title: High plasma concentrations of transforming growth factor-β and tissue inhibitor of metalloproteinase-1: potential non-invasive predictors for electroanatomical remodeling of atrium in patients with non-valvular atrial fibrillation.
abstract: BACKGROUND
  The degree of electroanatomical remodeling of the left atrial (LA) affects the clinical outcome after rhythm control of atrial fibrillation (AF). Our hypothesis was that plasma concentrations of transforming growth factor (TGF)-β and tissue inhibitor of metalloproteinase (TIMP)-1 reflect LA voltage and structural remodeling in patients with non-valvular AF.
  
  
  RESULTS
  In the study, 242 patients (male 79.4%, 55.1 ± 11.0 years old) with AF (155 paroxysmal AF, 87 persistent AF) underwent catheter ablation. Pre-ablation plasma concentrations of TGF-β and TIMP-1 and the degree of electroanatomical remodeling quantified by LA voltage map (NavX) and 3D-CT were evaluated. The mean LA voltage and volume were compared in patients with high TGF-β (≥10.0 ng/ml, H-TGF) vs. low TGF-β (<10.0 ng/ml, L-TGF) and high TIMP-1 (≥1.1 ng/ml, H-TIMP) vs. low TIMP-1 (<1.1 ng/ml, L-TIMP). Patients with H-TGF had lower mean LA voltage (P=0.014) and greater LA volume (P=0.022), particularly, posterior venous LA volume (P=0.005) than those with L-TGF. In patients with H-TIMP, the mean LA voltage (P=0.019) was lower than those with L-TIMP. LA volume was significantly higher (P<0.001) in patients with ejection fraction ≤58% than those with >58%.
  
  
  CONCLUSIONS
  In patients with non-valvular AF, high plasma concentrations TGF-β and TIMP-1 and low ejection fraction were closely related with electroanatomical remodeling of LA.
authors.affiliation: Yonsei University Health System, 250 Seungsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Sook Kyoung
authors.initials: SK
authors.lastname: Kim
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
authors.forename: Jong Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Jong Il
authors.initials: JI
authors.lastname: Choi
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.forename: Sung Soon
authors.initials: SS
authors.lastname: Kim
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D022062:Electrophysiologic Techniques, Cardiac; D055724:Electrophysiological Phenomena / Q000502:physiology; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*; D016212:Transforming Growth Factor beta / Q000097:blood*
chemical_list: D015415:Biomarkers; D019715:Tissue Inhibitor of Metalloproteinase-1; D016212:Transforming Growth Factor beta