Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atrium

Suzuki, Atsushi; Fukuzawa, Koji; Yamashita, Tomoya; Yoshida, Akihiro; Sasaki, Naoto; Emoto, Takuo; Takei, Atsushi; Fujiwara, Ryosuke; Nakanishi, Teruyuki; Yamashita, Soichiro; Matsumoto, Akinori; Konishi, Hirokazu; Ichibori, Hirotoshi; Hirata, Ken–ichi

doi:10.1093/europace/euv422

Cited by 38 publications

(37 citation statements)

References 20 publications

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“…One of the important limitations of our study was using an automatically counted monocyte numbers rather than the proportion of monocyte subsets. Thus, the study by Suzuki et al 1 may support and confirm our previous findings when the ratio of circulating intermediate CD14þþCD16þ monocytes to HDL-C levels has been calculated and analysed. Because MHR combines the two detrimental processes like inflammation and oxidative stress, it could be used as a novel marker for prediction of the severity of atrial remodelling.…”

Section: Letters To the Editorsupporting

confidence: 88%

“…We would like to thank Dr Albert, Founder and Chief Medical Officer of AliveCor, for his interpretation of our study results to the readership in the light of different software versions. 1 As one may have noted in the article, 'despite' the findings of our study, our conclusions were positive about using AliveCor (as well as MyDiagnostick) in a hospital screening setting. 2 Those conclusions only get stronger with the clarifications of Dr Albert.…”

contrasting

confidence: 56%

“…The result of the 'recalled' defects in the app version used in the Europace study, and our enhanced specificity biasing, resulted in the very low sensitivity of 55% in the cardiology patients, and 79% in the geriatric patients and high specificity of 98% in both patient groups after exclusion of paced rhythms. 1 This was significantly different than the published performance of the research algorithm in the two previous AF studies using the AliveCor device, 3,4 and would impact the economic assessments made in the Desteghe article. Higher sensitivity (71%) compared with the 55% seen in the cardiology patients, and very high specificity (99.4%) of our commercial algorithm during AFib screening has been demonstrated in a recent presentation.…”

mentioning

confidence: 90%

“…Performance of hand-held electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting I read the article on the performance of two hand-held electrocardiogram devices for detecting atrial fibrillation by Desteghe et al 1 with great interest. As the founder of AliveCor, I supplied the senior author Dr. Heidbuchel with the AliveCor device, as it was neither approved nor available for sale in Belgium at that time, and his group understood that it could be used only for clinical research purposes.…”

mentioning

confidence: 99%

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‘Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting: authors' response’

Desteghe

Heidbüchel

2016

Europace

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Performance of hand-held electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting I read the article on the performance of two hand-held electrocardiogram devices for detecting atrial fibrillation by Desteghe et al. 1 with great interest. As the founder of AliveCor, I supplied the senior author Dr. Heidbuchel with the AliveCor device, as it was neither approved nor available for sale in Belgium at that time, and his group understood that it could be used only for clinical research purposes. It had been approved by the FDA and EC and was commercially available in the USA and the UK. Per email communication, the investigators downloaded the Apple iPhone App in December, 2014 but did not update the app for the duration of the study for consistency purposes. AliveCor had to voluntarily recall that version of the App in February, 2015 due to several defects which impaired diagnostic accuracy. 2 Our commercial AFib algorithm has been biased for enhanced specificity when compared with the algorithm used in two previous AFib detection studies 3,4 as our product is primarily sold directly to patients, who may not seek a physician read. The version of our AF detection algorithm utilized in the published AF screening studies 3,4 was biased to very high sensitivity because every positive result would be reviewed by a Cardiologist. The result of the 'recalled' defects in the app version used in the Europace study, and our enhanced specificity biasing, resulted in the very low sensitivity of 55% in the cardiology patients, and 79% in the geriatric patients and high specificity of 98% in both patient groups after exclusion of paced rhythms. 1 This was significantly different than the published performance of the research algorithm in the two previous AF studies using the AliveCor device, 3,4 and would impact the economic assessments made in the Desteghe article. Higher sensitivity (71%) compared with the 55% seen in the cardiology patients, and very high specificity (99.4%) of our commercial algorithm during AFib screening has been demonstrated in a recent presentation. 5 I contacted Drs. Desteghe and Heidbuchel to notify them of these issues after seeing the publication, and offered to re-analyse the electrocardiographic data using the currently released nondefective algorithm, or the original research AF algorithm, but the ECG data were no longer available on the iOS recording device, so this was not possible. We would like to thank Dr Albert, Founder and Chief Medical Officer of AliveCor, for his interpretation of our study results to the readership in the light of different software versions. 1 As one may have noted in the article, 'despite' the findings of our study, our conclusions were positive about using AliveCor (as well as MyDiagnostick) in a hospital screening setting. 2 Those conclusions only get stronger with the clarifications of Dr Albert. Improvement of the accuracy of the AliveCor algorithm will further reduce the costs for both in-hospital and out-of-hospital screeni...

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Section: Letters To the Editorsupporting

confidence: 88%

contrasting

confidence: 56%

mentioning

confidence: 90%

mentioning

confidence: 99%

See 2 more Smart Citations

‘Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting: authors' response’

Desteghe

Heidbüchel

2016

Europace

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“…+ monocytes than the controls, 23) although several papers have recently revealed that the cell counts of intermediate CD14 ++…”

Section: Article P64mentioning

confidence: 93%

Can Anti-inflammatory Therapy Prevent Atrial Fibrillation in Myocardial Infarction Patients?

Nakayama

Fujiu

2018

Int. Heart J.

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C ardiovascular diseases still remain one of the greatest health challenges. While the incidence and case-fatality rate of acute myocardial infarction (AMI) have decreased with the development of medications and reperfusion therapy, the disease burden of complications has increased. 1) Arrhythmia in the setting of AMI is an adverse prognostic factor, and atrial fibrillation (AF), the most frequent supraventricular arrhythmia, is associated with the increased risk of short-term and longterm mortality.2,3) In addition, AMI patients with AF have more comorbidities as compared to patients in sinus rhythm, which relate to a higher re-infarction rate, higher stroke rate, and higher risk for heart failure. [4][5][6] The presence of AF requires anti-coagulant therapy for the prevention of strokes, although anticoagulant drug administration plus dual anti-platelet therapy after percutaneous coronary intervention would increase the risk of bleeding and a variety of clinical trials have been conducted to evaluate alternative regimens. 7,8) Hence, the prediction and prevention of atrial fibrillation as a complication of AMI could be a meaningful strategy. In patients with left ventricular dysfunction secondary to AMI, treatment with an angiotensinconverting-enzyme (ACE) inhibitor could reduce the incidence of AF in the chronic phase. 9) Carvedilol has been shown to suppress AF and atrial flutter in a similar patient population, according to a sub-analysis in the the CAPRI-CORN study.10) Additionally, atorvastatin significantly reduced the incidence of postoperative AF after elective cardiac surgery.11,12) However, there is limited evidence suggesting that upstream medical therapy reduces the incidence of AF as primary endpoint.13) It is deemed desirable to provide preventive therapy tailored to risk stratification with respect to new-onset AF associated with AMI. Article p.64Zhang, et al. investigated the expression of Toll like receptors (TLRs) on the surface of peripheral blood mononuclear cells (PBMCs) in AMI patients. 14) They collected blood samples before any reperfusion therapy within two hours after AMI onset, and divided the clinical subjects into two groups: patients with new-onset AF in 1 month after AMI (AFMI group) or without (MI group). The results showed that the expressions of both TLR2 and TLR4 in PBMCs in the MI group were higher than that in healthy volunteers, and much higher in PBMCs in the AFMI group. Protein assay and flow cytometry analysis also showed a significant difference in TLR2 and TLR4 expression. With respect to the TLR adaptor proteins, myeloid differentiation factor 88 (MyD88) and TIR domain-containing protein-β antibody (TRIF-β), their protein levels were significantly higher in the AFMI group than in the MI group as well, indicating that the TLR2 and TLR4 pathway was surely augmented in PBMCs in the AFMI group. Of note, these differences were already found in the very rapid phase of AMI onset.Evidence to support the involvement of the inflammatory process in the pathophysiology of AF has...

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Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases

Ganjali

Gotto

Ruscica

et al. 2018

Journal Cellular Physiology

219

188

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Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

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Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atrium

Abstract: Intermediate CD14++CD16+monocytes might be closely related to the pathogenesis of AF and reflect functional remodelling of the left atrium.

Cited by 38 publications

References 20 publications

‘Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting: authors' response’

‘Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting: authors' response’

Can Anti-inflammatory Therapy Prevent Atrial Fibrillation in Myocardial Infarction Patients?

Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases

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