Abstract

Background: Brain-derived neurotropic factor (BDNF) is a growth factor with roles within the nervous system and cardiovascular system. It has been reported that serum BDNF is decreased in diseases related to persistent stress, such as chronic inflammation. Atrial fibrillation (AF) is also considered to be one of the diseases related to chronic inflammation, although the relationship between serum BDNF and AF remains unclear. Methods: This prospective study included 68 consecutive patients (44 men; 69 [58-69] years) who underwent first session of paroxysmal AF ablation. Before and 3 months after the ablation, blood samples were obtained to measure the several biomarkers that are known to be related to AF in addition to serum BDNF. AF recurrence was defined as the appearance of AF after 3 month blanking period following the ablation. Results: The serum BDNF levels before ablation were significantly increased after AF ablation (3.5 [1.6-16.6] ng/ml vs. 22.1 [16.2-27.4] ng/ml, p<0.001). During follow-up period of 10±2 months, AF recurrence occurred in 5 (7%) patients. The serum BDNF at 3 months post-ablation were significantly lower in patients with recurrent AF than in those without (19.6 [13.8-20.8] ng/ml vs. 22.0 [17.5-27.1] ng/ml, p=0.019). Furthermore, the serum BDNF at 3 months post-ablation was an independent predictor of AF recurrence (odds ratio 0.912, 95% confidence interval 0.835-0.996, p=0.040). According to the ROC curve analysis, the serum BDNF at 3 months post-ablation <22.0 ng/ml was associated with AF recurrence with 100% sensitivity and 54% specificity (area under the curve=0.817, p=0.019). Kaplan-Meier survival curve showed that the recurrence rate of AF was higher in the group L (the serum BDNF at 3 months post-ablation <22.0 ng/ml) than the group H at 3 months post-ablation >22.0 ng/ml) (p = 0.02) [figure 1]. Conclusions: Lower serum BDNF levels at 3 months after blanking period following the AF ablation might be a predictor of AF recurrence.

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