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Combination of Circulating Type I Collagen-Related Biomarkers Is Associated With Atrial Fibrillation.

Abstract：

BACKGROUND:A combination of circulating biomarkers associated with excessive myocardial collagen type-I cross-linking or CCL+ (i.e., decreased carboxy-terminal telopeptide of collagen type-I to matrix metalloproteinase-1 ratio) and with excessive myocardial collagen type-I deposition or CD+ (i.e., increased carboxy-terminal propeptide of procollagen type-I) has been described in heart failure (HF) patients and associates with poor outcomes. OBJECTIVES:The purpose of this study was to investigate whether the CCL+CD+ combination of biomarkers associates with atrial fibrillation (AF). METHODS:Biomarkers were analyzed in serum samples from 242 HF patients (study 1) and 150 patients referred for AF ablation (study 2). Patients were classified into 3 groups (CCL-CD-, CCL+CD- or CCL-CD+, and CCL+CD+) in accordance to biomarker threshold values. Left atrial electroanatomic high-density mapping was performed in 71 patients from study 2. RESULTS:In study 1, 53.7% patients had AF at baseline and 19.6% developed AF (median follow-up 5.5 years). Adjusted odds and hazard ratios associated with baseline and new-onset AF, respectively, were both ≥3.3 (p ≤ 0.050) in CCL+CD+ patients compared with CCL-CD- patients, with nonsignificant changes in the other group. In study 2, 29.3% patients had AF recurrence during 1-year post-ablation. The adjusted hazard ratio for AF recurrence was 3.4 (p = 0.008) in CCL+CD+ patients compared with CCL-CD- patients, with nonsignificant changes in the other group. The CCL+CD+ combination added incremental predictive value over relevant covariables. CCL+CD+ patients exhibited lower left atrial voltage than the remaining patients (p = 0.005). CONCLUSIONS:A combination of circulating biomarkers reflecting excessive myocardial collagen type-I cross-linking and deposition is associated with higher AF prevalence, incidence, and recurrence after ablation.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Ravassa S,Ballesteros G,López B,Ramos P,Bragard J,González A,Moreno MU,Querejeta R,Vives E,García-Bolao I,Díez J

doi

10.1016/j.jacc.2018.12.074

subject

Has Abstract

pub_date

2019-04-02 00:00:00

pages

1398-1410

issue

12

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(19)30411-5

journal_volume

73

pub_type

杂志文章

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