Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Fibrosis Marker Soluble ST2 Predicts Atrial Fibrillation Recurrence after Cryoballoon Catheter Ablation of Nonvalvular Paroxysmal Atrial Fibrillation

  • Okar, Sefa (Department of Cardiology, University of Health Sciences, Adana Health Practices and Research Center) ;
  • Kaypakli, Onur (Department of Cardiology, Mustafa Kemal University, Faculty of Medicine) ;
  • Sahin, Durmus Yildiray (Department of Cardiology, University of Health Sciences, Adana Health Practices and Research Center) ;
  • Koc, Mevlut (Department of Cardiology, University of Health Sciences, Adana Health Practices and Research Center)
  • Received : 2018.02.07
  • Accepted : 2018.04.18
  • Published : 2018.10.31
⟨ Previous Next ⟩

Abstract

Background and Objectives: We aimed to investigate the relationship between the recurrence of atrial fibrillation (AF) and fibrosis marker soluble ST2 (sST2) in patients with nonvalvular paroxysmal AF (PAF). Methods: We prospectively included 100 consecutive patients with PAF diagnosis and scheduled for cryoballoon catheter ablation for AF (47 males, 53 females; mean age $55.1{\pm}10.8\;years$). sST2 plasma levels were determined using the ASPECT-PLUS assay on ASPECT Reader device (Critical Diagnostics). The measurement range of these measurements was 12.5-250 ng/mL. Patients had regular follow-up visits with 12-lead electrocardiogram (ECG), medical history, and clinical evaluation. Twenty-four hours Holter ECG monitoring had been recorded 12 months after ablation. Results: AF recurrence was detected in 22 patients after 1 year. Age, smoking history, diabetes mellitus,hypertension frequency, angiotensin converting enzyme inhibitor-angiotensin receptor blocker use, $CHA_2DS_2VASc$ and HAS-BLED scores, serum sST2 level, left atrium (LA) end-diastolic diameter, LA volume and LA volume index were related to AF recurrence. In multivariable logistic regression analysis, sST2 was found to be only independent parameter for predicting AF recurrence (odds ratio, 1.085; p=0.001). Every 10-unit increase in sST2 was found to be associated with 2.103-fold increase in the risk of AF recurrence. The cut-off value of sST2 obtained by receiver operating characteristic curve analysis was 30.6 ng/mL for prediction of AF recurrence (sensitivity: 77.3%, specificity: 79.5%). The area under the curve was 0.831 (p<0.001). Conclusions: sST2, which is associated with atrial fibrosis, can be thought to be a useful marker for detection of patients with high-grade fibrosis who will get less benefit from cryoablation.

Keywords

References

  1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation 2014;129:837-47. https://doi.org/10.1161/CIRCULATIONAHA.113.005119
  2. Allessie MA, de Groot NM, Houben RP, Schotten U, Boersma E, Smeets JL. Electropathological substrate of long-standing persistent atrial fibrillation in patients with structural heart disease: longitudinal dissociation. Circ Arrhythm Electrophysiol 2010;3:606-15. https://doi.org/10.1161/CIRCEP.109.910125
  3. Anne W, Willems R, Roskams T, et al. Matrix metalloproteinases and atrial remodeling in patients with mitral valve disease and atrial fibrillation. Cardiovasc Res 2005;67:655-66. https://doi.org/10.1016/j.cardiores.2005.04.016
  4. Shinagawa K, Shi YF, Tardif JC, Leung TK, Nattel S. Dynamic nature of atrial fibrillation substrate during development and reversal of heart failure in dogs. Circulation 2002;105:2672-8. https://doi.org/10.1161/01.CIR.0000016826.62813.F5
  5. Sonmez O, Ertem FU, Vatankulu MA, et al. Novel fibro-inflammation markers in assessing left atrial remodeling in nonvalvular atrial fibrillation. Med Sci Monit 2014;20:463-70. https://doi.org/10.12659/MSM.890635
  6. Parikh RH, Seliger SL, Christenson R, Gottdiener JS, Psaty BM, deFilippi CR. Soluble ST2 for prediction of heart failure and cardiovascular death in an elderly, community-dwelling population. J Am Heart Assoc 2016;5:e003188.
  7. Ky B, French B, McCloskey K, et al. High-sensitivity ST2 for prediction of adverse outcomes in chronic heart failure. Circ Heart Fail 2011;4:180-7. https://doi.org/10.1161/CIRCHEARTFAILURE.110.958223
  8. Rienstra M, Yin X, Larson MG, et al. Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation. Am Heart J 2014;167:109-115.e2. https://doi.org/10.1016/j.ahj.2013.10.003
  9. Dieplinger B, Egger M, Gegenhuber A, Haltmayer M, Mueller T. Analytical and clinical evaluation of a rapid quantitative lateral flow immunoassay for measurement of soluble ST2 in human plasma. Clin Chim Acta 2015;451:310-5. https://doi.org/10.1016/j.cca.2015.10.015
  10. Neumann T, Vogt J, Schumacher B, et al. Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. J Am Coll Cardiol 2008;52:273-8. https://doi.org/10.1016/j.jacc.2008.04.021
  11. Andrade JG, Khairy P, Guerra PG, et al. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm 2011;8:1444-51. https://doi.org/10.1016/j.hrthm.2011.03.050
  12. Packer DL, Kowal RC, Wheelan KR, et al. Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol 2013;61:1713-23. https://doi.org/10.1016/j.jacc.2012.11.064
  13. Kuhne M, Suter Y, Altmann D, et al. Cryoballoon versus radiofrequency catheter ablation of paroxysmal atrial fibrillation: biomarkers of myocardial injury, recurrence rates, and pulmonary vein reconnection patterns. Heart Rhythm 2010;7:1770-6. https://doi.org/10.1016/j.hrthm.2010.08.028
  14. Balk EM, Garlitski AC, Alsheikh-Ali AA, Terasawa T, Chung M, Ip S. Predictors of atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review. J Cardiovasc Electrophysiol 2010;21:1208-16. https://doi.org/10.1111/j.1540-8167.2010.01798.x
  15. D'Ascenzo F, Corleto A, Biondi-Zoccai G, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analysis. Int J Cardiol 2013;167:1984-9. https://doi.org/10.1016/j.ijcard.2012.05.008
  16. Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006;27:136-49. https://doi.org/10.1093/eurheartj/ehi645
  17. Youn JY, Zhang J, Zhang Y, et al. Oxidative stress in atrial fibrillation: an emerging role of NADPH oxidase. J Mol Cell Cardiol 2013;62:72-9. https://doi.org/10.1016/j.yjmcc.2013.04.019
  18. McMurray JJ, Adamopoulos S, Anker SD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012;33:1787-847. https://doi.org/10.1093/eurheartj/ehs104
  19. Weinberg EO. ST2 protein in heart disease: from discovery to mechanisms and prognostic value. Biomark Med 2009;3:495-511. https://doi.org/10.2217/bmm.09.56
  20. Miller AM, Liew FY. The IL-33/ST2 pathway--a new therapeutic target in cardiovascular disease. Pharmacol Ther 2011;131:179-86. https://doi.org/10.1016/j.pharmthera.2011.02.005

Cited by

  1. Cardiac Biomarkers in the Emergency Department: The Role of Soluble ST2 (sST2) in Acute Heart Failure and Acute Coronary Syndrome—There is Meat on the Bone vol.8, pp.2, 2018, https://doi.org/10.3390/jcm8020270
  2. Using Soluble ST2 to Predict Adverse Postoperative Outcomes in Patients with Impaired Left Ventricular Function Undergoing Coronary Bypass Surgery vol.55, pp.9, 2018, https://doi.org/10.3390/medicina55090572
  3. Decreased left atrial global longitudinal strain predicts the risk of atrial fibrillation recurrence after cryoablation in paroxysmal atrial fibrillation vol.58, pp.1, 2018, https://doi.org/10.1007/s10840-019-00573-4
  4. Circulating Cardiac Biomarkers in Diabetes Mellitus: A New Dawn for Risk Stratification—A Narrative Review vol.11, pp.6, 2020, https://doi.org/10.1007/s13300-020-00835-9
  5. The prognostic value of soluble suppression of tumourigenicity 2 and galectin-3 for sinus rhythm maintenance after cardioversion due to persistent atrial fibrillation in patients with normal left vent vol.22, pp.10, 2020, https://doi.org/10.1093/europace/euaa135
  6. Utilizing biomarkers associated with cardiovascular events in atrial fibrillation: informing a precision medicine response vol.5, pp.5, 2018, https://doi.org/10.1080/23808993.2020.1804864
  7. Role of sST2 in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation vol.43, pp.11, 2018, https://doi.org/10.1111/pace.14029
  8. Potential Biomarkers in Atrial Fibrillation: Insight Into Their Clinical Significance vol.78, pp.2, 2018, https://doi.org/10.1097/fjc.0000000000001042
  9. Association of Serum Biomarkers and Cardiac Inflammation in Patients With Atrial Fibrillation: Identification by Positron Emission Tomography vol.8, pp.None, 2018, https://doi.org/10.3389/fcvm.2021.735082
  10. Additional diagnostic criteria for atrial cardiomyopathy in patients with lone atrial fibrillation vol.26, pp.1, 2018, https://doi.org/10.15829/1560-4071-2021-4258
  11. Promising Novel Biomarkers in Cardiovascular Diseases vol.11, pp.8, 2018, https://doi.org/10.3390/app11083654
  12. Predictors of Early-Recurrence Atrial Fibrillation after Catheter Ablation in Women and Men with Abnormal Body Weight vol.10, pp.12, 2018, https://doi.org/10.3390/jcm10122694
  13. Impact of Midregional N‐Terminal Pro-Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrilla vol.10, pp.13, 2018, https://doi.org/10.1161/jaha.121.020917
  14. Biomarkers of ageing and cardiac remodeling are associated with atrial fibrillation vol.55, pp.4, 2021, https://doi.org/10.1080/14017431.2021.1889653
  15. The Role of Galectin-3 and ST2 in Cardiology: A Short Review vol.11, pp.8, 2021, https://doi.org/10.3390/biom11081167
  16. Cardiovascular magnetic resonance-determined left ventricular myocardium impairment is associated with C-reactive protein and ST2 in patients with paroxysmal atrial fibrillation vol.23, pp.1, 2018, https://doi.org/10.1186/s12968-021-00732-5