Source of inflammatory markers in patients with atrial fibrillation
Source of inflammatory markers in patients with atrial fibrillation
复制标题
DOI：
10.1093/europace/eun111
复制
发表时间：
2008-07-01
期刊：
影响因子：
6.1
通讯作者：
Walfridsson, Hakan
中科院分区：
文献类型：
--
作者：
Liuba, Ioan;Ahlmroth, Henrik;Walfridsson, Hakan
在一些房颤（AF）患者中报告了C反应蛋白和其他炎症标志物水平升高。这一发现是否与房颤本身或其他疾病有关尚不清楚。此外，炎症标志物的来源不明。因此，在本研究中，我们试图评估AF患者的炎症程度和来源，并且没有其他伴随的心脏或炎症状况。10例阵发性AF患者，8例永久性AF患者，和10例无AF证据的Wolf-Parkinson-白色综合征（WPW）对照患者（平均年龄54 +/- 11 vs. 57 +/- 13 vs. 43 +/- 16）。没有患者患有结构性心脏病或炎症性疾病。从股静脉、右心房、冠状窦和左上肺静脉和右上肺静脉采集血样，评估高敏C反应蛋白、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）。所有样本均在消融前采集。与对照组和阵发性房颤患者相比，永久性房颤患者的股静脉、右心房和冠状静脉窦样本中IL-8的血浆水平较高，但肺静脉样本中的IL-8水平不高（股静脉中位值：2.58 vs. 2.97 vs. 4.66 pg/mL，P = 0.003;右心房：2.30 vs. 3.06 vs. 3.93 pg/mL，P = 0.013;冠状窦：2.85 vs. 3.15 vs. 4.07，P = 0.016）。血清IL-8水平之间存在高度相关性（r = 0.929 ~ 0.976，P < 0.05）。三组患者的C-反应蛋白和IL-6水平无差异。永久性房颤患者的C-反应蛋白和IL-6水平正常，IL-8水平升高，而阵发性房颤患者则没有，这表明轻度炎症反应和长期房颤之间存在联系。外周血、右心房、和冠状窦，但不是在肺静脉提示一个可能的来源炎症的体循环。
Elevated levels of C-reactive protein and other inflammatory markers have been reported in some patients with atrial fibrillation (AF). Whether this finding is related to AF per se or to other conditions remains unclear. In addition, the source of inflammatory markers is unknown. Therefore, in the present study, we sought to assess the extent and the source of inflammation in patients with AF and no other concomitant heart or inflammatory conditions.The study group consisted of 29 patients referred for radiofrequency catheter ablation: 10 patients with paroxysmal AF, 8 patients with permanent AF, and 10 control patients with Wolf-Parkinson-White (WPW) syndrome and no evidence of AF (mean age 54 +/- 11 vs. 57 +/- 13 vs. 43 +/- 16). No patient had structural heart diseases or inflammatory conditions. High-sensitive C-reactive protein, interleukin-6 (IL-6), and interleukin-8 (IL-8) were assessed in blood samples from the femoral vein, right atrium, coronary sinus, and the left and right upper pulmonary veins. All samples were collected before ablation. Compared with controls and patients with paroxysmal AF, patients with permanent AF had higher plasma levels of IL-8 in the samples from the femoral vein, right atrium, and coronary sinus, but not in the samples from the pulmonary veins (median values in the femoral vein: 2.58 vs. 2.97 vs. 4.66 pg/mL, P = 0.003; right atrium: 2.30 vs. 3.06 vs. 3.93 pg/mL, P = 0.013; coronary sinus: 2.85 vs. 3.15 vs. 4.07, P = 0.016). A high-degree correlation existed between the IL-8 levels in these samples (correlation coefficient between 0.929 and 0.976, P < 0.05). No differences in the C-reactive protein and IL-6 levels were noted between the three groups of patients.The normal levels of C-reactive protein and IL-6, along with the elevated levels of IL-8 in patients with permanent AF but not in those with paroxysmal AF, suggest a link between a low-grade inflammatory reaction and long-lasting AF. The elevated IL-8 levels in the peripheral blood, right atrium, and coronary sinus but not in the pulmonary veins suggest a possible source of inflammation in the systemic circulation.