The Receptor for Advanced Glycation End Products (RAGE) Is Associated with Persistent Atrial Fibrillation.
The Receptor for Advanced Glycation End Products (RAGE) Is Associated with Persistent Atrial Fibrillation.
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DOI：
10.1371/journal.pone.0161715
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Burrell LM
中科院分区：
文献类型：
--
作者：
Lancefield TF;Patel SK;Freeman M;Velkoska E;Wai B;Srivastava PM;Horrigan M;Farouque O;Burrell LM
晚期糖基化终末产物受体（AGEs）的上调被认为是心房颤动（AF）发生的病理生理学机制。我们试图研究可溶性β-内酰胺酶水平是否与白人患者的房颤相关。前瞻性招募患者（n = 587），测定血清可溶性β-内酰胺酶（sCRP）和内源性分泌性β-内酰胺酶（esCRP）水平。其中窦性心律527例，持续性房颤32例（持续时间>7天，n = 32），阵发性房颤28例（持续时间<7天，n = 28）。房颤患者年龄较大，心力衰竭的患病率高于窦性心律患者。持续性房颤患者的循环血肌酐水平较高[中位数1190（724-2041）pg/ml和中位数esRAGE 452（288-932）pg/ml]与阵发性AF [sRAGE 799]相比（583-1033）pg/ml和雌二醇279（201-433）pg/ml，p ≤ 0.01]或窦性心律[雌二醇782（576-1039）pg/ml和雌二醇289（192-412）pg/ml，p < 0.001]。在多变量logistic回归分析中，持续性AF的独立预测因素为年龄、心力衰竭、sCRP [比值比1.1/100 pg/ml，95%置信区间（CI）1.0-1.1，p = 0.001]和esCRP [比值比1.3/100 pg/ml，95% CI 1.1-1.4，p < 0.001]。心力衰竭和年龄是阵发性AF的唯一独立预测因子。在AF患者中，sAF [比值比1.1/100 pg/ml，95% CI 1.1-1.2，p = 0.007]和esAF [比值比1.3/100 pg/ml，95% CI 1.0-1.5，p = 0.017]与阵发性房颤相比，可独立预测持续性房颤。白人房颤患者可溶性房颤升高，sCRP和esCRP均可预测持续性房颤的存在。
Upregulation of the receptor for advanced glycation end products (RAGE) has been proposed as a pathophysiological mechanism underlying the development of atrial fibrillation (AF). We sought to investigate if soluble RAGE levels are associated with AF in Caucasian patients. Patients (n = 587) were prospectively recruited and serum levels of soluble RAGE (sRAGE) and endogenous secretory RAGE (esRAGE) measured. The patients included 527 with sinus rhythm, 32 with persistent AF (duration >7 days, n = 32) and 28 with paroxysmal AF (duration <7 days, n = 28). Patients with AF were older and had a greater prevalence of heart failure than patients in sinus rhythm. Circulating RAGE levels were higher in patients with persistent AF [median sRAGE 1190 (724–2041) pg/ml and median esRAGE 452 (288–932) pg/ml] compared with paroxysmal AF [sRAGE 799 (583–1033) pg/ml and esRAGE 279 (201–433) pg/ml, p ≤ 0.01] or sinus rhythm [sRAGE 782 (576–1039) pg/ml and esRAGE 289 (192–412) pg/ml, p < 0.001]. In multivariable logistic regression analysis, independent predictors of persistent AF were age, heart failure, sRAGE [odds ratio 1.1 per 100 pg/ml, 95% confidence interval (CI) 1.0–1.1, p = 0.001] and esRAGE [odds ratio 1.3 per 100 pg/ml, 95% CI 1.1–1.4, p < 0.001]. Heart failure and age were the only independent predictors of paroxysmal AF. In AF patients, sRAGE [odds ratio 1.1 per 100 pg/ml, 95% CI 1.1–1.2, p = 0.007] and esRAGE [odds ratio 1.3 per 100 pg/ml, 95% CI 1.0–1.5, p = 0.017] independently predicted persistent compared with paroxysmal AF. Soluble RAGE is elevated in Caucasian patients with AF, and both sRAGE and esRAGE predict the presence of persistent AF.
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