TY - JOUR
T1 - Disturbed atrial metabolism, shear stress, and cardiac load AF after ablation
T2 - AXAFA biomolecule study
AU - Chua, Winnie
AU - Khashaba, Alya
AU - Canagarajah, Hansel
AU - Nielsen, Jens Cosedis
AU - di Biase, Luigi
AU - Haeusler, Karl Georg
AU - Hindricks, Gerhard
AU - Mont, Lluis
AU - Piccini, Jonathan
AU - Schnabel, Renate B
AU - Schotten, Ulrich
AU - Wienhues-Thelen, Ursula-Henrike
AU - Zeller, Tanja
AU - Fabritz, Larissa
AU - Kirchhof, Paulus
PY - 2024/1/24
Y1 - 2024/1/24
N2 - BACKGROUND: Different disease processes can combine to cause to atrial fibrillation (AF). Their contribution to recurrent AF after ablation in patients is not known. OBJECTIVE: Cardiovascular processes associated with recurrent AF after AF ablation were determined by quantifying biomolecules related to inflammation, metabolism, proliferation, fibrosis, shear-stress, atrial pressure, and others in the AXAFA biomolecule study. METHODS: Twelve circulating cardiovascular biomolecules (ANGPT2, BMP10, CA125, hsCRP, ESM1, FABP3, FGF23, GDF15, IGFBP7, IL6, NT-proBNP, hsTnT) were quantified in plasma samples obtained prior to a first AF ablation using high-throughput, high-precision assays. Cox regression was used to identify biomolecules associated with recurrent AF during the first three months after AF ablation. RESULTS: In 433 patients (64 years [58, 70]; 33% women), baseline concentrations of ANGPT2, BMP10, hsCRP, FGF23, FABP3, GDF15, and NT-proBNP were elevated in patients with recurrent AF (120/433; 28%). After adjustment for 11 clinical features and randomized treatment, elevated NT-proBNP (hazard ratio, HR 1.58, 95% confidence interval [1.29, 1.94]), ANGPT2 (HR 1.37, [1.12, 1.67]), and BMP10 (HR 1.24 [1.02, 1.51]) remained associated with recurrent AF. Concentrations of ANGPT2, BMP10 and NT-proBNP decreased in patients who remained arrhythmia free, but not in patients with recurrent AF, highlighting their connection to AF. The other eight biomarkers showed unchanged concentrations. CONCLUSIONS: Elevated concentrations of ANGPT2, BMP10 and NT-proBNP are associated with recurrent atrial fibrillation after a first AF ablation, suggesting that processes linked to disturbed cardiomyocyte metabolism, altered atrial shear stress, and increased load contribute to atrial fibrillation after AF ablation in patients.
AB - BACKGROUND: Different disease processes can combine to cause to atrial fibrillation (AF). Their contribution to recurrent AF after ablation in patients is not known. OBJECTIVE: Cardiovascular processes associated with recurrent AF after AF ablation were determined by quantifying biomolecules related to inflammation, metabolism, proliferation, fibrosis, shear-stress, atrial pressure, and others in the AXAFA biomolecule study. METHODS: Twelve circulating cardiovascular biomolecules (ANGPT2, BMP10, CA125, hsCRP, ESM1, FABP3, FGF23, GDF15, IGFBP7, IL6, NT-proBNP, hsTnT) were quantified in plasma samples obtained prior to a first AF ablation using high-throughput, high-precision assays. Cox regression was used to identify biomolecules associated with recurrent AF during the first three months after AF ablation. RESULTS: In 433 patients (64 years [58, 70]; 33% women), baseline concentrations of ANGPT2, BMP10, hsCRP, FGF23, FABP3, GDF15, and NT-proBNP were elevated in patients with recurrent AF (120/433; 28%). After adjustment for 11 clinical features and randomized treatment, elevated NT-proBNP (hazard ratio, HR 1.58, 95% confidence interval [1.29, 1.94]), ANGPT2 (HR 1.37, [1.12, 1.67]), and BMP10 (HR 1.24 [1.02, 1.51]) remained associated with recurrent AF. Concentrations of ANGPT2, BMP10 and NT-proBNP decreased in patients who remained arrhythmia free, but not in patients with recurrent AF, highlighting their connection to AF. The other eight biomarkers showed unchanged concentrations. CONCLUSIONS: Elevated concentrations of ANGPT2, BMP10 and NT-proBNP are associated with recurrent atrial fibrillation after a first AF ablation, suggesting that processes linked to disturbed cardiomyocyte metabolism, altered atrial shear stress, and increased load contribute to atrial fibrillation after AF ablation in patients.
KW - Atrial fibrillation
KW - N-terminal pro-B-type natriuretic peptide
KW - ablation
KW - angiopoietin 2
KW - bone morphogenetic protein 10
KW - rhythm control
U2 - 10.1093/europace/euae028
DO - 10.1093/europace/euae028
M3 - Article
SN - 1099-5129
VL - 26
JO - EP Europace
JF - EP Europace
IS - 2
M1 - euae028
ER -