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Circulating primary bile acid is correlated with structural remodeling in atrial fibrillation

Xin-Hua Wang1, Zheng Li2, Min-Hua Zang2

  • 1Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd., Shanghai, 200127, China. ttwwxh@126.com.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|March 28, 2019
PubMed

Insights

Elevated chenodeoxycholic acid (CDCA) correlates with atrial fibrillation structural remodeling. Higher CDCA levels are linked to low voltage areas and induce atrial myocyte apoptosis.

Area of Science:

  • Cardiology
  • Biochemistry
  • Electrophysiology

Background:

  • Primary bile acids regulate cardiac function and myocyte apoptosis.
  • The role of bile acids in atrial fibrillation (AF) structural remodeling remains unclear.

Purpose of the Study:

  • To investigate the hypothesis that elevated chenodeoxycholic acid (CDCA) concentration correlates with left atrial low voltage areas (LVA) in AF.
  • To determine if CDCA induces apoptosis of atrial myocytes.

Main Methods:

  • Serum bile acid levels were measured in patients with AF and other arrhythmias.
  • Electoanatomical mapping identified LVA in AF patients.
  • Mouse atrial myocytes were incubated with CDCA to assess apoptosis.

Main Results:

  • Serum CDCA and cholic acid levels were higher in AF patients compared to PSVT patients.
  • CDCA levels were significantly higher in persistent AF than paroxysmal AF.
  • CDCA serum levels positively correlated with LVA size and proportion in AF patients.
  • CDCA promoted atrial myocyte apoptosis in a dose-dependent manner.

Conclusions:

  • Elevated circulating CDCA levels are associated with AF.
  • CDCA correlates with LVA, suggesting a role in AF structural remodeling.
  • CDCA may significantly contribute to the progression of AF structural remodeling via myocyte apoptosis.
Abstract

Keywords:
Atrial fibrillationChenodeoxycholic acidLow voltage areaPrimary bile acidStructural remodeling

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