Differences in endothelial dysfunction induced by paroxysmal and persistent atrial fibrillation

Insights from restoration of sinus rhythm by catheter ablation

Keisuke Okawa, Toru Miyoshi, Saori Tsukuda, Syouhei Hara, Naoaki Matsuo, Noriyuki Nishibe, Masahiro Sogo, Tomoaki Okada, Kazumasa Nosaka, Kousuke Sakane, Masayuki Doi, Hiroshi Morita, Hiroshi Itoh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Atrial fibrillation (AF) is associated with endothelial dysfunction. Studies have shown the incidence of cardiovascular events to be greater in patients with persistent AF (PeAF) than paroxysmal AF (PAF). Objective: The aim of this study was to investigate whether endothelial dysfunction and the impact of catheter ablation on the endothelial function differs between PAF and PeAF. Methods: We prospectively measured the endothelial function by reactive hyperemia peripheral arterial tonometry (RH-PAT) in 103 PAF, 75 PeAF, and 51 control patients at baseline, with follow-up in the AF patients at 6 and 12. months after the catheter ablation. Results: The log-transformed RH-PAT index (ln RHI) was the highest in the control group, followed by the PAF and PeAF (0.67. ±. 0.23, 0.57. ±. 0.29, and 0.45. ±. 0.3, respectively, p <. 0.001) groups. PeAF was determined to be an independent factor of endothelial dysfunction (ln RHI <. 0.55) even after adjustment for the conventional cardiovascular risk factors. For 12. months after the catheter ablation, 102 (99%) PAF and 72 (96%) PeAF patients maintained sinus rhythm. On average, the ln RHI in the PAF group did not change during the follow-up, but it significantly increased in the PeAF group to a level comparable to that of the PAF patients 6. months after the catheter ablation (0.53. ±. 0.28, p = 0.034), and maintained the same level at 12. months after the catheter ablation. Conclusions: The persistent form of AF may independently contribute to endothelial dysfunction. In addition, by catheter ablation, the maintenance of sinus rhythm may protect against exacerbations of endothelial dysfunction.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Catheter Ablation
Atrial Fibrillation
Hyperemia
Manometry
Maintenance
Control Groups
Incidence

Keywords

  • Catheter ablation
  • Endothelial dysfunction
  • Paroxysmal atrial fibrillation
  • Persistent atrial fibrillation

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Differences in endothelial dysfunction induced by paroxysmal and persistent atrial fibrillation : Insights from restoration of sinus rhythm by catheter ablation. / Okawa, Keisuke; Miyoshi, Toru; Tsukuda, Saori; Hara, Syouhei; Matsuo, Naoaki; Nishibe, Noriyuki; Sogo, Masahiro; Okada, Tomoaki; Nosaka, Kazumasa; Sakane, Kousuke; Doi, Masayuki; Morita, Hiroshi; Itoh, Hiroshi.

In: International Journal of Cardiology, 2017.

Research output: Contribution to journalArticle

Okawa, Keisuke ; Miyoshi, Toru ; Tsukuda, Saori ; Hara, Syouhei ; Matsuo, Naoaki ; Nishibe, Noriyuki ; Sogo, Masahiro ; Okada, Tomoaki ; Nosaka, Kazumasa ; Sakane, Kousuke ; Doi, Masayuki ; Morita, Hiroshi ; Itoh, Hiroshi. / Differences in endothelial dysfunction induced by paroxysmal and persistent atrial fibrillation : Insights from restoration of sinus rhythm by catheter ablation. In: International Journal of Cardiology. 2017.
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title = "Differences in endothelial dysfunction induced by paroxysmal and persistent atrial fibrillation: Insights from restoration of sinus rhythm by catheter ablation",
abstract = "Background: Atrial fibrillation (AF) is associated with endothelial dysfunction. Studies have shown the incidence of cardiovascular events to be greater in patients with persistent AF (PeAF) than paroxysmal AF (PAF). Objective: The aim of this study was to investigate whether endothelial dysfunction and the impact of catheter ablation on the endothelial function differs between PAF and PeAF. Methods: We prospectively measured the endothelial function by reactive hyperemia peripheral arterial tonometry (RH-PAT) in 103 PAF, 75 PeAF, and 51 control patients at baseline, with follow-up in the AF patients at 6 and 12. months after the catheter ablation. Results: The log-transformed RH-PAT index (ln RHI) was the highest in the control group, followed by the PAF and PeAF (0.67. ±. 0.23, 0.57. ±. 0.29, and 0.45. ±. 0.3, respectively, p <. 0.001) groups. PeAF was determined to be an independent factor of endothelial dysfunction (ln RHI <. 0.55) even after adjustment for the conventional cardiovascular risk factors. For 12. months after the catheter ablation, 102 (99{\%}) PAF and 72 (96{\%}) PeAF patients maintained sinus rhythm. On average, the ln RHI in the PAF group did not change during the follow-up, but it significantly increased in the PeAF group to a level comparable to that of the PAF patients 6. months after the catheter ablation (0.53. ±. 0.28, p = 0.034), and maintained the same level at 12. months after the catheter ablation. Conclusions: The persistent form of AF may independently contribute to endothelial dysfunction. In addition, by catheter ablation, the maintenance of sinus rhythm may protect against exacerbations of endothelial dysfunction.",
keywords = "Catheter ablation, Endothelial dysfunction, Paroxysmal atrial fibrillation, Persistent atrial fibrillation",
author = "Keisuke Okawa and Toru Miyoshi and Saori Tsukuda and Syouhei Hara and Naoaki Matsuo and Noriyuki Nishibe and Masahiro Sogo and Tomoaki Okada and Kazumasa Nosaka and Kousuke Sakane and Masayuki Doi and Hiroshi Morita and Hiroshi Itoh",
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TY - JOUR

T1 - Differences in endothelial dysfunction induced by paroxysmal and persistent atrial fibrillation

T2 - Insights from restoration of sinus rhythm by catheter ablation

AU - Okawa, Keisuke

AU - Miyoshi, Toru

AU - Tsukuda, Saori

AU - Hara, Syouhei

AU - Matsuo, Naoaki

AU - Nishibe, Noriyuki

AU - Sogo, Masahiro

AU - Okada, Tomoaki

AU - Nosaka, Kazumasa

AU - Sakane, Kousuke

AU - Doi, Masayuki

AU - Morita, Hiroshi

AU - Itoh, Hiroshi

PY - 2017

Y1 - 2017

N2 - Background: Atrial fibrillation (AF) is associated with endothelial dysfunction. Studies have shown the incidence of cardiovascular events to be greater in patients with persistent AF (PeAF) than paroxysmal AF (PAF). Objective: The aim of this study was to investigate whether endothelial dysfunction and the impact of catheter ablation on the endothelial function differs between PAF and PeAF. Methods: We prospectively measured the endothelial function by reactive hyperemia peripheral arterial tonometry (RH-PAT) in 103 PAF, 75 PeAF, and 51 control patients at baseline, with follow-up in the AF patients at 6 and 12. months after the catheter ablation. Results: The log-transformed RH-PAT index (ln RHI) was the highest in the control group, followed by the PAF and PeAF (0.67. ±. 0.23, 0.57. ±. 0.29, and 0.45. ±. 0.3, respectively, p <. 0.001) groups. PeAF was determined to be an independent factor of endothelial dysfunction (ln RHI <. 0.55) even after adjustment for the conventional cardiovascular risk factors. For 12. months after the catheter ablation, 102 (99%) PAF and 72 (96%) PeAF patients maintained sinus rhythm. On average, the ln RHI in the PAF group did not change during the follow-up, but it significantly increased in the PeAF group to a level comparable to that of the PAF patients 6. months after the catheter ablation (0.53. ±. 0.28, p = 0.034), and maintained the same level at 12. months after the catheter ablation. Conclusions: The persistent form of AF may independently contribute to endothelial dysfunction. In addition, by catheter ablation, the maintenance of sinus rhythm may protect against exacerbations of endothelial dysfunction.

AB - Background: Atrial fibrillation (AF) is associated with endothelial dysfunction. Studies have shown the incidence of cardiovascular events to be greater in patients with persistent AF (PeAF) than paroxysmal AF (PAF). Objective: The aim of this study was to investigate whether endothelial dysfunction and the impact of catheter ablation on the endothelial function differs between PAF and PeAF. Methods: We prospectively measured the endothelial function by reactive hyperemia peripheral arterial tonometry (RH-PAT) in 103 PAF, 75 PeAF, and 51 control patients at baseline, with follow-up in the AF patients at 6 and 12. months after the catheter ablation. Results: The log-transformed RH-PAT index (ln RHI) was the highest in the control group, followed by the PAF and PeAF (0.67. ±. 0.23, 0.57. ±. 0.29, and 0.45. ±. 0.3, respectively, p <. 0.001) groups. PeAF was determined to be an independent factor of endothelial dysfunction (ln RHI <. 0.55) even after adjustment for the conventional cardiovascular risk factors. For 12. months after the catheter ablation, 102 (99%) PAF and 72 (96%) PeAF patients maintained sinus rhythm. On average, the ln RHI in the PAF group did not change during the follow-up, but it significantly increased in the PeAF group to a level comparable to that of the PAF patients 6. months after the catheter ablation (0.53. ±. 0.28, p = 0.034), and maintained the same level at 12. months after the catheter ablation. Conclusions: The persistent form of AF may independently contribute to endothelial dysfunction. In addition, by catheter ablation, the maintenance of sinus rhythm may protect against exacerbations of endothelial dysfunction.

KW - Catheter ablation

KW - Endothelial dysfunction

KW - Paroxysmal atrial fibrillation

KW - Persistent atrial fibrillation

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DO - 10.1016/j.ijcard.2017.06.038

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