title: Transforming growth factor-β1 level and outcome after catheter ablation for nonparoxysmal atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrosis plays a role in the development of a vulnerable substrate for atrial fibrillation (AF). Transforming growth factor (TGF)-β(1) is related to the degree of atrial fibrosis and the recurrence of AF after surgical maze procedures. Whether TGF-β(1) is associated with the outcome after catheter ablation for AF remains unclear.
  
  
  OBJECTIVE
  The purpose of this study was to investigate whether plasma TGF-β(1) was an independent predictor of AF recurrence after catheter ablation.
  
  
  METHODS
  Two hundred consecutive AF patients (154 with paroxysmal AF and 46 with nonparoxysmal AF) underwent catheter ablation. Their TGF-β(1) levels and clinical and echocardiographic data were collected before ablation.
  
  
  RESULTS
  Thirty patients (65%) with nonparoxysmal AF and 57 (37%) with paroxysmal AF had AF recurrence after catheter ablation. Among patients with nonparoxysmal AF, those experiencing recurrence had higher TGF-β(1) levels than did those who did not experience recurrence (34.63 ± 11.98 ng/mL vs 27.33 ± 9.81 ng/mL; P = .026). In patients with paroxysmal AF, recurrence was not associated with different TGF-β(1) levels. In patients with nonparoxysmal AF, TGF-β(1) levels and left atrial diameter (LAD) were independent predictors of AF recurrence after catheter ablation. Moreover, TGF-β(1) levels had an incremental value over LAD in predicting AF recurrence after catheter ablation (global χ(2) of LAD alone: 6.3; LAD and TGF-β(1) levels: 11.9; increment in global χ(2) = 5.6; P = .013). Patients with small LAD and low TGF-β(1) levels had the lowest AF recurrence rate at 11%.
  
  
  CONCLUSIONS
  TGF-β(1) level is an independent predictor of AF recurrence in patients with nonparoxysmal AF and might be useful for identifying those patients likely to have better outcomes after catheter ablation.
authors.affiliation: Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Cheng-Hsueh
authors.initials: CH
authors.lastname: Wu
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chou
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.forename: Jo-Nan
authors.initials: JN
authors.lastname: Liao
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D004452:Echocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D016212:Transforming Growth Factor beta / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D016212:Transforming Growth Factor beta