Serum sRANKL/OPG predict recurrence after radiofrequency catheter ablation of lone atrial fibrillation.
Serum sRANKL/OPG predict recurrence after radiofrequency catheter ablation of lone atrial fibrillation.
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DOI：
10.1016/j.ijcard.2013.08.084
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发表时间：
2014
影响因子：
3.5
通讯作者：
H. Cao;Ying Wu;Qingguo Li;Yanhu Wu;Qing Zhou;O. Røe;Yijiang Chen;Ruxing Wang;Dongjin Wang-Dongjin
中科院分区：
文献类型：
--
作者：
H. Cao;Ying Wu;Qingguo Li;Yanhu Wu;Qing Zhou;O. Røe;Yijiang Chen;Ruxing Wang;Dongjin Wang-Dongjin
射频消融（Radiofrequency catheter ablation，RFCA）是治疗心房颤动（atrial fibrillation，AF）的有效方法.相当大的复发率部分归因于心房重构。骨保护素（OPG）/核因子-κB受体激活因子（RANK）/RANK配体（RANKL）轴可能通过调节心房结构重构参与AF的发生和发展。本研究旨在确定血清可溶性RANKL（sRANKL）/OPG和消融孤立性AF后复发性心律失常的风险之间的关系。MethodsWe招募了527例孤立性AF患者进行首次RFCA完整的随访数据。消融前静脉血样本的测量血清sRANKL和OPG. ResultsIn随访期间的15（3-64）个月，AF复发187例（35.5%）。复发与血清sRANKL水平和sRANKL/OPG比值升高相关。在多因素生存回归分析中，持续性房颤、房颤持续时间、左房内径、消融后胺碘酮，特别是血清sRANKL水平和sRANKL/OPG比值独立预测房颤复发。根据ROC曲线分析，sRANKL水平和sRANKL/OPG比值预测复发的最佳诊断值分别为4.89pmol/l和0.76pmol/l。结论sRANKL水平和sRANKL/OPG比值升高与孤立性房颤患者初次消融术后房颤复发有关，可用于预测此类患者的房颤复发。
BackgroundRadiofrequency catheter ablation (RFCA) is a widely accepted strategy for eliminating atrial fibrillation (AF). A considerable recurrence rate has partly been ascribed to atrial remodeling. Osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL) axis may contribute to the development and progression of AF by regulating atrial structural remodeling. This study aimed to determine the relationship between serum soluble RANKL (sRANKL)/OPG and the risk of recurrent arrhythmia after ablation of lone AF.MethodsWe enrolled 527 lone AF patients undergoing first-time RFCA with complete follow-up data. Pre-ablation venous blood samples were obtained for measurement of serum sRANKL and OPG.ResultsDuring the follow-up period of 15 (3–64) months, AF recurred in 187 patients (35.5%). Recurrence was associated with an elevation of serum sRANKL level and sRANKL/OPG ratio. In multivariate survival regression, persistent AF, AF duration, left atrial diameter, amiodarone after ablation, particularly serum sRANKL level and sRANKL/OPG ratio independently predicted AF recurrence. According to ROC curve analysis, the best diagnostic values of serum sRANKL level and sRANKL/OPG ratio for predicting recurrence were 4.89 pmol/l and 0.76, respectively.ConclusionsBaseline serum high sRANKL level and sRANKL/OPG ratio are associated with AF recurrence after primary ablation procedure in lone AF patients, and may be used in the prediction of AF recurrence in these patients.