Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atrium
Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atrium
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DOI：
10.1093/europace/euv422
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发表时间：
2017-01-01
期刊：
影响因子：
6.1
通讯作者：
Hirata, Ken-ichi
中科院分区：
文献类型：
--
作者：
Suzuki, Atsushi;Fukuzawa, Koji;Hirata, Ken-ichi
最近的一项大型临床研究表明，中间CD 14 ++ CD 16+单核细胞与心血管事件之间存在相关性。然而，单核细胞亚群是否有助于心房颤动（AF）的发病机制尚未阐明。我们比较了AF患者和健康人的循环单核细胞亚群，并调查了中间的CD 14 ++ CD 16+单核细胞在AF的病理生理学的可能作用。方法和结果这一病例对照研究包括44个连续的AF患者没有全身性疾病的导管消融术在我院，和40名健康对照。排除了全身性疾病患者，包括结构性心脏病、肝或肾功能不全、胶原病、恶性肿瘤和炎症。进行单核细胞亚群分析（三种不同的人单核细胞亚群：经典CD 14 ++ CD 16-、中间CD 14 ++ CD 16+和非经典CD 14 + CD 16 ++单核细胞）。我们比较了单核细胞亚群，并评估了与其他临床结果的相关性。在排除了14例因炎症而导致的AF患者后，共纳入了60名参与者（30名AF患者和30名对照组作为年龄匹配组）。房颤患者循环中的中间型CD 14 ++ CD 16+单核细胞比例高于对照组（17.0 +/- 9.6 vs. 7.5 +/-4.1%，P < 0.001）。多变量逻辑回归分析表明，只有中等水平的CD 14 ++ CD 16+单核细胞的比例（比值比：1.316; 95%置信区间：1.095-1.582,P = 0.003）与房颤的存在独立相关。窦性心律时，中间型CD 14 ++ CD 16+单核细胞与左心耳血流呈负相关结论中间型CD 14 ++ CD 16+单核细胞可能与房颤的发生密切相关，并反映了左心房的功能重构。
Aims A recent large clinical study demonstrated the association between intermediate CD14++CD16+monocytes and cardiovascular events. However, whether that monocyte subset contributes to the pathogenesis of atrial fibrillation (AF) has not been clarified. We compared the circulating monocyte subsets in AF patients and healthy people, and investigated the possible role of intermediate CD14++CD16+monocytes in the pathophysiology of AF.Methods and results This case-control study included 44 consecutive AF patients without systemic diseases referred for catheter ablation at our hospital, and 40 healthy controls. Patients with systemic diseases, including structural heart disease, hepatic or renal dysfunction, collagen disease, malignancy, and inflammation were excluded. Monocyte subset analyses were performed (three distinct human monocyte subsets: classical CD14++CD16-, intermediate CD14++CD16+, and non-classical CD14+CD16++monocytes). We compared the monocyte subsets and evaluated the correlation with other clinical findings. A total of 60 participants (30 AF patients and 30 controls as an age-matched group) were included after excluding 14 AF patients due to inflammation. Atrial fibrillation patients had a higher proportion of circulating intermediate CD14++CD16+monocytes than the controls (17.0 +/- 9.6 vs. 7.5 +/- 4.1%, P < 0.001). A multivariable logistic regression analysis demonstrated that only the proportion of intermediate CD14++CD16+monocytes (odds ratio: 1.316; 95% confidence interval: 1.095-1.582, P = 0.003) was independently associated with the presence of AF. Intermediate CD14++CD16+monocytes were negatively correlated with the left atrial appendage flow during sinus rhythm (r = -0.679, P = 0.003) and positively with the brain natriuretic peptide (r = 0.439, P = 0.015).Conclusion Intermediate CD14++CD16+monocytes might be closely related to the pathogenesis of AF and reflect functional remodelling of the left atrium.