Biomarkers of left atrial overload in obese and nonobese patients with atrial fibrillation qualified for electrical cardioversion

Abstract

Background Biomarkers of left atrial (LA) overload are considered factors affecting the efficacy of atrial fibrillation (AF) treatment. Increasing obesity rates contribute to a growing number of obese patients qualified for electrical cardioversion (CVE). aims The aim of the study was to evaluate serum concentrations of biomarkers of LA overload and their impact on the efficacy of CVE. methods A total of 82 patients with persistent AF who underwent successful CVE were prospectively enrolled in the study. The study population was divided into the obese group (OG) and the nonobese group (NOG). The serum levels of the following biomarkers were measured on the day of admission and at follow -up: high -sensitivity C -reactive protein (hs-CRP), N -terminal pro -B-type natriuretic peptide, copeptin, galectin 3, growth differentiation factor 15 (GDF-15), and renalase. results Baseline and follow -up hs-CRP levels were increased in the OG compared with the NOG. Four -week CVE efficacy was 38.8% in the OG and 60.6% in the NOG. Time of the observation, allocation to the groups, and CVE outcomes showed no associations with most LA biomarkers during follow-up. Baseline concentrations of 2 biomarkers of LA overload were associated with clinical characteristics of the study group, that is, log 10 serum GDF-15 and log 10 serum renalase levels correlated positively with the CHA 2 DS 2 -VASc score. conclusions Although obesity modifies the long -term efficacy of CVE, the OG and NOG did not differ significantly in most biomarkers of LA overload, except hs-CRP. The efficacy of CVE seems to be independent of the levels of biomarkers. A favorable procedure outcome did not affect their blood concentrations.

Biomarkers of Atrial Fibrillation Recurrence in Patients with Paroxysmal or Persistent Atrial Fibrillation Following External Direct Current Electrical Cardioversion

“…Gürses KM et al (2019) [98] reported that pre-cardioversion Gal-3 levels in persistent AF corresponded to a higher left atrial volume index and were associated with early AF recurrence following successful sinus rhythm restoration. In contrast, Cicho ń M et al (2021) [101] did not find any link between circulating Gal-3 levels and the risk of recurrent AF in obese and non-obese patients with persistent AF. The same results were obtained in another study involving 75 non-HF patients with paroxysmal or persistent AF referred for electrical cardioversion [102].…”

“…Clinical evidence for the discriminative value of GDF15 for AF relapse or sinus rhythm maintenance is extremely limited. There is one small study that prospectively included 82 patients with persistent AF [101]. Although log10 serum GDF-15 levels correlated positively with the CHA2DS2-VASc score, there was no close association between GDF-15 levels and sinus rhythm maintenance in patients after successful electric cardioversion [101].…”

“…There is one small study that prospectively included 82 patients with persistent AF [101]. Although log10 serum GDF-15 levels correlated positively with the CHA2DS2-VASc score, there was no close association between GDF-15 levels and sinus rhythm maintenance in patients after successful electric cardioversion [101]. Thus, a discriminative potency of GDF15 for the prediction of clinical efficacy of electrical cardioversion among patients with nonvalvular/valvular AF is not completely understood and requires scrutiny in large clinical studies.…”

Remote Monitoring of Cardiac Implantable Electronic Devices in Patients Undergoing Hybrid Comprehensive Telerehabilitation in Comparison to the Usual Care. Subanalysis from Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomised Clinical Trial

“…Cardiovascular risk factors (i.e., hypertension, obesity or sleep apnoea) may contribute to the development of AF [ 34 , 35 ]. The CARDIO-FIT study showed that cardiorespiratory fitness predicts the recurrence of arrhythmia in obese patients with symptomatic AF [ 36 ].…”

Screening for atrial fibrillation: Different approaches targeted to reduce ischemic stroke

“…Patient targeting may important to maximize the chance of detecting AF, which is a difficult balance between the possibility to maximize sensitivity and the problems linked to managing a large number of subjects. A series of criteria for patient targeting can be applied, including age, CHA 2 DS 2 --VASc, or CHA 2 DS 2 -VA [5], but also biomarkers such as brain natriuretic peptide (BNP) or N-terminal pro-BNP peptide (NT-proBNP) [4,10,11]. We think that the large amount of data collected in NOMED-AF deserves further analysis to assess the potential for specific targeting of candidates to AF screening based on clinical criteria (age, CHA 2 DS 2 -VASc) or biomarkers (NT-proBNP was measured in the study to assess the possibilities to maximize the feasibility of screening programs in daily practice) [5].…”