title: Atrial fibrillation-induced endothelial dysfunction improves after restoration of sinus rhythm.
abstract: 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
  Loge RH-PAT index (RHI) was significantly lower in the persistent AF group than in the control (SR) group (0.52 ± 0.20; 0.69 ± 0.24, p<0.01). Multivariate logistic regression analysis revealed that persistent AF was the only independent predictor of impaired endothelial function defined as loge RHI<0.6 (odds ratio, 4.96; 95% CI, 1.2 to 21.3; p<0.05). Loge RHI was significantly higher after ABL than before ABL (0.53±0.20; 0.73 ± 0.25; p<0.01) in the day 1-restored SR group. Loge 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.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoshikawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Sanemasa
authors.initials: S
authors.lastname: Ishida
authors.forename: Naoya
authors.initials: N
authors.lastname: Oketani
authors.forename: Keishi
authors.initials: K
authors.lastname: Saihara
authors.forename: Hideki
authors.initials: H
authors.lastname: Okui
authors.forename: So
authors.initials: S
authors.lastname: Kuwahata
authors.forename: Shoji
authors.initials: S
authors.lastname: Fujita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ichiki
authors.forename: Nami
authors.initials: N
authors.lastname: Ueya
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Iriki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Maenosono
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014463:Ultrasonography