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Wu S, Yuan C, Chen Z, Gao Y, Guo X, Chen R, Dai Y, Chen K. Genetically predicted systemic inflammation and the risk of atrial fibrillation: A bidirectional two-sample Mendelian randomization study. IJC HEART & VASCULATURE 2024; 52:101422. [PMID: 38756452 PMCID: PMC11096748 DOI: 10.1016/j.ijcha.2024.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
Background Systemic inflammation has been proposed to be associated with the incidence of atrial fibrillation (AF), but whether it is a cause or a consequence of AF remains uncertain. We sought to explore the causal associations between systemic inflammation and AF using bidirectional Mendelian randomization (MR) analysis. Methods Independent genetic variants strongly associated with AF were selected as instrumental variables from the largest genome-wide association study (GWAS) with up to 1,030,836 individuals. Regarding inflammation traits, genetic associations with 41 inflammatory cytokines and 5 inflammatory biomarkers were obtained from their corresponding GWASs databases. Effect estimates were primarily evaluated using the inverse-variance weighted (IVW) method, supplemented by sensitivity analyses using MR-Egger, weighted median, and MR-PRESSO methods. Results In our initial MR analyses, we observed suggestive associations of genetically predicted interleukin-17 (IL-17), interleukin-2 receptor subunit alpha (IL-2rα), and procalcitonin (PCT) with AF. One standard deviation (SD) increase in IL-17, IL-2rα, and PCT caused an increase in AF risk by 6.3 % (OR 1.063, 95 %CI 1.011---1.118, p = 0.018), 4.9 % (OR 1.049, 95 %CI 1.007---1.094, p = 0.023) and 3.4 % (OR 1.034, 95 %CI 1.005---1.064, p = 0.022), respectively. Furthermore, our reverse MR analyses indicated that genetically predicted AF contributed to a suggestive increase in the levels of macrophage inflammatory protein-1β (MIP1β) (β 0.055, 95 %CI 0.006 to 0.103, p = 0.028), while a decrease in the levels of fibrinogen (Fbg) (β -0.091, 95 %CI -0.140 to -0.041, p < 0.001), which remained significant after multiple test correction. Conclusions Our MR study identified several inflammatory biomarkers with suggestive causal associations regarding the upstream and downstream regulation of AF occurrence, offering new insights for therapeutic exploitation of AF. Further research is required to validate the underlying link between systemic inflammation and AF in larger cohorts.
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Affiliation(s)
- Sijin Wu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chenxi Yuan
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Zhongli Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Gao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaogang Guo
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ruohan Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Dai
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Keping Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Fang W, Xie S, Deng W. Epicardial Adipose Tissue: a Potential Therapeutic Target for Cardiovascular Diseases. J Cardiovasc Transl Res 2024; 17:322-333. [PMID: 37848803 DOI: 10.1007/s12265-023-10442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
With increased ageing of the population, cardiovascular disease (CVD) has become the most important factor endangering human health worldwide. Although the treatment of CVD has become increasingly advanced, there are still a considerable number of patients with conditions that have not improved. According to the latest clinical guidelines of the European Cardiovascular Association, obesity has become an independent risk factor for CVD. Adipose tissue includes visceral adipose tissue and subcutaneous adipose tissue. Many previous studies have focused on subcutaneous adipose tissue, but visceral adipose tissue has been rarely studied. However, as a type of visceral adipose tissue, epicardial adipose tissue (EAT) has attracted the attention of researchers because of its unique anatomical and physiological characteristics. This review will systematically describe the physiological characteristics and evaluation methods of EAT and emphasize the important role and treatment measures of EAT in CVD.
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Affiliation(s)
- Wenxi Fang
- Department of Cardiology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, 430060, People's Republic of China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, People's Republic of China
| | - Saiyang Xie
- Department of Cardiology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, 430060, People's Republic of China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, People's Republic of China
| | - Wei Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, 430060, People's Republic of China.
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, People's Republic of China.
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Yu B, Wei J, Zhao J, Fan H, Zhang W, Li X, Wang L, Zhang Y, Ren Z, Song X, Liu G, Liang B. The neutrophil-to-lymphocyte ratio is a potential biomarker for the occurrence of atrial fibrillation in patients with obstructive sleep apnea: A BIOMARKER OF AF IN OSA PATIENTS. Sleep Med 2023; 110:259-267. [PMID: 37669611 DOI: 10.1016/j.sleep.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) affects the occurrence of atrial fibrillation (AF) and usually coexists with AF. Chronic inflammation has been identified as an important factor in the development of AF, and the neutrophil-to-lymphocyte ratio (NLR) has been identified as a biomarker that positively correlates with the degree of inflammation. However, little information regarding how NLR correlates with AF in OSA patients. METHODS Our study enrolled 368 patients with OSA between September 2018 and April 2023. All data were collected after admission. Independently associated factors were assessed by multivariate logistic regression and then constructed a nomogram to predict AF risk. Nomogram's calculation model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The correlation between CHA2DS2-VASc scores and NLR was assessed using Spearman correlation. RESULTS Multivariate logistic regression showed that high level log-transformed NLR (OR, 1.664; 95% CI, 1.026-2.699; P = 0.039) was independently associated with the presence of AF in patients with OSA. The concordance index (0.817, 95% CI, 0.770-0.864), ROC curve, calibration curve, and DCA of the nomogram indicated this model had well clinical utility. Also, the nomogram's calculation model could identify patients who are at a higher risk of developing AF, and the CHA2DS2-VASc score was positively correlated with NLR in patients with AF (P < 0.05). CONCLUSION The elevated NLR may serve as a promising biomarker for assessing the risk of AF in individuals with OSA. The nomogram's calculation model may be utilized as a tool to estimate the probability of AF occurrence in OSA patients.
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Affiliation(s)
- Bing Yu
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Jian Wei
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Jianqi Zhao
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Hongxuan Fan
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Wenjing Zhang
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Xin Li
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Leigang Wang
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Yao Zhang
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Zhaoyu Ren
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Xiaosu Song
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Gaizhen Liu
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China
| | - Bin Liang
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road, Taiyuan, 030000, Shanxi, China.
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García-Seara J, González Melchor L, Rodríguez García J, Gude F, Martínez Sande JL, Rodríguez Mañero M, Fernández López XA, Minguito Carazo C, González Ferrero T, Eiras S, Lage R, Moscoso I, Bandín SF, Lago F, Alvarez E, Alvarez CV, González Juanatey JR. Role of Soluble ST2 Biomarker in Predicting Recurrence of Atrial Fibrillation after Electrical Cardioversion or Pulmonary Vein Isolation. Int J Mol Sci 2023; 24:14045. [PMID: 37762349 PMCID: PMC10531224 DOI: 10.3390/ijms241814045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This study aims to determine the predictive value of the soluble suppression of tumorigenicity 2 (sST2) biomarker in atrial fibrillation (AF) recurrence. This prospective, observational study included patients with AF referred for electrical cardioversion (ECV) or pulmonary vein isolation (PVI) procedures. Baseline characteristics were collected, and sST2 was determined at baseline and at 3 and 6 months of follow-up. sST2 was determined at baseline in a matched control group. Left atrial voltage mapping was performed in patients undergoing PVI. The sST2 maximal predictive capacity of AF recurrence was at the 3-month FU in the cohort of patients undergoing ECV with respect to 6-month AF recurrence with an AUC of 0.669, a cut-off point of 15,511 pg/mL, a sensitivity of 60.97%, and a specificity of 69.81%. The ROC curve of the sST2 biomarker at baseline and 3 months in the cohort of patients undergoing PVI showed AUCs of 0.539 and 0.490, respectively. The logistic regression model identified the rhythm (AF) and the sST2 biomarker at 3 months as independent factors for recurrence at 6 months in the ECV cohort. In the logistic regression model, sST2 was not an independent factor for recurrence at 6 months of follow-up in the PVI cohort. In patients who underwent ECV, sST2 values at 3 months may provide utility to predict AF recurrence at 6 months of follow-up. In patients who underwent PVI, sST2 had no value in predicting AF recurrence at 6 months of follow-up.
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Affiliation(s)
- Javier García-Seara
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Laila González Melchor
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Javier Rodríguez García
- Clinical Analysis Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Francisco Gude
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
- Epidemiology and Biostatistics Unit, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - José Luis Martínez Sande
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Moisés Rodríguez Mañero
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
- Cardiology Translational Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Xesús Alberte Fernández López
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Carlos Minguito Carazo
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Teba González Ferrero
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Sonia Eiras
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
- Cardiology Translational Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Ricardo Lage
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Cardiology Group, Centre for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Isabel Moscoso
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Cardiology Group, Centre for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Sandra Feijoo Bandín
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
- Cellular and Molecular Cardiology Unit and Department of Cardiology, Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Francisca Lago
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain;
- Cellular and Molecular Cardiology Unit and Department of Cardiology, Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Ezequiel Alvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Clara V. Alvarez
- Neoplasia & Endocrine Differentiation, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS), University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain;
| | - José Ramón González Juanatey
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (L.G.M.); (J.L.M.S.); (M.R.M.); (X.A.F.L.); (C.M.C.); (T.G.F.); (J.R.G.J.)
- Centro de Investigación Biomédica Cardiovascular en Red (CIBERCV), Institute of Health Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (S.E.); (R.L.); (I.M.); (S.F.B.); (F.L.)
- Neoplasia & Endocrine Differentiation, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS), University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain;
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Identification and Verification of Biomarkers and Immune Infiltration in Obesity-Related Atrial Fibrillation. BIOLOGY 2023; 12:biology12010121. [PMID: 36671813 PMCID: PMC9855995 DOI: 10.3390/biology12010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
Obesity is an independent risk factor for atrial fibrillation (AF). However, the mechanisms underlying this crosstalk are still being uncovered. Co-differentially expressed genes (co-DEGs) of AF and obesity microarrays were identified by bioinformatics analysis. Subsequently, functional enrichment, cell-type enrichment, and protein-protein interaction network analyses of co-DEGs were carried out. Then, we validated the hub genes by qRT-PCR of patients' blood samples. Finally, CIBERSORT was utilized to evaluate the AF microarray to determine immune infiltration and the correlation between validated hub genes and immune cells. A total of 23 co-up-regulated DEGs in AF and obesity microarrays were identified, and these genes were enriched in inflammation- and immune-related function. The enriched cells were whole blood, CD33+ myeloid, and CD14+ monocytes. The hub genes were identified as MNDA, CYBB, CD86, FCGR2C, NCF2, LCP2, TLR8, HLA-DRA, LCP1, and PTPN22. All hub genes were only elevated in blood samples of obese-AF patients. The CIBERSORT analysis revealed that the AF patients' left atrial appendage had increased infiltration of naïve B cells and decreased infiltration of memory B cells. The hub genes were related positively to naïve B cells and negatively to memory B cells. Ten hub genes may serve as biomarkers for obesity-related AF. These findings may also aid in comprehending pathophysiological mechanisms for obesity-related AF.
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Cui C, Qin H, Zhu X, Lu X, Wang B, Wang X, Wang J, Jiao J, Chu M, Wang C, Li M, Wang X, Wang D, Chen M. Unsupervised machine learning reveals epicardial adipose tissue subtypes with distinct atrial fibrosis profiles in patients with persistent atrial fibrillation: A prospective 2-center cohort study. Heart Rhythm 2022; 19:2033-2041. [PMID: 35934243 DOI: 10.1016/j.hrthm.2022.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epicardial adipose tissue (EAT) accumulation is associated with the progression of atrial fibrillation. However, the histological features of EATs are poorly defined and their correlation with atrial fibrosis is unclear. OBJECTIVE The purpose of this study was to identify and characterize EAT subgroups in the persistent atrial fibrillation (PeAF) cohorts. METHODS EATs and the corresponding left atrial appendage samples were obtained from patients with PeAF via surgical intervention. Adipocyte markers, that is, Uncoupling Protein 1, Transcription Factor 21, and CD137, were examined. On the basis of expression of adipocyte markers, patients with PeAF were categorized into subgroups by using unsupervised clustering analysis. Clinical characteristics, histological analyses, and outcomes were subsequently compared across the clusters. External validation was performed in a validation cohort. RESULTS The ranking of feature importance revealed that the 3 adipocyte markers were the most relevant factors for atrial fibrosis compared with other clinical indicators. On the k-medoids analysis, patients with PeAF could be categorized into 3 clusters in the discovery cohort. The histological studies revealed that patients in cluster 1 exhibited statistically larger size of adipocytes in EATs and severe atrial fibrosis in left atrial appendages. Findings were replicated in the validation cohort, where severe atrial fibrosis was noted in cluster 1. Moreover, in the validation cohort, there was a high degree of overlap between the supervised classification results and the unsupervised cluster results from the k-medoids method. CONCLUSION Machine learning-based cluster analysis could identify subtypes of patients with PeAF having distinct atrial fibrosis profiles. Additionally, EAT whitening (increased proportion of white adipocytes) may be involved in the process of atrial fibrosis.
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Affiliation(s)
- Chang Cui
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huiyuan Qin
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiyu Zhu
- Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaohu Lu
- Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Wang
- School of Medicine, Southeast University, Nanjing, China
| | - Xingyao Wang
- School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Junxia Wang
- Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jincheng Jiao
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Chu
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Cheng Wang
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mingfang Li
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaowei Wang
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dongjin Wang
- Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Minglong Chen
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
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Skoda I, Henningsson M, Stenberg S, Sundin J, Carlhäll C. Simultaneous Assessment of Left Atrial Fibrosis and Epicardial Adipose Tissue Using 3D Late Gadolinium Enhanced Dixon MRI. J Magn Reson Imaging 2022; 56:1393-1403. [PMID: 35128754 PMCID: PMC9790523 DOI: 10.1002/jmri.28100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Epicardial adipose tissue (EAT) may induce left atrium (LA) wall inflammation and promote LA fibrosis. Therefore, simultaneous assessment of these two important atrial fibrillation (AF) risk factors would be desirable. PURPOSE To perform a comprehensive evaluation of 3D Dixon water-fat separated late gadolinium enhancement (LGE-Dixon) MRI by analysis of repeatability and systematic comparison with reference methods for assessment of fibrosis and fat. STUDY TYPE Prospective. POPULATION Twenty-eight, 10, and 7 patients, respectively, with clinical indications for cardiac MRI. FIELD STRENGTH/SEQUENCE A 1.5-T scanner, inversion recovery multiecho spoiled gradient echo. ASSESSMENT Twenty-eight patients (age 58 ± 19 years, 15 males) were scanned using LGE-Dixon. A 5-point Likert-type scale was used to grade the image quality. Another 10 patients (age 46 ± 19 years, 9 males) were scanned using LGE-Dixon and 3D proton density Dixon (PD-Dixon). Finally, seven patients (age 62 ± 14 years, 4 males) were scanned using LGE-Dixon and conventional LGE. The scan time, intraobserver and interobserver variability, and levels of agreement were assessed. STATISTICAL TESTS Student's t-test, one-way ANOVA, and Mann-Whitney U-test were used; P < 0.05 was considered significant, intraclass correlation coefficient (ICC). RESULTS The scan time (minutes:seconds) for LGE-Dixon (n = 28) was 5:01 ± 1:40. ICC values for intraobserver and interobserver measurements of LA wall fibrosis percentage were 0.98 (95% CI, 0.97-0.99) and 0.97 (95% CI, 0.94-0.99) while of EAT were 0.92 (95% CI, 0.82-0.97) and 0.90 (95% CI, 0.80-0.95). The agreement for LA fibrosis percentage between the LGE-Dixon and the conventional LGE was 0.92 (95% CI, 0.66-0.99) and for EAT volume between the LGE-Dixon and the PD-Dixon was 0.93 (95% CI, 0.72-0.98). CONCLUSION LA fibrosis and EAT can be assessed simultaneously using LGE-Dixon. This method allows a high level of intraobserver and interobserver repeatability as well as agreement with reference methods and can be performed in a clinically feasible scan time. EVIDENCE LEVEL 2 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Iulia Skoda
- Department of Cardiology in LinköpingLinköping UniversityLinköpingSweden,Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Markus Henningsson
- Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden,Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
| | - Sofia Stenberg
- Department of Cardiology in LinköpingLinköping UniversityLinköpingSweden
| | - Jonathan Sundin
- Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden,Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
| | - Carl‐Johan Carlhäll
- Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden,Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden,Department of Clinical Physiology in LinköpingLinköping UniversityLinköpingSweden
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8
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Ren KW, Yu XH, Gu YH, Xie X, Wang Y, Wang SH, Li HH, Bi HL. Cardiac-specific knockdown of Bhlhe40 attenuates angiotensin II (Ang II)-Induced atrial fibrillation in mice. Front Cardiovasc Med 2022; 9:957903. [PMID: 36304536 PMCID: PMC9592817 DOI: 10.3389/fcvm.2022.957903] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Atrial fibrosis and atrial inflammation are associated with the pathogenesis of atrial fibrillation (AF). Basic helix–loop–helix family member E40 (Bhlhe40) is an important transcription factor, which is involved in tumors, inflammation, apoptosis, viral infection, and hypoxia. However, its role and molecular mechanism in AF remain unclear. In this study, a mouse model of AF was induced by Ang II infusion. The atrial diameter was evaluated using echocardiography. Induction and duration of AF were measured by programmed electrical stimulation. Atrial structural remodeling was detected using routine histologic examinations. Our results showed that Bhlhe40 was significantly upregulated in angiotensin II (Ang II)-stimulated atrial cardiomyocytes and atrial tissues and in tissues from patients with AF. Cardiac-specific knockdown of Bhlhe40 in mice by a type 9 recombinant adeno-associated virus (rAAV9)-shBhlhe40 significantly ameliorated Ang II-induced atrial dilatation, atrial fibrosis, and atrial inflammation, as well as the inducibility and duration of AF. Mechanistically, cardiac-specific knockdown of Bhlhe40 attenuated Ang II-induced activation of NF-κB/NLRP3, TGF-1β/Smad2 signals, the increased expression of CX43, and the decreased expression of Kv4.3 in the atria. This is the first study to suggest that Bhlhe40 is a novel regulator of AF progression, and identifying Bhlhe40 may be a new therapeutic target for hypertrophic remodeling and heart failure.
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Affiliation(s)
- Kai-Wen Ren
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiao-Hong Yu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu-Hui Gu
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xin Xie
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Wang
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shi-hao Wang
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hui-Hua Li
- Department of Emergency Medicine, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,*Correspondence: Hui-Hua Li,
| | - Hai-Lian Bi
- Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China,Hai-Lian Bi,
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9
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Mao Y, Zhao K, Li P, Sheng Y. The emerging role of leptin in obesity-associated cardiac fibrosis: evidence and mechanism. Mol Cell Biochem 2022; 478:991-1011. [PMID: 36214893 DOI: 10.1007/s11010-022-04562-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/15/2022] [Indexed: 11/24/2022]
Abstract
Cardiac fibrosis is a hallmark of various cardiovascular diseases, which is quite commonly found in obesity, and may contribute to the increased incidence of heart failure arrhythmias, and sudden cardiac death in obese populations. As an endogenous regulator of adiposity metabolism, body mass, and energy balance, obesity, characterized by increased circulating levels of the adipocyte-derived hormone leptin, is a critical contributor to the pathogenesis of cardiac fibrosis. Although there are some gaps in our knowledge linking leptin and cardiac fibrosis, this review will focus on the interplay between leptin and major effectors involved in the pathogenesis underlying cardiac fibrosis at both cellular and molecular levels based on the current reports. The profibrotic effect of leptin is predominantly mediated by activated cardiac fibroblasts but may also involve cardiomyocytes, endothelial cells, and immune cells. Moreover, a series of molecular signals with a known profibrotic property is closely involved in leptin-induced fibrotic events. A more comprehensive understanding of the underlying mechanisms through which leptin contributes to the pathogenesis of cardiac fibrosis may open up a new avenue for the rapid emergence of a novel therapy for preventing or even reversing obesity-associated cardiac fibrosis.
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Affiliation(s)
- Yukang Mao
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China.,Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Peng Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China.
| | - Yanhui Sheng
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China. .,Department of Cardiology, Jiangsu Province Hospital, Nanjing, Jiangsu, People's Republic of China.
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10
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Wu TC. First-Degree Atrioventricular Block: A Finding Not Always Benign! Arq Bras Cardiol 2022; 119:572-573. [PMID: 36287412 PMCID: PMC9563881 DOI: 10.36660/abc.20220643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Tan Chen Wu
- Instituto do Coração (InCor) - Unidade de Arritmia - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
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11
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Mechanism of Sevoflurane Anesthesia under Hypothermic Cardiopulmonary Bypass on Postoperative Atrial Fibrillation Rhythm in Patients Undergoing Mitral Valve Replacement. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5312897. [PMID: 35800224 PMCID: PMC9256416 DOI: 10.1155/2022/5312897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/11/2022] [Accepted: 04/25/2022] [Indexed: 11/23/2022]
Abstract
Objective It was to investigate the mechanism of atrial fibrillation after mitral valve replacement under extracorporeal circulation in patients with rheumatic heart disease under sevoflurane anesthesia maintenance and to provide scientific and effective basis for clinical treatment. Methods Forty patients with rheumatic heart disease who underwent mitral valve replacement were randomly rolled into group I (sinus rhythm of propofol anesthesia, n = 10), group II (atrial fibrillation rhythm of propofol anesthesia, n = 10), group III (sinus rhythm of sevoflurane anesthesia, n = 10), and group IV (atrial fibrillation rhythm of sevoflurane anesthesia, n = 10). Inflammatory factors, free tissue of right atrium, and incidence of postoperative atrial fibrillation were compared among all groups. Results (i) The serum levels of NT-proBNP, CRP, sST-2, IL-6, TNF-α, and TGF-β1 in group II were higher than those in group I, group III, and group IV, and the indexes in group III were higher than those in group IV (P < 0.05). (ii) The relative expression levels of PLB, CaMK II, Bax, and TP53 in the free tissue of right atrium in group II were higher than those in group I, III, and IV, and the index levels in group IV were higher than those in group III (P < 0.05). (iii) The incidence of postoperative atrial fibrillation in group III (0.00%) was significantly lower than that in group I (30%), group II (50%), and group IV (40.0%), and group II (50%) was the highest (P < 0.05). Conclusion The maintenance of sevoflurane anesthesia can improve the inflammatory response and myocardial tissue autophagy in patients with sinus rhythm and atrial fibrillation rhythm and can reduce the incidence of postoperative atrial fibrillation in patients.
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12
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Sun WP, Du X, Chen JJ. Biomarkers for Predicting the Occurrence and Progression of Atrial Fibrillation: Soluble Suppression of Tumorigenicity 2 Protein and Tissue Inhibitor of Matrix Metalloproteinase-1. Int J Clin Pract 2022; 2022:6926510. [PMID: 36683600 PMCID: PMC9825235 DOI: 10.1155/2022/6926510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Soluble suppression of tumorigenicity 2 protein (sST2) and tissue inhibitor of matrix metalloproteinase (TIMP)-1 are involved in multiple pathogenic pathways, including cardiac remodeling, which is the main pathology of atrial fibrillation (AF). This study aims to investigate the previously unexplored relationship between the serum levels of sST2, TIMP-1, and AF. METHODS This was a prospective cross-sectional study conducted at the Capital Medical University Affiliated Beijing Anzhen Hospital between June 2019 and July 2020, with a total of 359 participants. The clinical characteristics and laboratory results of the patients were compared, and multivariable ordinal logistic regression was used to evaluate the relationship between serum sST2, TIMP-1, and AF. RESULTS The participants included 110 patients with sinus rhythm (SR), 113 with paroxysmal AF (the paroxysmal AF group), and 136 with persistent AF (the persistent AF group). It was found that the sST2 levels gradually increased in these three groups, from 9.1 (6.7-12.4 pg/ml) in the SR group to 14.0 (10.4-20.8 pg/ml) in the paroxysmal AF group and to 19.0 (13.1-27.8) pg/ml) in the persistent AF group (p < 0.001). The multivariable ordinal logistic regression model for sST2 and TIMP-1 demonstrated that sST2 had an area under the receiver operating characteristic (ROC) curve (AUC) of 0.797 (95% confidence interval (CI) 0.749-0.846, p < 0.001) and TIMP-1 had an AUC of 0.795 (95% CI 0.750-0.841, p=0.000). The multivariable ordinal logistic regression model for sST2 and TIMP-1 showed good discrimination between SR and AF, with an AUC of 0.846, and the addition of clinical factors, such as brain natriuretic peptide (BNP), left atrial diameter, age, and gender, to the biomarker model improved the detection of SR and AF (AUC 0.901). CONCLUSIONS In this cohort study, sST2 and TIMP-1 were associated with AF progression, independent of clinical characteristics and biomarkers. Soluble ST2 and TIMP-1 combined with age, elevated N-terminal-pro hormone BNP(NT-BNP), and an enlarged left atrium were able to demonstrate the progression of AF reliably.
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Affiliation(s)
- Wei-Ping Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | - Xiao Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | - Jun-Jun Chen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
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13
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Chahine Y, Macheret F, Ordovas K, Kim J, Boyle PM, Akoum N. MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation. Front Cardiovasc Med 2022; 9:1045742. [PMID: 36531696 PMCID: PMC9755198 DOI: 10.3389/fcvm.2022.1045742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) plays a significant role in promoting atrial fibrillation (AF) due to its proinflammatory properties and anatomic proximity to the myocardium. We sought to assess whether left atrial (LA) EAT volume is associated with AF recurrence following catheter ablation. Methods EAT was assessed via the 3D MRI Dixon sequence in 101 patients undergoing AF ablation. Patients were followed for arrhythmia recurrence. Results During an average follow-up period of 1 year, post-ablation AF recurrence occurred in 31 (30.7%) patients. LA EAT index was higher in those with compared to without recurrence (20.7 [16.9, 30.4] vs. 13.7 [10.5, 20.1] mL/m2, p < 0.001), and so was LA volume index (66 [52.6, 77.5] vs. 49.9 [37.7, 61.8] mL/m2, p = 0.001). Cox regression analysis showed LA EAT (HR = 1.089; 95% CI: [1.049-1.131], p < 0.001) to be an independent predictor of post-ablation AF recurrence. The ROC curve for LA EAT index in the prediction of AF recurrence had an AUC of 0.77 (95% CI 0.68-0.86, p < 0.001) and showed an optimal cutoff value of 14.29 mL/m2 to identify patients at risk of post-ablation AF recurrence. Integrating LA EAT with clinical risk factors improved prediction of AF recurrence (AUC increased from 0.65 to 0.79, DeLong test p = 0.044). Kaplan-Meier analysis for recurrence-free survival showed a significant difference between two groups of patients identified by the optimal LA EAT index cutoff of 14.29 mL/m2 (log rank = 14.79; p < 0.001). Conclusion EAT quantified using cardiac MRI, a reproducible and widely accessible imaging parameter, is a strong and independent predictor of post-ablation AF recurrence.
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Affiliation(s)
- Yaacoub Chahine
- Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Fima Macheret
- Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Joonseok Kim
- Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Patrick M Boyle
- Department of Bioengineering, University of Washington, Seattle, WA, United States.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, United States.,Center for Cardiovascular Biology, University of Washington, Seattle, WA, United States
| | - Nazem Akoum
- Division of Cardiology, University of Washington, Seattle, WA, United States.,Department of Bioengineering, University of Washington, Seattle, WA, United States
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14
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Fender AC, Gawalko M, Dobrev D. Direct oral anticoagulation and severe obesity - One size fits all? IJC HEART & VASCULATURE 2021; 37:100923. [PMID: 34934804 PMCID: PMC8654775 DOI: 10.1016/j.ijcha.2021.100923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Indexed: 01/14/2023]
Abstract
Oral anticoagulation is obligatory in patients with atrial fibrillation (AF) to prevent thromboembolic stroke. Direct direct oral anticoagulants (DOAC) exhibit improved safety over Vitamin K antagonists, but any interference in haemostasis can impact on bleeding. Optimal anticoagulation remains challenging particularly in patients with co-morbidities. International Society of Thrombosis and Haemostasis (ISTH) guidelines recommend avoiding DOAC in patients with severe obesity, and systematic data on individual DOAC drug concentrations, clinical efficacy and safety in relation to body weight are lacking. A new study now provides reassurance that DOAC are safe and effective in a real-world cohort of morbidly obese patients, going some way to fill the knowledge gap pertaining to optimal management of concomitant obesity and AF.
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Affiliation(s)
- Anke C Fender
- Institute of Pharmacology, Medical Faculty, University Duisburg-Essen, Germany
| | - Monika Gawalko
- Institute of Pharmacology, Medical Faculty, University Duisburg-Essen, Germany.,Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.,1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Dobromir Dobrev
- Institute of Pharmacology, Medical Faculty, University Duisburg-Essen, Germany
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15
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Guo XJ, Qiu XB, Wang J, Guo YH, Yang CX, Li L, Gao RF, Ke ZP, Di RM, Sun YM, Xu YJ, Yang YQ. PRRX1 Loss-of-Function Mutations Underlying Familial Atrial Fibrillation. J Am Heart Assoc 2021; 10:e023517. [PMID: 34845933 PMCID: PMC9075371 DOI: 10.1161/jaha.121.023517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Atrial fibrillation (AF) is the most common form of clinical cardiac dysrhythmia responsible for thromboembolic cerebral stroke, congestive heart failure, and death. Aggregating evidence highlights the strong genetic basis of AF. Nevertheless, AF is of pronounced genetic heterogeneity, and in an overwhelming majority of patients, the genetic determinants underpinning AF remain elusive. Methods and Results By genome‐wide screening with polymorphic microsatellite markers and linkage analysis in a 4‐generation Chinese family affected with autosomal‐dominant AF, a novel locus for AF was mapped to chromosome 1q24.2–q25.1, a 3.20‐cM (≈4.19 Mbp) interval between markers D1S2851 and D1S218, with the greatest 2‐point logarithm of odds score of 4.8165 for the marker D1S452 at recombination fraction=0.00. Whole‐exome sequencing and bioinformatics analyses showed that within the mapping region, only the mutation in the paired related homeobox 1 (PRRX1) gene, NM_022716.4:c.319C>T;(p.Gln107*), cosegregated with AF in the family. In addition, sequencing analyses of PRRX1 in another cohort of 225 unrelated patients with AF revealed a new mutation, NM_022716.4:c.437G>T; (p.Arg146Ile), in a patient. The 2 mutations were absent in 908 control subjects. Biological analyses in HeLa cells demonstrated that the 2 mutants had significantly diminished transactivation on the target genes ISL1 and SHOX2 and markedly decreased ability to bind the promoters of ISL1 and SHOX2 (2 genes causally linked to AF), although with normal intracellular distribution. Conclusions This study first indicates that PRRX1 loss‐of‐function mutations predispose to AF, which provides novel insight into the molecular pathogenesis underpinning AF, implying potential implications for precisive prophylaxis and management of AF.
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Affiliation(s)
- Xiao-Juan Guo
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Xing-Biao Qiu
- Department of Cardiology Shanghai Chest HospitalShanghai Jiao Tong University Shanghai China
| | - Jun Wang
- Department of Cardiology Shanghai Jing'an District Central HospitalFudan University Shanghai China
| | - Yu-Han Guo
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Chen-Xi Yang
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Li Li
- Key Laboratory of Arrhythmias of the Ministry of Education of China Shanghai East HospitalTongji University School of Medicine Shanghai China.,Institute of Medical GeneticsTongji University Shanghai China
| | - Ri-Feng Gao
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Zun-Ping Ke
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Ruo-Min Di
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Yu-Min Sun
- Department of Cardiology Shanghai Jing'an District Central HospitalFudan University Shanghai China
| | - Ying-Jia Xu
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China
| | - Yi-Qing Yang
- Department of Cardiology and the Center for Complex Cardiac Arrhythmias of Minhang District Shanghai Fifth People's HospitalFudan University Shanghai China.,Cardiovascular Research Laboratory and Central Laboratory Shanghai Fifth People's HospitalFudan University Shanghai China
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16
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Sugrue A, Lin D. Cutting through the fat: Relationship between comorbidities and arrhythmias in hypertrophic cardiomyopathy. J Cardiovasc Electrophysiol 2021; 33:30-31. [PMID: 34845783 DOI: 10.1111/jce.15301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Alan Sugrue
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Lin
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Dai W, Chao X, Jiang Z, Zhong G. lncRNA KCNQ1OT1 may function as a competitive endogenous RNA in atrial fibrillation by sponging miR‑223‑3p. Mol Med Rep 2021; 24:870. [PMID: 34698362 PMCID: PMC8569515 DOI: 10.3892/mmr.2021.12510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022] Open
Abstract
Atrial fibrillation (AF) is one of the most common forms of cardiac arrhythmia. Novel evidence has indicated that a competing endogenous RNA (ceRNA) mechanism may occur in AF. The present study aimed to identify differentially expressed microRNAs (miRNAs/miRs) in AF and predict their targeting long non-coding RNAs (lncRNAs) to identify a potential ceRNA network involved in AF using bioinformatics analysis. The GSE68475 microarray dataset was downloaded from the Gene Expression Omnibus database and differentially expressed miRNAs in AF were obtained. In addition, right atrial appendage (RAA) tissues from patients with AF were collected to determine the expression levels of the miRNAs identified following bioinformatics analysis using reverse transcription-quantitative PCR (n=8 per group). Subsequently, Gene Ontology (GO) functional term and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analyses of the target genes of differentially expressed miRNAs of interest were performed. The potential upstream lncRNAs targeting the identified miRNAs were predicted using bioinformatics analysis. A dual luciferase reporter assay was used to verify the existence of a targeted relationship between the differentially expressed miRNA and lncRNA of interest. The results identified 43 differentially expressed miRNAs, including 23 upregulated miRNAs. The trends in the expression levels of miR-223-3p were inconsistent between the microarray data and those recorded in the RAA tissues from patients with persistent AF. Therefore, miR-223-3p was selected as the miRNA of interest for further investigations. The target gene of miR-233-3p was found to be enriched in 57 GO terms and 21 KEGG signaling pathways. According to the bioinformatics prediction, 69 lncRNAs targeting miR-223-3p were identified, including the lncRNA growth arrest-specific transcript 5, lncRNA KCNQ1 opposite strand/antisense transcript 1 (KCNQ1OT1) and lncRNA MYC-induced long non-coding RNA. The results from dual luciferase assay confirmed that miR-223-3p was a direct target of KCNQ1OT1. A ceRNA regulatory relationship may exist between KCNQ1OT1 and miR-223-3p in AF, providing therefore a novel potential research target for further studies.
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Affiliation(s)
- Weiran Dai
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Xiaoying Chao
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhiyuan Jiang
- Department of Hypertension, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Guoqiang Zhong
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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18
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ANGPTL4 Attenuates Ang II-Induced Atrial Fibrillation and Fibrosis in Mice via PPAR Pathway. Cardiol Res Pract 2021; 2021:9935310. [PMID: 34422410 PMCID: PMC8371667 DOI: 10.1155/2021/9935310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/16/2021] [Accepted: 07/29/2021] [Indexed: 12/19/2022] Open
Abstract
Atrial fibrillation (AF) is the more significant portion of arrhythmia in clinical practice, with inflammation and fibrosis as its central pathological mechanisms. This study aimed to investigate angiopoietin-like 4 (ANGPTL4) effects on angiotensin II- (Ang II-) induced AF and its related pathophysiological mechanisms. C57BL/6J mice were randomized and divided into three groups: the control group, the Ang II group, and the ANGPTL4 group (Ang II with ANGPTL4 treatment). Mice were infused with Ang II (2000 ng/kg/min) and were administrated with recombinant human ANGPTL4 (rhANGPTL4, 20 μg/kg/day) for 3 weeks. The fibrosis was evaluated with Masson's trichrome staining in the atrial myocardium. mRNA levels of IL-1β, IL-6, collagen I, and collagen III were measured using real-time qRT-PCR. Protein levels of PPARα, PPARγ, CPT-1, and SIRT3 were measured using Western blotting. Compared to the control group, the mice infused with Ang II showed electrocardiogram characteristics of AF, and this effect was markedly attenuated in ANGPTL4-treated mice. ANGPTL4 also reversed the increase in cardiomyocyte apoptosis, inflammation, interstitial collagen fraction, and collagen gene expression in mice with Ang II. Mechanistically, ANGPTL4 inhibited the activation of several fatty acid metabolism-related proteins, including PPARα, PPARγ, and CPT-1, and the expression of SIRT3 protein in atrial tissues. In conclusion, ANGPTL4 attenuates Ang II-induced AF and atrial fibrosis by modulation in the SIRT3, PPARα, and PPARγ signaling pathways.
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van der Bijl P, van Rosendael A, Bax JJ. Atrial positron emission tomography in atrial fibrillation: predicting radiofrequency catheter ablation success. Eur Heart J Cardiovasc Imaging 2021; 23:113-114. [PMID: 34151943 DOI: 10.1093/ehjci/jeab113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pieter van der Bijl
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Alexander van Rosendael
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
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Imaging Techniques for the Study of Fibrosis in Atrial Fibrillation Ablation: From Molecular Mechanisms to Therapeutical Perspectives. J Clin Med 2021; 10:jcm10112277. [PMID: 34073969 PMCID: PMC8197293 DOI: 10.3390/jcm10112277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
Atrial fibrillation (AF) is the most prevalent form of cardiac arrhythmia. It is often related to diverse pathological conditions affecting the atria and leading to remodeling processes including collagen accumulation, fatty infiltration, and amyloid deposition. All these events generate atrial fibrosis, which contribute to beget AF. In this scenario, cardiac imaging appears as a promising noninvasive tool for monitoring the presence and degree of LA fibrosis and remodeling. The aim of this review is to comprehensively examine the bench mechanisms of atrial fibrosis moving, then to describe the principal imaging techniques that characterize it, such as cardiac magnetic resonance (CMR) and multidetector cardiac computed tomography (MDCT), in order to tailor atrial fibrillation ablation to each individual.
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