Inflammation in lone atrial fibrillation: new insights by coronary sinus thermography.
BACKGROUND
In the clinical setting there are conflicting results regarding the role of inflammatory activation in atrial fibrillation (AF). Coronary sinus (CS) thermography assesses myocardial heat production and is correlated with inflammatory states. We investigated in patients with AF whether 1) there is increased CS blood temperature and 2) the correlation of heat production with systemic inflammation.


METHODS
We included patients with AF and subjects with sinus rhythm. C-reactive protein (CRP) levels were measured in all patients. CS and right atrium (RA) blood temperature measurements were performed by a dedicated 7F thermography catheter. DeltaT was calculated by subtracting RA from CS blood temperature.


RESULTS
We included 47 patients with AF and 23 subjects with sinus rhythm. We stratified patients with AF into two groups: normotensive (AFN) and hypertensive (AFH). DeltaT was lower in the RA compared with the CS in AFH (37.27+/-0.52 degrees C vs 37.47+/-0.54 degrees C, p<0.01), in AFN (37.13+/-0.53 degrees C vs 37.34+/-0.54 degrees C, p<0.01), and in controls (37.41+/-0.69 degrees C vs 37.55+/-0.68 degrees C, p<0.01). DeltaTau was greater in AFH, and AFN compared to controls (0.20+/-0.07 degrees C, 0.20+/-0.08 degrees C, vs 0.14+/-0.06 degrees C, p<0.01). DeltaT was similar between AFH and AFN (p=0.95). CRP was higher in AFH and AFN compared to controls (1.72+/-0.85 mg/Dl, 1.69+/-0.94 mg/dL, 0.98+/-0.71 mg/dL, p<0.01). CRP was similar between AFH and AFN (p=0.87). A correlation between CRP with DeltaT was observed in AFH and AFN (R=0.58, p<0.01, R=0.44, p=0.02).


CONCLUSIONS
Patients with AF have increased myocardial heat production, which is correlated to the systemic inflammation. CS blood temperature measurement may provide significant information for the pathogenesis of AF.
Toutouzas
Konstantinos
K
First Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece. ktoutouz@otenet.gr
Drakopoulou
Maria
M
Dilaveris
Polychronis
P
Vaina
Sophia
S
Gatzoulis
Kostas
K
Karabelas
John
J
Riga
Maria
M
Stefanadi
Elli
E
Synetos
Andreas
A
Vlasis
Konstantinos
K
Stefanadis
Christodoulos
C
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000473:pathology*; D001831:Body Temperature / Q000502:physiology; D054326:Coronary Sinus / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis / Q000473:pathology*; D013817:Thermography / Q000379:methods*