Atrial fibrillation-induced endothelial dysfunction improves after restoration of sinus rhythm

作者：Yoshino Satoshi; Yoshikawa Akiko; Hamasaki Shuichi^*; Ishida Sanemasa; Oketani Naoya; Saihara Keishi; Okui Hideki; Kuwahata So; Fujita Shoji; Ichiki Hitoshi; Ueya Nami; Iriki Yasuhisa; Maenosono Ryuichi; Miyata Masaaki; Tei Chuwa

来源：International Journal of Cardiology, 2013, 168(2): 1280-1285.

DOI：10.1016/j.ijcard.2012.12.006

• Atrial fibrillation
• Endothelial dysfunction
• Restoration of sinus rhythm
• Reactive hyperemia peripheral arterial tonometry (RH-PAT)
• RH-PAT index (RHI)

Background: Recent evidence suggests that atrial fibrillation (AF) adversely affects endothelial function. The goal of this study was to assess endothelial function in patients with AF before and after restoration of sinus rhythm by catheter ablation (ABL).
Methods: Reactive hyperemia peripheral arterial tonometry (RH-PAT) measurements reflecting endothelial function were conducted with Endo-PAT2000 (Itamar Medical, Caesarea, Israel) in 27 patients with persistent AF before ABL and in 21 control subjects with sinus rhythm (SR). According to cardiac rhythm on the morning after ABL, patients were divided into two groups: day 1-restored SR group (n=19) and day 1-recurred AF group (n=8). Based on the cardiac rhythm at 6 months after ABL, the restored SR group was further subdivided into the month 6-maintained SR group (n=11) and the month 6-recurred AF group (n=6).
Results: Log(e) RH-PAT index (RHI) was significantly lower in the persistent AF group than in the control (SR) group (0.52 +/- 0.20; 0.69 +/- 0.24, p<0.01). Multivariate logistic regression analysis revealed that persistent AF was the only independent predictor of impaired endothelial function defined as log(e) RHI<0.6 (odds ratio, 4.96; 95% CI, 1.2 to 21.3; p<0.05). Log(e) RHI was significantly higher after ABL than before ABL (0.53 +/- 0.20; 0.73 +/- 0.25; p<0.01) in the day 1-restored SR group. Log(e) RHI of the month 6-maintained SR group was comparable to that of the day 1-restored SR group.
Conclusions: These results suggest that AF is associated with impairment of endothelial dysfunction and that this impairment is reversed by restoration of sinus rhythm.

• 出版日期2013-9-30