Document Detail


Endothelin-1 as a predictor of atrial fibrillation recurrence after pulmonary vein isolation.
MedLine Citation:
PMID:  19467500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A considerable rate of atrial fibrillation (AF) recurrence is one of the major limitations of pulmonary vein isolation (PVI). Although endothelin-1 (ET-1) is involved in atrial remodeling, it is unknown whether plasma ET-1 level before PVI can be used as a predictive factor for AF recurrence. OBJECTIVE: The goal of this study was to clarify whether the plasma ET-1 level, before PVI, can be used as a predictive factor for AF recurrence after PVI. METHODS: Fifty-one patients without structural heart disease who underwent PVI for symptomatic and drug-refractory paroxysmal/persistent AF were included in the study. Neurohumoral factors were measured, and transthoracic echocardiography was performed before and 6 months after each PVI. Mean left atrial (LA) pressure and arterial blood pressure (BP) were evaluated just before PVI. AF recurrence was detected by 12-lead electrocardiogram (ECG), Holter ECG, and event ECG monitor recordings, 3 to 6 months after PVI. RESULTS: Among plasma levels of ET-1, atrial and brain natriuretic peptides, renin, angiotensin II, and aldosterone before PVI, only ET-1 was significantly higher in the recurrence group compared with the nonrecurrence group (2.15 +/- 0.51 vs. 1.65 +/- 0.35 pg/ml, P < .001). Both mean LA pressure and diastolic BP in the recurrence group were significantly higher than in the nonrecurrence group (mean LA pressure, 10 +/- 3 vs. 8 +/- 3 mm Hg, P < .01; diastolic BP, 82 +/- 11 vs. 71 +/- 12 mm Hg, P < .01). The plasma ET-1 level and mean LA pressure were correlative. Multiple logistic regression analyses showed that higher levels of plasma ET-1 and diastolic BP were significant prognostic predictors of AF recurrence 3 to 6 months after PVI (P < .01 and P < .05, respectively). CONCLUSION: Our findings suggest that the plasma ET-1 level before PVI could be a crucial predictor of AF recurrence 3 to 6 months after PVI.
Authors:
Yuko Nakazawa; Takashi Ashihara; Takayoshi Tsutamoto; Makoto Ito; Minoru Horie
Publication Detail:
Type:  Journal Article     Date:  2009-02-24
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  6     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-26     Completed Date:  2009-10-08     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  725-30     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Respiratory Medicine, Heart Rhythm Center, Shiga University of Medical Science, Otsu, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / blood*,  therapy*
Biological Markers / blood
Catheter Ablation
Endothelin-1 / blood*
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Pulmonary Veins
Recurrence
Time Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Endothelin-1
Comments/Corrections
Comment In:
Heart Rhythm. 2009 Jun;6(6):731-2   [PMID:  19467501 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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