title: Serum inflammation markers predicting successful initial catheter ablation for atrial fibrillation.
abstract: BACKGROUND
  We investigated various serum inflammatory markers to predict ablation responders who have no atrial fibrillation (AF) relapse after the initial ablation.
  
  
  METHODS
  Forty-four consecutive AF patients (age: 59 ± 8 years, paroxysmal: 31, CHADS₂: 1.1 ± 1.1) who underwent an initial pulmonary vein isolation were investigated. Various serum inflammatory markers, such as adiponectin, ANP, BNP, 1CTP, F1+2, hs-CRP, IL-6, intact P1NP, MDA-LDL, MMP-2, TGF-β, TIMP-2, and TNF-α, were evaluated prior to ablation. AF relapse was defined as AF documented in telemonitoring electrocardiograms twice a day during 9.7 ± 2.4 months of follow-up with three months of a blanking-period.
  
  
  RESULTS
  A total of 29 patients (paroxysmal: 21) maintained sinus rhythm after the initial catheter ablation. These ablation responders had significantly lower MMP-2 (Sinus vs. Relapsed: 748 ± 132.7 vs. 841.2 ± 152.4 ng/mL, P=0.042) and TNF-α (1.1 ± 0.4 vs. 1.8 ± 1.7 pg/mL, P=0.046) levels prior to ablation. A BNP-adjusted Cox multivariate regression analysis revealed that the independent predictive factor for AF recurrence was high MMP-2 levels (>766 ng/mL) accompanied by high TNF-α levels (>1.2 pg/mL).
  
  
  CONCLUSIONS
  The levels of MMP-2 and TNF-α might be useful for predicting initial AF catheter ablation responders.
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN. Electronic address: kimura@z7.keio.jp.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Seiji
authors.initials: S
authors.lastname: Takatsuki
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Kohei
authors.initials: K
authors.lastname: Inagawa
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Katsumata
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nishiyama
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nishiyama
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Aizawa
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tanimoto
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Tanimoto
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, JAPAN.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000601:surgery; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2
keywords: Atrial fibrillation; Catheter ablation; Follow-up, inflammation; Matrix metalloproteinase-2; Tumour necrosis factor-α