Atrial endocardial expression of von Willebrand factor and thrombomodulin is associated with recurrence after minimally invasive surgical atrial fibrillation ablation

An, Kang; Yin, Hang; Mei, Ju; Zhu, Jiaquan; Tang, Min

doi:10.1093/icvts/ivy075

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Patients with non-valvular AF have increased levels of immunoreactive vWF within the LAA which could lead to increased thrombogenicity ( 28 ). Recently this increase in vWF was also demonstrated in patients undergoing minimally invasive surgery for atrial fibrillation ( 29 ). Left atrial appendage isolation or ablation leads to endocardial damage at the left atrial appendage, which could lead to increased vWF, and consequently increasing the in-situ risk of LAA thrombi formation.…”

Section: Discussionmentioning

confidence: 80%

Long-Term Stroke Risk in Patients Undergoing Left Atrial Appendage Ablation With and Without Complete Isolation

Dhorepatil

Lang

et al. 2021

Front. Cardiovasc. Med.

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Background: Catheter ablation (CA) for atrial fibrillation (AF), may require ablation beyond the pulmonary veins. Prior data suggest that additional LA ablation, particularly left atrial appendage (LAA) ablation, may alter atrial function leading to increased risk of ischemic stroke or transient ischemic attack (IS/TIA). We sought to study the long-term risk of IS/TIA in patients receiving ablation at the LAA compared to those receiving PVI alone and those receiving PVI with additional non-LAA locations.Methods: 350 patients who underwent CA for AF from 2008 to 2018 were included in the study. Locations of ablation in LA evaluated were the posterior wall, anterior wall, inferior wall, inter-atrial septum, lateral wall and the left atrial appendage (LAA). Patients undergoing LAA ablation were further divided as complete isolation (LAAi) and without complete isolation (LAAa).Results: Mean follow up of 4.8 years. In entire cohort, risk of IS/TIA was 1.62/100 patient-years (pys). The risk was highest in patients with LAAi (3.81/100 pys), followed by ablation LAAa (3.74/100 pys). Amongst all LA locations, only LAAi (HR 3.32, p = 0.03) and LAAa (HR 3.18, p = 0.02) were statistically significant predictors of IS/TIA after adjusting for OAC (Oral anticoagulant) use and baseline CHA2DS2VASc score.Conclusions: During long term follow-up, only ablation at the left atrial appendage with and without complete isolation was independently associated with an increased risk of IS/TIA in patients undergoing CA for AF. Potential strategies to reduce stroke risk, such as LAA closure, should be considered in these patients.

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Section: Discussionmentioning

confidence: 80%

Long-Term Stroke Risk in Patients Undergoing Left Atrial Appendage Ablation With and Without Complete Isolation

Dhorepatil

Lang

et al. 2021

Front. Cardiovasc. Med.

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“…In the non-O-type blood groups (A, B, or AB type) patients, blood group antigens are expressed on the oligosaccharide side chains of VWF molecules, causing the slow clearance of VWF levels [ 22 ]. Increased VWF expression on the atrial endocardium in AF patients increases atrial structural remodeling and predicts AF recurrence in patients receiving surgical AF ablation [ 23 , 24 ]. Overall, the ABO blood groups were potentially linked to atrial inflammation and remodeling.…”

Section: Discussionmentioning

confidence: 99%

ABO Blood Groups as a Disease Marker to Predict Atrial Fibrillation Recurrence after Catheter Ablation

Liu

Chhay

et al. 2023

JPM

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Chronic inflammation harbors a vulnerable substrate for atrial fibrillation (AF) recurrence after catheter ablation. However, whether the ABO blood types are associated with AF recurrence after catheter ablation is unknown. A total of 2106 AF patients (1552 men, 554 women) who underwent catheter ablation were enrolled retrospectively. The patients were separated into two groups according to the ABO blood types, the O-type (n = 910, 43.21%) and the non-O-type groups (A, B, or AB type) (n = 1196, 56.79%). The clinical characteristics, AF recurrence, and risk predictors were investigated. The non-O type blood group had a higher incidence of diabetes mellitus (11.90 vs. 9.03%, p = 0.035), larger left atrial diameters (39.43 ± 6.74 vs. 38.20 ± 6.47, p = 0.007), and decreased left ventricular ejection fractions (56.01 ± 7.33 vs. 58.65 ± 6.34, p = 0.044) than the O-type blood group. In the non-paroxysmal AF (non-PAF) patients, the non-O-type blood groups have significantly higher incidences of very late recurrence (67.46 vs. 32.54%, p = 0.045) than those in the O-type blood group. The multivariate analysis revealed the non-O blood group (odd ratio 1.40, p = 0.022) and amiodarone (odd ratio 1.44, p = 0.013) were independent predictors for very late recurrence in the non-PAF patients after catheter ablation, which could be applied as a useful disease marker. This work highlighted the potential link between the ABO blood types and inflammatory activities that contribute to the pathogenic development of AF. The presence of surface antigens on cardiomyocytes or blood cells in patients with different ABO blood types will have an impactful role in risk stratification for AF prognosis after catheter ablation. Further prospective studies are warranted to prove the translational benefits of the ABO blood types for the patients receiving catheter ablation.

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“…The results suggest that the expression of vWF and TM in the atrial endocardium might be linked to the recurrence of AF after minimally invasive surgical AF ablation. Specifically, patients who experienced AF recurrence had higher vWF expression and lower TM expression [40]. Patients with AF had significantly lower soluble thrombomodulin levels compared to control subjects [41].…”

Section: Thrombomodulinmentioning

confidence: 91%

The Association between Coagulation and Atrial Fibrillation

Rafaqat,

Gluscevic,

Patoulias

et al. 2024

Biomedicines

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The existing literature highlights the presence of numerous coagulation factors and markers. Elevated levels of coagulation factors are associated with both existing and newly diagnosed cases of atrial fibrillation (AF). However, this article summarizes the role of coagulation in the pathogenesis of AF, which includes fibrinogen and fibrin, prothrombin, thrombomodulin, soluble urokinase plasminogen activator receptor, von Willebrand factor, P-selectin, D-dimer, plasminogen activator inhibitor-1, and platelet activation. Coagulation irregularities play a significant role in the pathogenesis of AF.

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Atrial endocardial expression of von Willebrand factor and thrombomodulin is associated with recurrence after minimally invasive surgical atrial fibrillation ablation

Abstract: Atrial endocardial expression of vWF and TM might be associated with recurrence after minimally invasive surgical AF ablation. Patients with AF recurrence seem to have elevated vWF expression and decreased TM expression.

Cited by 4 publications

References 20 publications

Long-Term Stroke Risk in Patients Undergoing Left Atrial Appendage Ablation With and Without Complete Isolation

Long-Term Stroke Risk in Patients Undergoing Left Atrial Appendage Ablation With and Without Complete Isolation

ABO Blood Groups as a Disease Marker to Predict Atrial Fibrillation Recurrence after Catheter Ablation

The Association between Coagulation and Atrial Fibrillation

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