Dynamics of Soluble Thrombomodulin and Circulating miRNAs in Patients with Atrial Fibrillation Undergoing Radiofrequency Catheter Ablation
Dynamics of Soluble Thrombomodulin and Circulating miRNAs in Patients with Atrial Fibrillation Undergoing Radiofrequency Catheter Ablation
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DOI：
10.1177/1076029619851570
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发表时间：
2019-05
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通讯作者：
Fuminori Namino;M. Yamakuchi;Yasuhisa Iriki;Hideki Okui;H. Ichiki;Ryuichi Maenosono;N. Oketani;I. Masamoto;M. Miyata;M. Horiuchi;T. Hashiguchi;M. Ohishi;I. Maruyama
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作者：
Fuminori Namino;M. Yamakuchi;Yasuhisa Iriki;Hideki Okui;H. Ichiki;Ryuichi Maenosono;N. Oketani;I. Masamoto;M. Miyata;M. Horiuchi;T. Hashiguchi;M. Ohishi;I. Maruyama
心房颤动（AF）是世界上最常见的心律失常，具有血栓栓塞的高风险。最有效的方法是导管消融，需要通过心电图进行评估。本研究的目的是研究预测导管消融术后窦性心律（SR）恢复的新临床标志物。78例房颤患者接受导管消融术，分为复律组和复发组，分别于消融前后检测血清和血浆中4种蛋白和3种成熟microRNA（miRNAs）及其初级miRNAs（pri-miRNAs）水平，并对各指标之间的相关性进行统计学分析。在恢复的SR中，消融后可溶性血栓调节蛋白（s-TM）和纤溶酶原激活物抑制剂-1（派-1）水平高于基线水平。（s-TM 11.55 [2.92] vs 13.75 [3.38]，P <0.001;派-1 25.74 [15.25] vs 37.79 [19.56]，P < .001）和复发性房颤（s-TM 10.28 [2.78] vs 11.67 [3.37]，P < .001;派-1 26.16 [15.70] vs 40.74 [22.55]，P < .001）组。C-反应蛋白和不对称二甲基精氨酸水平无显著变化。在复发性AF组中，消融术后Pri-miR-126水平显著降低，但其他miRNA和pri-miRNA没有降低。血中s-TM和pri-miR-126的测定可作为反映房颤患者导管消融情况的有效工具。
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world and has a high risk of thromboembolism. The most effective approach, catheter ablation, requires evaluation by electrocardiography. The aim of our study was to investigate novel clinical markers that predict restoration of sinus rhythm (SR) after catheter ablation. Seventy-eight consecutive patients with AF underwent catheter ablation and were separated into 2 groups: restored SR and recurrent AF. The levels of 4 blood proteins (serum or plasma) and 3 mature microRNAs (miRNAs) and their primary miRNAs (pri-miRNAs) in serum were measured before and after ablation, and the associations between each parameter were analyzed statistically. Soluble thrombomodulin (s-TM) and plasminogen activator inhibitor-1 (PAI-1) levels increased above baseline after ablation in both the restored SR (s-TM 11.55 [2.92] vs 13.75 [3.38], P < .001; PAI-1 25.74 [15.25] vs 37.79 [19.56], P < .001) and recurrent AF (s-TM 10.28 [2.78] vs 11.67 [3.37], P < .001; PAI-1 26.16 [15.70] vs 40.74 [22.55], P < .001) groups. Levels of C-reactive protein and asymmetric dimethylarginine were not significantly changed. Pri-miR-126 levels significantly decreased after ablation in the recurrent AF group, but the other miRNAs and pri-miRNAs did not. The measurement of s-TM and pri-miR-126 in blood was a useful tool to reflect the condition of AF patients with catheter ablation.