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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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C-reactive protein but not atrial dysfunction predicts recurrences of atrial fibrillation after cardioversion in

Federico Lombardi1, Fabrizio Tundo, Sebastiano Belletti

  • 1Cardiology Laboratory, Department of Medicine, Surgery and Odontoiatry, Hospital San Paolo, University of Milan, Italy. Federico.Lombardi@unimi.it

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|May 14, 2008
PubMed

Insights

High C-reactive protein (CRP) levels predict atrial fibrillation recurrence after cardioversion in patients with preserved ejection fraction. Atrial dysfunction indices did not predict recurrence, but NT-proBNP levels reflected hemodynamic changes.

Area of Science:

  • Cardiology
  • Biomarkers
  • Electrophysiology

Background:

  • Maintaining sinus rhythm after cardioversion for atrial fibrillation (AF) is challenging, especially in patients with preserved left ventricular ejection fraction (LVEF).
  • Subclinical inflammation and atrial strain are implicated in AF pathogenesis and perpetuation.
  • Predictive markers for AF recurrence are crucial for guiding clinical management.

Purpose of the Study:

  • To compare the predictive value of C-reactive protein (CRP) and atrial dysfunction indices for subacute AF recurrence.
  • To assess these markers in patients with persistent AF and normal LVEF.

Main Methods:

  • 53 patients with preserved LVEF underwent electrical cardioversion.
  • Left atrial diameter, area, emptying velocity, NT-proBNP, and CRP levels were measured before cardioversion.
  • NT-proBNP and CRP were re-measured at 1 hour and 3 weeks post-cardioversion.

Main Results:

  • 18 patients (33.9%) experienced subacute AF recurrence.
  • Higher CRP levels (>3.0 mg/l) significantly predicted AF recurrence (OR: 1.6; P=0.031).
  • Atrial dysfunction indices did not predict recurrence; NT-proBNP levels decreased in patients maintaining sinus rhythm.

Conclusions:

  • CRP is an independent predictor of subacute AF recurrence in patients with persistent AF and preserved LVEF.
  • Indices of atrial dysfunction did not predict arrhythmic outcome.
  • NT-proBNP levels reflect hemodynamic alterations associated with AF presence.
Abstract

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