Atrial Fibrillation SuPAR, MMP-2, HsCRP Level And Radiofrequency Ablation Outcomes Discussed

BackgroundAtrial fibrillation (AF) is the most common arrhythmia in clinical work. And its prevalence is increasing as the population ages. AF confers higher risk of stroke, increases the total mortality, and decreases the quality of life significantly. In recent years, radiofrequency ablation procedure has become an important means for the treatment of AF. Because of the relative higher expense and risk of the procedure, it is important to find the predictors of recurrence after the procedure. The impact of inflammation factors in AF and its value in the prediction of recurrence after RFCA have become the focus of recent clinical research. Recently it is reported that high sensitivity C-reactive protein (hsCRP) and matrix metalloproteinases are valuable in the recurrence prediction, but controversy still exists. Soluble urokinase-type plasminogen activator receptor (suPAR) is another inflammation factor that is the cleavage form of the urokinase-type plasminogen activator receptor (uPAR). Recent research shows that suPAR is related to the risk of cardiovascular disease, but the level of suPAR in AF patients and its relationship with AF recurrence are still unknown.Objectives1. To research the difference of the baseline suPAR, MMP-2, hsCRP levels between AF patients and the control group.2. To research the change of the inflammation factor levels after the RFCA procedure.3. To research the recurrence of AF after RFCA and the relative clinical factors, and to research the relationship between the levels of suPAR, MMP-2and hsCRP and the recurrence.Methods1. The AF patients that underwent RFCA in the cardiology department of Peking Union medical college hospital between July,2011and February,2012were included in this research. The clinical data and blood samples at baseline were collected. The recurrence in the follow-up was recorded.2. The subjects of the control group are selected from the people that underwent phisycal examination at the PUMCH physical examination center in May,2012. The age, gender, and history of hypertension, diabetes mellitus, CVD and smoking were matched with the AF group. Anyone with AF history or other kinds of arrhythmia was concluded.3. The plasma levels of MMP-2and suPAR were determined with double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). The serum levels of hsCRP were determined with immune transmission turbidity method. The baseline levels of inflammation factors were detected and the relationships with AF were analyzed.4. The levels of inflammation factors at baseline and after the RFCA procedure were determined.5. The relativity and value of inflammation factors in the recurrence of AF after RFCA were analyzed.Result1. The baseline level of plasma MMP-2in the persistent AF patients is significantly higher than the control group, and the baseline level of plasma suPAR in the paroxysmal AF patients is lower than the control group.2. The plasma level of suPAR in AF patients is positively related to age and the levels of serum creatine (SCr), hsCRP and MMP-2.3. The level of hsCRP increases greatly at1-4days after ablation. The amplitude in the patients with early recurrence of AF in one week after ablation is significantly higher than the patients without recurrence. However the early recurrence shows no relationship with the recurrence during follow-up.4. There are no significant differences between the levels of baseline MMP-2, suPAR and hsCRP in the recurrence gtoup and non-recurrence group.5. There are no significant differences between the left atrial dimensions and left atrial volumes of the recurrence group and non-recurrence group, the left atrial volume index (LAVI) of the recurrence group is significantly higher than the non-recurrence group.Conclusions1. In this research the baseline MMP-2, suPAR and hsCRP levels cannot predict the AF recurrence after RFCA.2. The early AF recurrence in one week after RFCA is related the increase of inflammation level. 3. The increase of LAVI is better related to the risk of AF recurrence after RFCA than left atrial dimension and volume.