Alteration of Endothelin 1, MCP-1 and Chromogranin A in patients with atrial fibrillation undergoing pulmonary vein isolation

Abstract

BackgroundThe relation between arrhythmias and stress is known. The aim of our current study was to elucidate whether plasma levels of previously described stress parameters are altered in highly symptomatic patients with atrial fibrillation (AF) per se and in patients undergoing ablation therapy by pulmonary vein isolation (PVI).Methods96 patients with AF undergoing PVI were recruited. Plasma levels of Endothelin-1 (ET-1), MCP-1 and Chromogranin-A (CGA) were measured before and three months after ablation completed with clinical follow-up with respect to AF recurrence. Additionally, we examined 40 healthy age- and sex-matched volunteers as a reference.ResultsSymptomatic AF patients showed increased levels of ET-1 compared to healthy controls (2.62pg/ml vs. 1.57pg/ml; p<0.01). Baseline levels of ET-1 were higher in patients presenting with AF after PVI (2.96pg/ml vs. 2.57pg/ml;p = 0.02). The temporal comparison revealed decreased ET-1 levels in patients without (2.57pg/ml vs. 2.33pg/ml; p<0.01) and unchanged ET-1 levels in patients with AF after PVI. Baseline MCP-1 was increased in AF patients vs. controls (268pg/ml vs. 227 pg/ml; p = 0.03). Both groups, with and without AF after PVI, showed an increase of MCP-1 compared to baseline (268pg/ml vs. 349pg/ml;p<0.01; 281pg/ml vs. 355pg/ml;p = 0.03). CGA was lower in AF patients compared to healthy controls (13.8ng/ml vs. 25.6ng/ml;p<0.01). Over time patients without AF after PVI showed an increase of CGA (14.2ng/ml vs. 20.7ng/ml;p<0.01). No change was observed in patients with AF after PVI.ConclusionOur study demonstrated dysregulated levels of ET-1, MCP-1 and CGA in symptomatic AF patients. We could demonstrate an association between ET-1 to presence or absence of AF. Furthermore, we could show that a decrease of ET-1 as well as an increase of CGA after PVI, representing a trend towards control cohort levels, were both associated with restoration of sinus rhythm. These results provide new insights into the role of stress-related biomarkers in AF and AF treatment by ablation therapy.

RETRACTED: Safety of radiofrequency ablation for reducing inflammatory cytokine levels and the left atrial diameter in patients with atrial fibrillation

“…As reported in the clinical literature, pulmonary vein isolation is pivotal in radiofrequency ablation (RFA) to reduce signs and symptoms in patients with AF. 6 However, RFA may lead to recurrence of AF and is usually performed under sedation and in surgical conditions. The long immobilization time of RFA can weaken the patients' autonomous ventilation.…”

Unveiling the Role of Endothelial Dysfunction: A Possible Key to Enhancing Catheter Ablation Success in Atrial Fibrillation

“…Three months post-CA, patients without new AF episodes exhibited a drop in ET-1 levels, nearly matching those of healthy individuals. In contrast, patients with AF recurrence showed unchanged ET-1 levels three months after CA [71]. However, other studies did not confirm these findings, showing no significant difference in ET-1 levels between the no-recurrence and recurrence groups (25.5 ± 4.4 vs. 26.7 ± 5.4; p = 0.286) [88].…”

“…Research evaluating endothelial function through biochemical markers like Endothelin-1 (ET-1) or mechanical parameters such as FMD has established a correlation between the state of the endothelium before CA and its success. Studies have consistently shown that ET-1 levels are higher in patients with persistent AF (PeAF) or paroxysmal AF (PAF) compared to healthy individuals [70][71][72]. Additionally, lower ET-1 levels were associated with a greater likelihood of maintaining AF-free status three months post-ablation [71], and ET-1 was identified as an independent risk factor for the postoperative recurrence of PeAF only [70].…”

“…Studies have consistently shown that ET-1 levels are higher in patients with persistent AF (PeAF) or paroxysmal AF (PAF) compared to healthy individuals [70][71][72]. Additionally, lower ET-1 levels were associated with a greater likelihood of maintaining AF-free status three months post-ablation [71], and ET-1 was identified as an independent risk factor for the postoperative recurrence of PeAF only [70]. However, Wang et al recognized ET-1 as a predictor of AF recurrence, particularly in PAF patients, contrasting with other studies where the main predictor for PeAF recurrence was the duration of AF [72].…”

The Role of Major Biomarkers of Stress in Atrial Fibrillation: A Literature Review

“…Given that the adrenergic system has a huge impact on the development of AF, the authors expected higher CGA levels as a surrogate for elevated sympathoadrenergic tone. 48,49 Lackermair et al explored the relationship between arrhythmias and stress, noting that the plasma levels of previously described stress parameters were altered in highly symptomatic patients with AF per se and patients undergoing ablation therapy by pulmonary vein isolation (PVI). In addition, CgA was lower in AF patients compared to healthy controls.…”