Impact of Biomarkers of Inflammation and Extracellular Matrix Turnover on the Outcome of Atrial Fibrillation Ablation: Importance of Matrix Metalloproteinase-2 as a Predictor of Atrial Fibrillation Recurrence
Impact of Biomarkers of Inflammation and Extracellular Matrix Turnover on the Outcome of Atrial Fibrillation Ablation: Importance of Matrix Metalloproteinase-2 as a Predictor of Atrial Fibrillation Recurrence
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DOI：
10.1111/j.1540-8167.2011.02059.x
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发表时间：
2011-09-01
影响因子：
2.7
通讯作者：
Hirayama, Atsushi
中科院分区：
文献类型：
--
作者：
Okumura, Yasuo;Watanabe, Ichiro;Hirayama, Atsushi
基质金属蛋白酶-2预测房颤消融术的预后简介：虽然导管消融术可以有效地消除心房颤动（AF），但心房重构的进展增加了复发的风险。AF与炎症和随后的心肌纤维化相关。因此，我们研究了使用炎症和胶原蛋白周转的生物标志物确定AF患者消融后预后的可能性。方法和结果：受试者为50例因耐药房颤接受导管消融术的患者。检测超敏C反应蛋白（hs-CRP）、白细胞介素（IL）-6、I型胶原羧基端肽（ICTP）、金属蛋白酶（MMP）-2，在消融前和消融后2.2 ± 0.8个月测量MMP-2组织抑制物（TIMP-2）、心房利钠肽（ANP）和脑利钠肽（BNP）。在14.0（4.7-20.9）个月的随访期间，50例患者中有21例AF复发。复发与MMP-2升高（860.3 +/- 120.8 ng/mL vs 687.0 +/- 122.5 ng/mL [在无复发的患者中]）、ICTP升高（3.2 +/- 1.1 ng/mL vs 2.7 +/- 0.6 ng/mL）、BNP升高、更高的体重指数、非阵发性AF和高血压相关（均P < 0.05）。多因素分析显示，血清MMP-2和非阵发性AF是消融术后AF复发的独立预测因子。总体而言，hs-CRP，IL-6，ANP和BNP水平下降，MMP-2，TIMP-2，和ICTP水平增加2个月后ablation.Conclusions：我们的研究发现，胶原蛋白周转标记物升高的患者经历了AF复发后消融表明，这些标记物可能是一个有用的指南，以确定一个亚组的AF患者谁需要广泛的消融策略。消融后2个月胶原蛋白周转标记物升高表明消融后伤口愈合过程持续了很长时间。（J.E. Vasc Electrophysiol，Vol. 22，pp. 987-993，2011年9月）
MMP-2 Predicts the Outcome of AF Ablation. Introduction: Although catheter ablation can effectively eliminate atrial fibrillation (AF), the progression of atrial remodeling increases the risk of recurrence. AF is associated with inflammation and subsequent myocardial fibrosis. We therefore examined the possibility of determining the postablation prognosis of patients with AF using biomarkers of inflammation and collagen turnover.Methods and Results: Subjects were 50 patients who underwent catheter ablation for drug-resistant AF. High-sensitivity CRP (hs-CRP), interleukin (IL)-6, carboxyl-terminal telopeptide of collagen type I (ICTP), metalloproteinase (MMP)-2, tissue inhibitor of MMP-2 (TIMP-2), atrial natriuretic peptide (ANP), and brain natriuretic peptide (BNP) were measured before and 2.2 +/- 0.8 months after ablation. During the follow-up period of 14.0 (4.7-20.9) months, AF recurred in 21 of the 50 patients. Recurrence was associated with an MMP-2 elevation (860.3 +/- 120.8 ng/mL vs 687.0 +/- 122.5 ng/mL [in patients without recurrence]), ICTP elevation (3.2 +/- 1.1 ng/mL vs 2.7 +/- 0.6 ng/mL), BNP elevation, greater body mass index, nonparoxysmal AF, and hypertension (P < 0.05 for all). Serum MMP-2 and nonparoxysmal AF were shown by multivariate analysis to be independent predictors for postablation AF recurrence. Overall, hs-CRP, IL-6, ANP, and BNP levels decreased, and MMP-2, TIMP-2, and ICTP levels increased 2 months after ablation.Conclusions: Our finding that markers of collagen turnover were elevated in patients who experienced AF recurrence after ablation indicate that these markers might be a useful guide to identify a subgroup of AF patients who require extensive ablation strategies. A 2-month postablation elevation in collagen turnover markers suggests that the wound healing process persists for that long after ablation. (J Cardiovasc Electrophysiol, Vol. 22, pp. 987-993, September 2011)