Abstract
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.
Highlights
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and it increases the risk of ischemic stroke, systemic embolization, heart failure, and mortality, compared to patients without AF [1]
The Left atrial (LA) diameter was larger in the AF group than in the no-AF groups (p = 0.011), and the LA volume was larger in the AF group than in the no-AF groups (p = 0.038)
LA remodeling in patients with AF was significantly associated with a higher atrial high-rate episodes (AHREs) burden, higher MIP-1α, and lower levels of transforming growth factor (TGF)-β1 and TGF-β3
Summary
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and it increases the risk of ischemic stroke, systemic embolization, heart failure, and mortality, compared to patients without AF [1]. There is growing evidence of inflammatory and fibrotic cytokines involvement in the context of both AF occurrence and LA remodeling. It has become clear that inflammation, inflammation-related structural alteration and fibrosis are involved in AF propagation and LA remodeling [9]. LA remodeling itself is an independent risk factor for ischemic stroke and mortality, with or without AF [5]. Several inflammatory and fibrotic cytokines, including IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)β1, could be used to predict AF occurrence and clinical outcome [10,11,12,13]. Very few published studies have discussed the predictive biomarkers of LA remodeling in patients with and without AF [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
