title: Endothelial dysfunction in paroxysmal atrial fibrillation as a prothrombotic state. Comparison with permanent/persistent atrial fibrillation.
abstract: OBJECTIVE
  Atrial fibrillation (AF), regardless of subtype, is associated with a prothrombotic state, which is related to endothelial dysfunction (ED).We hypothesized that paroxysmal atrial fibrillation (PAF) patients have endothelial dysfunction, and this may partially explain the high thromboembolic risk and poorer outcome in this category of patients.
  
  
  METHODS
  The study population consisted of 100 consecutive outpatients with AF (mean age 65.9±7.9 years; 68 (68%) male) and 21 characteristics and comorbidity matched control subjects (mean age 64.8±7.0 years; 13 (61.9%) male). AF patients were divided into the PAF group (n=50) and permanent/persistent AF (PeAF) group (n=50).Reactive hyperemia pulse amplitude tonometry index (RHI) was measured to evaluate endothelial function.
  
  
  RESULTS
  RHI was significantly lower in the PAF (1.67±0.30) and PeAF (1.63±0.28) groups in comparison with control subjects (2.12±0.40, both p< 0.001). There was no significant difference in RHI between the PAF and PeAF groups (p= 0.88). On linear regression analysis, both PeAF and PAF are significant independent predictors of RHI.
  
  
  CONCLUSIONS
  In conclusion, ED in PAF patients was comparable to PeAF patients, and the presence of PAF itself is a contributing factor for ED independent of other coexisting comorbidities. This may provide a mechanism explaining why the risk of thromboembolism in PAF is comparable with PeAF patients.
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-chou, Kamagawa, Chiba, Japan. yuya8950@yahoo.co.jp
authors.forename: Yuya
authors.initials: Y
authors.lastname: Matsue
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masami
authors.initials: M
authors.lastname: Abe
authors.forename: Maki
authors.initials: M
authors.lastname: Ono
authors.forename: Mie
authors.initials: M
authors.lastname: Seya
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Ryota
authors.initials: R
authors.lastname: Iwatsuka
authors.forename: Akira
authors.initials: A
authors.lastname: Mizukami
authors.forename: Kentarou
authors.initials: K
authors.lastname: Toyama
authors.forename: Leon
authors.initials: L
authors.lastname: Kumasaka
authors.forename: Keita
authors.initials: K
authors.lastname: Handa
authors.forename: Wataru
authors.initials: W
authors.lastname: Nagahori
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ohno
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012306:Risk; D013923:Thromboembolism / Q000209:etiology; D019851:Thrombophilia / Q000150:complications*; D014652:Vascular Diseases