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Published on: July 20, 2022
Assessment of Blood Endothelial Cell Biomarkers in Women and Men with Abnormal Body Mass and Paroxysmal Atrial
Wiesław Sikora1,2, Dominika Kanikowska1, Jan Budzianowski3
1Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
Insights
Women with paroxysmal atrial fibrillation (AF) show more pronounced endothelial dysfunction (ED) than men. Biomarkers like soluble adhesion molecules and thrombomodulin are elevated in females, indicating higher ED regardless of AF risk score.
Area of Science:
- Cardiology
- Vascular Biology
- Biomarkers
Background:
- Endothelial dysfunction (ED) is a key factor in the development and persistence of atrial fibrillation (AF).
- Assessing ED severity in paroxysmal AF patients is crucial for risk stratification and management.
- The CHA2DS2-VASc score is used to evaluate stroke risk in AF patients.
Purpose of the Study:
- To compare the degree of endothelial dysfunction (ED) in female and male patients with paroxysmal atrial fibrillation (AF).
- To identify potential biomarkers that indicate more pronounced ED in either sex.
- To investigate the relationship between ED and the CHA2DS2-VASc score in paroxysmal AF patients.
Main Methods:
- Recruitment of 47 females and 48 males with paroxysmal AF and abnormal body mass.
- Classification of patients into low and high CHA2DS2-VASc score groups.
- Measurement of endothelial cell markers (t-PA, PAI-1, sVCAM-1, sICAM-1, vWF, sTM) using Elisa tests before AF ablation.
Main Results:
- Endothelial dysfunction was more pronounced in females compared to males with paroxysmal AF.
- Elevated levels of vascular cell adhesion molecule 1 (sVCAM-1) and thrombomodulin (sTM) were observed in females with low CHA2DS2-VASc scores.
- Higher levels of intercellular adhesion molecule (sICAM-1) were found in females with high CHA2DS2-VASc scores.
- Females exhibited postmenopausal status, higher thrombosis risk, lower GFR, and more frequent antiarrhythmic drug use.
Conclusions:
- Women with paroxysmal AF demonstrate more significant endothelial dysfunction than men, irrespective of their CHA2DS2-VASc score.
- Soluble pro-inflammatory adhesion molecules and thrombomodulin are sensitive biomarkers for elevated ED in females with AF.
- Further research may elucidate the specific mechanisms driving sex differences in ED within the AF population.
Abstract:
Endothelial dysfunction (ED) promotes and maintains atrial fibrillation (AF). Using a CHA2DS2-VASc score in women and men with paroxysmal AF, we aimed to determine which patients' ED would be more pronounced. We recruited 47 females and 48 males (mean BMI 31 kg/m2 and 30 kg/m2, respectively) with paroxysmal AF and abnormal body mass and divided them into those with low (F < 3; M < 2) and high (F ≥ 3; M ≥ 2) CHA2DS2-VASC score. The blood samples were taken before AF ablation. Using Elisa tests, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), vascular cell adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule (sICAM-1), von Willebrand factor (vWF), and thrombomodulin (sTM). ED was more pronounced in females, expressed by higher endothelial cell marker concentrations: sVCAM-1 and sTM in low scores and sICAM-1 in high scores, CHA2DS2-VASc. Females were characterized by postmenopausal status, higher risk of thrombosis, lower GFR, and more frequent treatment with antiarrhythmic drugs. In contrast, males have only higher suppression of tumorigenicity 2 (ST2). In conclusion, women with paroxysmal AF exhibited more pronounced ED compared to men, regardless of their CHA2DS2-VASc scores. The soluble pro-inflammatory adhesion molecules and thrombomodulin emerge as the most sensitive biomarkers of ED elevated in females.
