title: Increased levels of inflammatory and extracellular matrix turnover biomarkers persist despite reverse atrial structural remodeling during the first year after atrial fibrillation ablation.
abstract: OBJECTIVE
  Left atrial (LA) remodeling associated with atrial fibrillation (AF) is known to be related to inflammation and collagen turnover. We investigated the changes in the biomarkers of inflammation and collagen turnover in relation to LA reverse remodeling during the 1st year after AF ablation.
  
  
  METHODS
  Biomarkers of inflammation [high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6)] and collagen turnover [matrix metalloproteinase-2 (MMP-2), tissue inhibitor of MMP-2 (TIMP-2), transforming growth factor beta 1 (TGF-β1)], as well as asymmetric dimethylarginine (ADMA) and adiponectin levels were measured, and echocardiographic measurements were obtained before and 3, 6, and 12 months after ablation in 60 AF patients (49 males; age, 57.6 ± 10.9 years).
  
  
  RESULTS
  During a 12.1 (11.5-12.9)-month follow-up period, AF recurred in 29 patients (48 %). Neither the LA volume (LAV) nor the left ventricular ejection fraction (LVEF) changed significantly during the 1st year in this group, but the LAV decreased significantly, and the LVEF increased significantly in the nonrecurrence group. The hs-CRP and IL-6 decreased after ablation but returned near to baseline levels in both groups by 12 months. The MMP-2 remained increased during the 1st year in both groups, whereas the TIMP-2 increased markedly in the nonrecurrence group but did not change substantially in the recurrence group. The TGF-β1 increased in both groups, but the change was less pronounced in the recurrence group. The ADMA and adiponectin levels did not change substantially in either group.
  
  
  CONCLUSIONS
  Despite reverse remodeling, the inflammation and collagen turnover biomarker levels are quite progressive during the 1st year after ablation and may explain the late AF recurrence.
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mano
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Sonoda
authors.forename: Rikitake
authors.initials: R
authors.lastname: Kogawa
authors.forename: Kimie
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D052242:Adiponectin / Q000097:blood; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D001281:Atrial Fibrillation / Q000097:blood* / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D017115:Catheter Ablation / Q000379:methods*; D003952:Diagnostic Imaging; D004452:Echocardiography; D004562:Electrocardiography; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000097:blood; D016212:Transforming Growth Factor beta / Q000097:blood; D016896:Treatment Outcome
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D015850:Interleukin-6; D016212:Transforming Growth Factor beta; C487735:dimethylarginine; D019716:Tissue Inhibitor of Metalloproteinase-2; D002097:C-Reactive Protein; D001120:Arginine; D020778:Matrix Metalloproteinase 2