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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by
Meng Wang1, Hua Xiong1, Li Lu1
1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Objectives:
The gut microbiota and its metabolites are linked to inflammation and contribute to the progression of atrial fibrillation (AF), but the predictive value of the gut microbiota-derived metabolite lipopolysaccharide (LPS) for AF recurrence (RAF) is unknown. This study is aimed at investigating (1) the correlation between LPS and RAF and (2) its relationship with inflammation and atrial fibrosis.
Method:
We performed a single-centre retrospective analysis in 159 AF patients. Fasting plasma samples were collected, and an enzyme-linked immunosorbent assay was used to determine the levels of serum LPS, interleukin-6 (IL-6), collagen type-1 C-terminal telopeptide (CITP), and transforming growth factor-β1 (TGFβ1). The cumulative risk for RAF was evaluated with Kaplan-Meier analysis. Cox proportional hazard analysis was carried out to predict the hazard of RAF. The correlations among LPS and IL-6, CITP, TGFβ1, and left atrial diameter (LAD) were analysed by Pearson's correlation coefficient. Subsequent univariate and multivariable linear regression analyses were carried out to evaluate the connection between clinical variables and Log-LPS.
Results:
All 159 AF patients were included in this study. The proportion of persistent atrial fibrillation was 40.3%, the mean age was 61.9 ± 10.1 years, the proportion of males was 61.6%, and the mean LPS was 56.5 ± 29.5 pg/mL. After all patients were divided into tertiles according to the circulating LPS level, a total of 44 RAF occurred: 10 in the first tertile, 15 in the second tertile, and 19 in the third tertile (log-rank test P = 0.037). Heart failure (hazard ratio 2.029, P = 0.041), LAD (hazard ratio 1.064, P = 0.022), Log-LPS (hazard ratio 5.686, P = 0.043), and CITP (hazard ratio 6.841, P = 0.033) independently predicted the risk of RAF. In all patients, univariate analysis showed that heart failure, LAD, hs-CRP, IL-6, CITP, and TGF-β1 were connected with Log-LPS. Multivariate linear regression analysis indicated that IL-6 and hs-CRP were independently and positively connected with Log-LPS.
Conclusions:
Our results indicated that circulating LPS was a predictor of RAF and may contribute to RAF incidence after ablation by increasing systemic inflammation and atrial fibrosis.
Insights
Elevated lipopolysaccharide (LPS) levels predict atrial fibrillation recurrence (RAF) after treatment. LPS may increase RAF risk by promoting inflammation and atrial fibrosis.
Area of Science:
- Cardiology
- Microbiology
- Immunology
Background:
- Gut microbiota metabolites influence cardiovascular health.
- Lipopolysaccharide (LPS), a gut-derived endotoxin, is implicated in inflammation.
- The role of LPS in predicting atrial fibrillation recurrence (RAF) remains unclear.
Purpose of the Study:
- To investigate the correlation between LPS and RAF.
- To examine the relationship between LPS, inflammation, and atrial fibrosis.
Main Methods:
- Retrospective analysis of 159 atrial fibrillation patients.
- Measurement of serum LPS, IL-6, CITP, and TGF-β1 using ELISA.
- Kaplan-Meier and Cox proportional hazard analyses for RAF prediction.
- Correlation and regression analyses to assess relationships between LPS, inflammatory markers, and clinical variables.
Main Results:
- Higher LPS levels were associated with increased RAF risk (log-rank P = 0.037).
- Heart failure, left atrial diameter (LAD), LPS, and collagen type-1 C-terminal telopeptide (CITP) independently predicted RAF.
- IL-6 and hs-CRP were independently and positively correlated with LPS levels.
Conclusions:
- Circulating LPS is a significant predictor of RAF.
- LPS may contribute to RAF by exacerbating systemic inflammation and atrial fibrosis.
