scholarly journals Macrophage Inflammatory Protein-1 Alpha, a Potential Biomarker for Predicting Left Atrial Remodeling in Patients With Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Yung-Lung Chen ◽  
Hui-Ting Wang ◽  
Pei-Ting Lin ◽  
Jiin-Haur Chuang ◽  
Ming-Yu Yang
Keyword(s):  
Atrial Fibrillation ◽  
Mrna Expression ◽  
Left Atrial ◽  
Transforming Growth Factor ◽  
Atrial Remodeling ◽  
Autoimmune Myocarditis ◽  
Inflammatory Protein ◽  
Potential Biomarker ◽  
Cytokine Levels ◽  
Macrophage Inflammatory Protein

Objectives: Left atrial (LA) remodeling itself is an independent risk factor for ischemic stroke and mortality, with or without atrial fibrillation (AF). Macrophage inflammatory protein-1 alpha (MIP-1α) has been reported to be involved in the induction of autoimmune myocarditis and dilated cardiomyopathy. Little is known about whether MIP-1α can be used to predict LA remodeling, especially in patients with AF.Methods: We prospectively enrolled 78 patients who had received a cardiac implantable electronic device due to sick sinus syndrome in order to define AF accurately. AF was diagnosed clinically before enrollment, according to 12-lead electrocardiography (ECG) and 24-h Holter test in 54 (69%) patients. The serum cytokine levels and the mRNA expression levels of peripheral blood leukocytes were checked and echocardiographic study was performed on the same day within 1 week after the patients were enrolled into the study. The 12-lead ECG and 24-h Holter test were performed on the same day of the patients' enrollment, and the device interrogation was performed every 3 months after enrollment. The enrolled patients were clinically followed up for 1 year.Results: There was no difference in baseline characteristics, cytokine levels and mRNA expression between patients with and without AF. Larger LA volume was positively correlated with higher levels of MIP-1α (r = 0.461, p ≤ 0.001) and the atrial high-rate episodes (AHREs) burden (r = 0.593, p < 0.001), and negatively correlated with higher levels of transforming growth factor (TGF)-β1 (r = −0.271, p = 0.047) and TGF-β3 (r = −0.279, p = 0.041). The higher AHREs burden and MIP-1α level could predict LA volume independently. The mRNA expression of RORC was negatively associated with the MIP-1α level.Conclusions: This study showed that higher MIP-1α was significantly associated with LA remodeling and may have the potentials to predict LA remodeling in terms of a larger LA volume, and that circadian gene derangement might affect the expression of MIP-1α.

Abstract 18601: Impact of Right and Left Atrial Remodeling on Outcomes From Atrial Fibrillation Rotor Ablation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Amir Schricker ◽  
Tina Baykaner ◽  
Junaid Zaman ◽  
Gautam Lalani ◽  
Kenneth Hopper ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Structural Changes ◽  
Unknown Etiology ◽  
Atrial Remodeling ◽  
Left Atrial Remodeling ◽  
Single Procedure ◽  
Clinical Indices ◽  
The Right

Introduction: Targets for the ablation of atrial fibrillation (AF) are debated. In particular, recent studies questioning fractionated electrograms and lines has increased focus on AF substrates of rotors and focal impulses. These AF sources are seen in both atria, but have unknown etiology. We hypothesized that differential remodeling between the right atrium (RA), whose structural changes are largely undefined, and left atrium (LA) influence the distribution of AF sources and the outcomes from AF source ablation. Methods: In 60 patients at AF ablation (62±10 years, 60% persistent, 5% long-standing persistent), we compared size differences between RA and LA to the number of sources in each chamber and outcomes from AF source-guide ablation. We studied if a 64-pole basket differentially fit the LA or RA, judged by deformation of its splines by the atria (fig. A, B) over multiple cardiac cycles on fluoroscopy. Ablation targeted sources in both atria and was followed by PVI, with follow-up per guidelines. Results: Using baskets in both atria, 205 sources (LA 138; RA 67) were identified and ablated. Notably, the same basket in each patient was dynamically deformed by RA in 51 (85%) of cases but in the LA in only 39 (65%), indicating greater LA remodeling. The number of AF sources was higher in the presence of basket deformation of RA (n=174) than LA (n=130). LA deformation correlated with LVEF (p=0.05). Freedom from AF at 1 year was reduced in patients with no basket deformation (i.e. dilation) in LA (p=0.07) or RA (p=0.06). Notably, single procedure AF freedom was substantially lower in patients with differential remodeling (deformation in only 1 chamber) of 84% vs. 60% (fig C). Conclusions: Structural atrial remodeling influences the number of electrical rotors and focal sources in each chamber. A mismatch between right and left atrial remodeling predicts lower success from rotor ablation. These data also provide novel clinical indices of effective basket positioning.

scholarly journals Echocardiography in Patients with Atrial Fibrillation - What Should the Internist Doctor Know?

2020 ◽  
Vol 17 (4) ◽  
pp. 49-60
Author(s):  
Maria-Luiza Toplicianu-Dimitriu ◽  
Ioan Tiberiu Nanea
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Structural Changes ◽  
Excess Mortality ◽  
Ventricular Dysfunction ◽  
Imaging Technique ◽  
Left Ventricular ◽  
Clinical Impact ◽  
Atrial Remodeling ◽  
Routine Imaging

AbstractAtrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing prevalence and an enormous clinical impact due to the high stroke rate, left ventricular dysfunction and excess mortality. The occurrence and maintenance of AF is favored by both the degree of left atrial (LA) dilation and the association of fibrotic lesions of the myocardium. The LA is a marker of adverse cardiovascular events in patients with AF. Atrial remodeling can be electrical (shortening atrial refractory), structural (altering geometry and altering collagen content) and contractile (loss of contractility). Cardiac imaging plays a central role in the clinical management of this arrhythmia. Echocardiography represents the routine imaging technique used in patients with AF, with a role in detecting LA dysfunction and cardiac structural changes that predispose to this arrhythmia, also having the ability to predict the maintenance of sinus rhythm after cardioversion and after ablation.

Acceleration of Palatal Wound Healing in Smad3-deficient Mice

2009 ◽  
Vol 88 (8) ◽  
pp. 757-761 ◽  
Author(s):  
K. Jinno ◽  
T. Takahashi ◽  
K. Tsuchida ◽  
E. Tanaka ◽  
K. Moriyama
Keyword(s):  
Wound Healing ◽  
Transforming Growth Factor ◽  
Smooth Muscle Actin ◽  
Monocyte Chemoattractant Protein 1 ◽  
Inflammatory Protein ◽  
Complex Process ◽  
Dermal Cells ◽  
Macrophage Inflammatory Protein ◽  
Tgf Β1

Wound healing is a well-orchestrated complex process leading to the repair of injured tissues. It is suggested that transforming growth factor (TGF)-β/Smad3 signaling is involved in wound healing. The purpose of this study was to investigate the role of TGF-β/Smad3 signaling in palatal wound healing in Smad3-deficient (Smad3−/−) mice. Histological examination showed that wound closure was accelerated by the proliferation of epithelium and dermal cells in Smad3−/− mice compared with wild-type (WT) mice. Macrophage/monocyte infiltration at wounded regions in Smad3−/− mice was decreased in parallel with the diminished production of TGF-β1, monocyte chemoattractant protein-1, and macrophage inflammatory protein-1α compared with WT mice. Fibrocytes, expressing hematopoietic surface marker and fibroblast products, were recruited and produced α-smooth-muscle actin in WT mice, but were not observed in Smad3−/− mice. These results suggest that TGF-β/Smad3 signaling may play an important role in the regulation of palatal wound healing.

Abstract 15901: Radiofrequency Ablation for Persistent Atrial Fibrillation: Earlier Catheter-based Interventions are associated With Better Outcomes and in Direct Association With Markers of Pathways of Atrial Remodeling

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Amr F Barakat ◽  
Ayman A Hussein ◽  
Mohammed Bassiouny ◽  
Ali Hakim ◽  
Shadi Al Halabi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Atrial Remodeling ◽  
Success Rates ◽  
Left Atrial Size ◽  
Ablation Time ◽  
Atrial Size ◽  
Direct Association ◽  
First Diagnosis

Introduction: Persistent atrial fibrillation (PerAF) ablation has been associated with significant recurrence rates which could reflect progressive AF-related atrial remodeling. We hypothesized that the first-diagnosis to ablation time for PerAF is a major determinant of success rates and in direct association with pathways of atrial remodeling. Methods: Two-year outcomes were assessed in 1241 patients undergoing first time ablation of PerAF between January 2005 and December 2012 at our institution. The time intervals between the first diagnosis of PerF and the ablation procedures were determined. Patients had echocardiograms and measures of B-type natriuretic peptide (BNP) and C-reactive protein (CRP) before the ablation procedures. During ablations, patients with atrial scarring by voltage were identified. Results: The median time-to-ablation since the first PerAF diagnosis was 3 years (interquartile range 1-6.5). With longer diagnosis-to-ablation time (based on quartiles), there was a significant increase in BNP levels (p=0.01), CRP levels (p<0.0001), left atrial size (p=0.03) and scarring (p=0.04). Atrial arrhythmia recurred after a single ablation in 555 patients (44.7%); and 364 (29.3%) underwent repeat ablations. At last follow-up, 1005 patients (81.0%, 390 on antiarrhythmic medications) were either arrhythmia free or had their arrhythmia controlled. In Cox Proportional Hazard analyzes, BNP levels, CRP levels, left atrial size and scarring were associated with arrhythmia recurrence. The diagnosis-to-ablation time had the strongest association with success rates which persisted in multivariate Cox analyzes (HR for recurrence per +1Log diagnosis-to-ablation time 1.25, 95%CI 1.11-1.42, p<0.0001; 4th vs. 1st quartile 2.27, 95%CI 1.52-3.47, p<0.0001). Conclusions: The success rates with PerAF ablation are highest with early intervention, that is ablation before the progression of atrial remodeling.

Abstract 3175: Plasma Tansforming Growth Factor Beta as a Biochemical Marker to Predict the Recurrence of Atrial Fibrillation After Surgical Maze

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Young Keun On ◽  
Dae-Hee Shin ◽  
Jin-Oh Choi ◽  
Yong Hwan Park ◽  
Sang Yeub Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Messenger Rna ◽  
Left Atrial ◽  
Multiple Logistic Regression Analysis ◽  
Internal Standard ◽  
Maze Procedure ◽  
Atrial Remodeling ◽  
Rt Pcr ◽  
Heart Operation

BACKGROUND Atrial remodeling leads to perpetuation of atrial fibrillation (AF). Structural remodeling in the form of fibrosis alters the substrate. The surgical Maze procedure was developed as a surgical treatment of AF. Our purpose was to evaluate the role of plasma NT-proBNP, hsCRP, TIMP-1(Tissue inhibitors of MetalloProteinase-1), TGF-β, MMP-3(Matrix MetalloProteinase-3), and pro-MMP-1in predicting the recurrence of AF after surgical Maze procedure. And we also evaluated the association of expression of CTGF, TGF-β, BNP, ANP, collagen-1α, and collagen-3α in LA with the recurrence of AF after surgical Maze procedure. METHODS Preoperative plasma NT-proBNP, hsCRP, TIMP, TGF-β, MMP-3, and pro-MMP-1 levels were measured in consecutive 86 patients (age 54±12 yrs) who underwent the open heart operation for valvular heart disease and surgical Maze procedure for AF. Moreover, we performed molecular examinations of CTGF, TGF-β, BNP, ANP, Collagen-1α, Collagen-3α in the resected left atrial tissues. Symptomatic AF documented by ECG or an episode of AF revealed at follow-up holter monitoring were considered atrial fibrillation recurrences. RESULTS At 1-year follow-up, 10 among 86 patients had persistence of AF. Patients with AF persistence had higher plasma TGF-β levels than the patients with sinus rhythm (0.44 ± 0.29 vs 0.32 ± 0.15 ng/ml) . Patients with AF persistence had higher messenger RNA expressions of Collagen-3α (0.21 ± 0.20 vs 0.12 ± 0.12, compared with internal standard GAPDH by RT-PCR) and lower messenger RNA expressions of ANP (0.31 ± 0.16 vs 0.60 ± 0.76, compared with internal standard GAPDH by RT-PCR ) in left atrial tissues. Multiple logistic regression analysis revealed that plasma TGF-β was independently associated with postoperative persistence of atrial fibrillation at 1 year follow-up after surgical Maze procedure. CONCLUSIONS Advanced atrial degenerative change might result in a decrease of atrial ANP secretion. Cardiac fibrosis might be a determinant of myocardial heterogeneity and the persistence of AF. Plasma TGF-β could predict the persistence of AF at 1 year follow-up after surgical Maze procedure.

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