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Circulating intermediate monocytes and atrial structural remodeling associated with atrial fibrillation recurrence
Hideya Suehiro1,2, Kunihiko Kiuchi1,2, Koji Fukuzawa1,2
1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Background:
Inflammation, such as that associated with intermediate CD14++ CD16+ monocytes and atrial structural remodeling (SRM), may be important in the recurrence of atrial fibrillation (AF) after catheter ablation. However, the relationship between the intermediate CD14++ CD16+ monocytes, SRM, and AF recurrence is unclear.
Methods:
Twenty-four patients with AF were enrolled. The proportion of intermediate monocytes (PIM) was assessed before ablation by flow cytometry. As a surrogate marker of SRM, the volume ratio (VR) of signal intensity greater than 1 standard deviation on late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) was calculated. We investigated whether PIM correlated with SRM on LGE-MRI and determined the optimal cutoff value for predicting AF recurrence.
Results:
Univariate analysis revealed positive correlations between PIM and BNP with SRM (PIM: r = .593, p = .002; BNP: r = .567, p = .004). Multivariable analysis revealed that PIM was independently associated with VR on LGE-MRI (β = .522; p = .033). The finding of an area under the receiver operating characteristic curve of 0.750 revealed that a VR ≥ 13.3% on LGE-MRI as the optimal cutoff value to predict AF recurrence with 80% sensitivity and 71% specificity, which was associated with PIM ≥ 10.0%.
Conclusion:
Intermediate monocytes were significantly positively correlated with SRM. PIM ≥ 10% was associated with a VR ≥ 13.3% on LGE-MRI, which predicted AF recurrence after catheter ablation.
Insights
Inflammation involving intermediate monocytes (CD14++ CD16+) is linked to atrial structural remodeling (SRM). Higher proportions of these monocytes predict atrial fibrillation recurrence after ablation.
Area of Science:
- Cardiology
- Immunology
- Biomedical Imaging
Background:
- Inflammation, particularly intermediate CD14++ CD16+ monocytes, and atrial structural remodeling (SRM) may influence atrial fibrillation (AF) recurrence post-catheter ablation.
- The precise relationship between these monocytes, SRM, and AF recurrence remains incompletely understood.
Purpose of the Study:
- To investigate the correlation between the proportion of intermediate monocytes (PIM) and SRM in AF patients undergoing catheter ablation.
- To identify optimal thresholds of PIM and SRM for predicting AF recurrence.
Main Methods:
- Flow cytometry was used to quantify PIM in 24 AF patients before ablation.
- Late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) assessed SRM using the volume ratio (VR) of signal intensity.
- Statistical analyses, including univariate and multivariable correlations, were performed to link PIM, SRM, and AF recurrence.
Main Results:
- A significant positive correlation was observed between PIM and SRM (r=0.593, p=0.002).
- Multivariable analysis confirmed PIM as an independent predictor of VR on LGE-MRI (β=0.522, p=0.033).
- A VR of ≥13.3% on LGE-MRI, associated with PIM ≥10.0%, predicted AF recurrence with 80% sensitivity and 71% specificity (AUC=0.750).
Conclusions:
- Intermediate monocytes are significantly correlated with atrial structural remodeling.
- A PIM of ≥10% combined with a VR of ≥13.3% on LGE-MRI effectively predicts AF recurrence following catheter ablation.
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