Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 1, January-February, p. 109–113
Publication type: original article
The influence of the atrial fibrillation episode duration on the endothelial function in patients treated with pulmonary veins isolation
1 1st Department of Cardiology, Medical University of Warsaw, Poland
2 Departament of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland
Background. Atrial fibrillation (AF) is associated with endothelial dysfunctions.
Objectives. The aim of the study was to assess the influence of the duration of an AF episode on the endothelial function.
Material and Methods. The study included 65 patients with persistent AF qualified for the percutaneous pulmonary veins isolation. Patients were divided into three subgroups with increasing time of the duration of AF episode, as follow: ≤ 7 months (n = 24 patients), from 7 to 14 months (n = 18 patients) and ≥ 14 months (n = 23 patients). Concentrations of endothelin-1 (ET-1), thrombomodulin (TM) and VEGF in serum were measured.
Results. Median age in the whole study group was 56 years with 84.6% of males. Patients with longer lasting AF episode had a higher body mass index and less incidence of heart failure. Median values of ET1, TM and VEGF were 3.1 (2.5–3.5) pg/mL, 3126.0 (2827.2–3594.1) pg/mL and 464.6 (323.6–630.1), respectively. Among increasing tertiles of AF episode duration, median ET-1 serum concentrations were as follows: 3.3 (2.8–3.7) pg/mL, 3.06 (2.6–3.4) pg/mL, 2.7 (2.3–3.2) pg/mL, p = 0.019, respectively. There was also a trend towards negative association of serum VEGF level with AF episode duration. Serum biomarkers’ levels were not associated with total AF duration.
Conclusion. AF episode duration may be associated with the endothelial function, assessed by serum biomarkers. ET-1 serum concentrations are significantly lower in patients with longer AF. ET-1, TM and VEGF have no correlation with total AF duration.
VEGF, endothelin-1, atrial fibrillation, thrombomodulin, endothelial function
- Halcox JP, Schenke WH, Zalos G, el al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002;106:653–658.
- Houde M, Desbiens L, D’Orléans-Juste P. Endothelin-1: Biosynthesis, signaling and vasoreactivity. Adv Pharmacol. 2016;77:143–175.
- Böhm F, Pernow J. The importance of endothelin-1 for vascular dysfunction in cardiovascular disease. Cardiovasc Res. 2007;76:8–18.
- Ito T, Kakihana Y, Maruyama I. Thrombomodulin as an intravascular safeguard against inflammatory and thrombotic diseases. Expert Opin Ther Targets. 2016;20:151–158.
- He H, Venema VJ, Gu X, Venema RC, Marrero MB, Caldwell RB. Vascular endothelial growth factor signals endothelial cell production of nitric oxide and prostacyclin through flk-1/KDR activation of c-Src. J Biol Chem. 1999;274:25130–25135.
- January CT, Wann LS, Alpert JS, el al. American College of Cardiology/American Heart Association. Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64:e1–76.
- Krishnamoorthy S, Lim SH, Lip GY. Assessment of endothelial (dys)function in atrial fibrillation. Ann Med. 2009;41:576–590.
- Iwasaki YK, Nishida K, Kato T, Nattel S. Atrial fibrillation pathophysiology: Implications for management. Circulation. 2011; 24:2264–2274.
- Yagi S, Akaike M, Aihara K, el al. Endothelial nitric oxide synthase–independent protective action of statin against angiotensin ii–induced atrial remodeling via reduced oxidant injury. Hypertension. 2010;55:918–923.
- Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92:1954–1968.
- Jiao W, Xu J, Zheng J, Shen Y, Lin L, Li J. Elevation of circulating big endothelin-1: An independent prognostic factor for tumor recurrence and survival in patients with esophageal squamous cell carcinoma. BMC Cancer. 2008;8:334.
- Stow LR, Jacobs ME, Wingo CS, Cain BD. Endothelin-1 gene regulation. FASEB J. 2011;25:16–28.
- Mayyas F, Niebauer M, Zurick A, el al. Association of left atrial endothelin-1 with atrial rhythm, size, and fibrosis in patients with structural heart disease. Circ Arrhythm Electrophysiol. 2010;3:369–379.
- Wozakowska-Kapłon B, Bartkowiak R, Janiszewska G, Grabowska U. Does atrial fibrillation affect plasma endothelin level? Cardiol J. 2010;17:471–476.
- Dézsi CA, Szücs A, Szücs G, el al. Short-term effect of rate control on plasma endothelin levels of patients with tachyarrhythmias. Exp Biol Med (Maywood). 2006;231:852–856.
- Mondillo S, Sabatini L, Agricola E, el al. Correlation between left atrial size, prothrombotic state and markers of endothelial dysfunction in patients with lone chronic nonrheumatic atrial fibrillation. Int J Cardiol. 2000;75:227–232.
- Waltenberger J. VEGF resistance as a molecular basis to explain the angiogenesis paradox in diabetes mellitus. Biochem Soc Trans. 2009;37:1167–1170.
- Kliche S, Waltenberger J. VEGF receptor signaling and endothelial function. IUBMB Life. 2001;52:61–66.
- Scridon A, Morel E, Nonin-Babary E, Girerd N, Fernandez C, Chevalier P. Increased intracardiac vascular endothelial growth factor levels in patients with paroxysmal, but not persistent atrial fibrillation. Europace. 2012;14:948–953.