatic and/or drug-refractory AF, including 103 with paroxysmal and 55 with persistent AF, were included in this study. Left atrial diameter was measured with echocardiography and plasma big ET-1 levels with ELISA. All patients were followed up for at least 12 months and AF recurrence defined as an episode of AF lasting ≥ 30 s, with or without atrial flutter or atrial tachycardia. RESULTS:The AF recurrence rate was 44.9% (71/158) during the median follow-up period of 22 (13, 40) months. Plasma levels of big ET-1 in the recurrence group were higher than those in the non-recurrence group in all patients [0.80 (0.54, 1.30) vs. 0.57 (0.48, 0.72) fmol·L(-) (1), p  = 0.001], in patients with paroxysmal AF [0.81 (0.46, 1.30) vs. 0.57 (0.48, 0.70) fmol·L(-) (1), p  = 0.009] as well as in patients with persistent AF [0.77 (0.57, 1.28) vs. 0.57 (0.49, 0.89) fmol·L(-) (1), p = 0.034]. Multiple logistic regression analyses showed that plasma levels of big ET-1 were associated with AF recurrence in patients with paroxysmal AF (p  = 0.037). Kaplan-Meier analysis demonstrated that the sinus rhythm maintenance rate was lower in patients with higher big ET-1 levels than those with lower levels (p  < 0.05). CONCLUSIONS:Baseline plasma big ET-1 levels are associated with AF recurrence after primary ablation procedure in patients with paroxysmal AF, and may be used in the prediction of AF recurrence in these patients.

journal_name

Herz

journal_title

Herz

authors

Wang H,Liu J,Fang P,Lei S,Li X,Hou Y,Zhang S

doi

10.1007/s00059-012-3626-9

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

919-25

issue

8

eissn

0340-9937

issn

1615-6692

journal_volume

37

pub_type

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