Atrial fibrillation-induced endothelial dysfunction improves after restoration of sinus rhythm

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• 作者：Satoshi Yoshino ; Akiko Yoshikawa ; Shuichi Hamasaki ; Sanemasa Ishida ; Naoya Oketani ; Keishi Saihara ; Hideki Okui ; So Kuwahata ; Shoji Fujita ; Hitoshi Ichiki ; Nami Ueya ; Yasuhisa Iriki ; Ryuichi Maenosono ; Masaaki Miyata ; Chuwa Tei
• 关键词：Atrial fibrillation ; Endothelial dysfunction ; Restoration of sinus rhythm ; Reactive hyperemia peripheral arterial tonometry (RH-PAT) ; RH-PAT index (RHI)
• 刊名：International Journal of Cardiology
• 出版年：2013
• 出版时间：30 September, 2013
• 年：2013
• 卷：168
• 期：2
• 页码：1280-1285
• 全文大小：588 K

文摘

Background

Recent evidence suggests that atrial fibrillation (AF) adversely affects endothelial function. The goal of this study was to assess endothelial function in patients with AF before and after restoration of sinus rhythm by catheter ablation (ABL).

Methods

Reactive hyperemia peripheral arterial tonometry (RH-PAT) measurements reflecting endothelial function were conducted with Endo-PAT2000 (Itamar Medical, Caesarea, Israel) in 27 patients with persistent AF before ABL and in 21 control subjects with sinus rhythm (SR). According to cardiac rhythm on the morning after ABL, patients were divided into two groups: day 1-restored SR group (n = 19) and day 1-recurred AF group (n = 8). Based on the cardiac rhythm at 6 months after ABL, the restored SR group was further subdivided into the month 6-maintained SR group (n = 11) and the month 6-recurred AF group (n = 6).

Results

Log_e RH-PAT index (RHI) was significantly lower in the persistent AF group than in the control (SR) group (0.52 ¡À 0.20; 0.69 ¡À 0.24, p < 0.01). Multivariate logistic regression analysis revealed that persistent AF was the only independent predictor of impaired endothelial function defined as log_e RHI < 0.6 (odds ratio, 4.96; 95 % CI, 1.2 to 21.3; p < 0.05). Log_e RHI was significantly higher after ABL than before ABL (0.53 ¡À 0.20; 0.73 ¡À 0.25; p < 0.01) in the day 1-restored SR group. Log_e RHI of the month 6-maintained SR group was comparable to that of the day 1-restored SR group.

Conclusions

These results suggest that AF is associated with impairment of endothelial dysfunction and that this impairment is reversed by restoration of sinus rhythm.