Abstract
BackgroundThis pilot study investigated the association between heat shock protein 70 (HSP70) and anti-HSP70 antibodies as well as their changes and rhythm outcome after atrial fibrillation (AF) catheter ablation.MethodsWe studied 67 patients with AF (59±11 years, 66% male, 66% lone AF) undergoing catheter ablation. Circulating HSP70 and anti-HSP70 antibody levels were quantified using commercially available assays before and 6 months after catheter ablation. Serial 7-day Holter ECGs were used to detect AF recurrences.ResultsAt baseline, HSP70 was detectable in 14 patients (21%), but there was no correlation between clinical or echocardiographic variables and the presence or the level of HSP70. In contrast, patients with paroxysmal AF (n=39) showed lower anti-HSP70 antibodies (median [IQR] of 43 [28 – 62] μg/ml) than patients with persistent AF (n=28; 53 [41 – 85] μg/ml, p=0.035). Using multivariable regression analysis, AF type was the only variable associated with anti-HSP70 antibodies (Beta=0.342, p=0.008). At 6 months, HSP70 was present in 27 patients (41%, p<0.001 vs. baseline). Similarly, there was an increase of anti-HSP70 antibodies (48 [36 – 72] vs. 57 [43 – 87] μg/ml, p<0.001). AF recurrence rates were higher in patients with HSP70 increase ≥0.025 ng/ml (32 vs. 11%, p=0.038) or anti-HSP70 increase ≥2.5 μg/ml (26 vs. 4%, p=0.033).ConclusionsHSP70 and anti-HSP70 antibodies may – at least in part – be associated in the progression of AF and AF recurrence after catheter ablation.
Highlights
This pilot study investigated the association between heat shock protein 70 (HSP70) and anti-HSP70 antibodies as well as their changes and rhythm outcome after atrial fibrillation (AF) catheter ablation
HSP70 and anti-HSP70 antibodies in AF At baseline, HSP70 was detectable in 21% of the patients and in 19% of the controls (p=ns)
In the AF cohort patients with paroxysmal AF had lower anti-HSP70 antibodies at baseline compared to patients with persistent AF (53, 41 – 85 μg/ml, p=0.035)
Summary
This pilot study investigated the association between heat shock protein 70 (HSP70) and anti-HSP70 antibodies as well as their changes and rhythm outcome after atrial fibrillation (AF) catheter ablation. Heat shock proteins (HSPs) are characterized as molecular chaperones and have important functions in the preservation and protection of cells and organs from stress and injury. The HSPs are subdivided into multimember families based on the molecular weights of the proteins encoded such as the HSP90, HSP70, HSP60 and small HSP families [1]. They seem to play a dominant role in mediating cytoprotective effects and limit necrosis of smooth muscle cells exposed to oxidative stress [2]. Antibodies against various HSPs have been associated with postoperative AF [13,14]
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