Serum levels of interleukin-2 predict the recurrence of atrial fibrillation after pulmonary vein ablation

Cabrera-Bueno, Fernando; Medina-Palomo, Carmen; Ruíz-Salas, Amalio; Flores, A.; Rodríguez-Losada, Noéla; Barrera, Alberto; Jiménez-Navarro, Manuel F.; Alzueta, Javier

doi:10.1016/j.cyto.2015.01.026

Cited by 29 publications

(21 citation statements)

References 16 publications

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“…Gene expression of pro-inflammatory factors associated to inflammatory response (IFN-γ, transcription factor T-bet, GATA-3; FoxP3 and CTLA-4; IL-17 and IL-18) were upregulated in heart samples of chronic Chagasic patients [24] and its inflammatory environment has been reported as inductor of gene expression related with heart failure [25] and gap junction dysfunction during Chagas disease [26], possibly explaining this fact the electrical disturbances observed in patients. Interestingly and closely related with our results, IL-2 was able to induce in vitro the expression of SCN3B and sodium current density [27], increasing of atrial action potential duration [28] and IL-2 has been linked to prognosis for atrial fibrillation in patients [29]. Additionally, Cx43 gene expression, a key protein of gap junctions tightly related with action potential spreading onto the heart, has been reported as impaired in Chagasic cardiomyopathy, reinforcing the possible association between inflammation and altered electrical function in Chagasic patients [30] and its fact possibly explains the positive effect of amiodarone treatment during Chagas disease [31].…”

Section: Discussionsupporting

confidence: 78%

“…Although this data does not allow itself to state that the increasing nor decreasing of IL-2 levels are associated to any outcome, high IL-2 serum levels have been reported as an atrial fibrillation predictor [29, 37] and low levels have been associated with therapeutic success of amiodarone treatment in atrial fibrillation [38]. Further studies are necessary for elucidating the molecular mechanisms associated to the heart microenvironment during chronic Chagas disease.…”

Section: Discussionmentioning

confidence: 99%

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Differential cytokine profiling in Chagasic patients according to their arrhythmogenic-status

Rodríguez-Angulo

Márques²,

Mendoza³

et al. 2017

BMC Infect Dis

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BackgroundChagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is actually challenging.Thus, the aim of this work was to determine the Th1/Th17 (IL-6, IL-2, TNF, IL-17 and IFN-γ) and Th2 (IL-4 and IL-10) serum profile in Venezuelan Chagasic patients stratified according amiodarone treatment, hypertension and arrhythmias.MethodsSera from 38 chagasic patients were analyzed to determine the level of cytokines by Multiplexed Bead-Based Immunoassays. ANOVA test was applied to determine differences for each group. Additionally, a Linear Discriminant Analysis (LDA) was applied to observe the accuracy of different cytokines to discriminate between the groups.ResultsThe levels of several cytokines were significantly higher in the high-risk of sudden death and untreated group. LDA showed that IL-2, IFN-γ and IL-10 were the best cytokines for discriminating between high-risk of sudden death and untreated patients versus low-risk of sudden death, treated and control groups.ConclusionsHigh IL-2 levels seem to identify patients with high-risk of sudden death and seems adequate as treatment efficacy marker. To our knowledge, this is the first report about the anti-inflammatory role of the amiodarone in Chagas disease, suggesting an inmunomodulatory effect that may be exploited as coadjutant therapy in chronic Chagas disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2324-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Differential cytokine profiling in Chagasic patients according to their arrhythmogenic-status

Rodríguez-Angulo

Márques²,

Mendoza³

et al. 2017

BMC Infect Dis

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“…In recent years, inflammation has been implicated in the pathogenesis of AF . Inflammatory markers such tumor necrosis factor α, interleukin 6, interleukin 2, and C‐reactive protein were all found to be elevated in patients with AF . Although data are not consistent, several authors have reported decreased levels of tumor necrosis factor α, interleukin 6, C‐reactive protein, and other proinflammatory cytokines after TRT .…”

Section: Discussionmentioning

confidence: 99%

Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation

Sharma

Oni

Gupta

et al. 2017

JAHA

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BackgroundAtrial fibrillation (AF) is the most common cardiac dysrhythmia associated with significant morbidity and mortality. Several small studies have reported that low serum total testosterone (TT) levels were associated with a higher incidence of AF. In contrast, it is also reported that anabolic steroid use is associated with an increase in the risk of AF. To date, no study has explored the effect of testosterone normalization on new incidence of AF after testosterone replacement therapy (TRT) in patients with low testosterone.Methods and ResultsUsing data from the Veterans Administrations Corporate Data Warehouse, we identified a national cohort of 76 639 veterans with low TT levels and divided them into 3 groups. Group 1 had TRT resulting in normalization of TT levels (normalized TRT), group 2 had TRT without normalization of TT levels (nonnormalized TRT), and group 3 did not receive TRT (no TRT). Propensity score–weighted stabilized inverse probability of treatment weighting Cox proportional hazard methods were used for analysis of the data from these groups to determine the association between post‐TRT levels of TT and the incidence of AF. Group 1 (40 856 patients, median age 66 years) had significantly lower risk of AF than group 2 (23 939 patients, median age 65 years; hazard ratio 0.90, 95% CI 0.81–0.99, P=0.0255) and group 3 (11 853 patients, median age 67 years; hazard ratio 0.79, 95% CI 0.70–0.89, P=0.0001). There was no statistical difference between groups 2 and 3 (hazard ratio 0.89, 95% CI 0.78– 1.0009, P=0.0675) in incidence of AF.ConclusionsThese novel results suggest that normalization of TT levels after TRT is associated with a significant decrease in the incidence of AF.

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“…In a cohort with preserved ejection fraction and permanent AF, patients with LV fibrosis had an exceptionally high rate of AF recurrence following catheter ablation; the 1‐year procedural success rate in those with extensive fibrosis and LV hypertrophy was only 7% . Even in patients with paroxysmal AF, the diagnosis of HFpEF or biomarkers of systemic inflammation presages a high rate of AF recurrence . These observations suggest that patients with latent or overt HFpEF have an underlying atrial myopathy that is the primary determinant of the development of AF; that substrate is highly resistant to therapeutic efforts to suppress or abolish the arrhythmia, especially when it is longstanding.…”

Section: Therapeutic Challenges In Patients With a Metabolic Disordermentioning

confidence: 99%

Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment

Packer

2019

European J of Heart Fail

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Obesity and diabetes can lead to heart failure with preserved ejection fraction (HFpEF), potentially because they both cause expansion and inflammation of epicardial adipose tissue and thus lead to microvascular dysfunction and fibrosis of the underlying left ventricle. The same process also causes an atrial myopathy, which is clinically evident as atrial fibrillation (AF); thus, AF may be the first manifestation of HFpEF. Many patients with apparently isolated AF have latent HFpEF or subsequently develop HFpEF. Most patients with obesity or diabetes who have AF and exercise intolerance have increased left atrial pressures at rest or during exercise, even in the absence of diagnosed HFpEF. Among patients with AF, those who also have latent HFpEF have increased risk for systemic thromboembolism and death. The identification of HFpEF in patients with obesity or diabetes alters the risk‐to‐benefit relationship of commonly prescribed treatments. Bariatric surgery and statins can ameliorate AF and reduce the risk for HFpEF. Conversely, antihyperglycaemic drugs that promote adipogenesis or cause sodium retention (insulin and thiazolidinediones) may increase the risk for heart failure in patients with an underlying ventricular myopathy. Patients with obesity and diabetes who undergo catheter ablation for AF are at increased risk for AF recurrence and for post‐ablation increases in pulmonary venous pressures and worsening heart failure, especially if HFpEF coexists. Therefore, AF may be the earliest indicator of HFpEF in patients with obesity or type 2 diabetes, and recognition of HFpEF alters the management of these patients.

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Serum levels of interleukin-2 predict the recurrence of atrial fibrillation after pulmonary vein ablation

Cited by 29 publications

References 16 publications

Differential cytokine profiling in Chagasic patients according to their arrhythmogenic-status

Differential cytokine profiling in Chagasic patients according to their arrhythmogenic-status

Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation

Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment

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