Abstract 1842: Inflammatory Activation In Patients With Lone Atrial Fibrillation: New Insights By Coronary Sinus Thermography.
Background: In the clinical setting there are conflicting results regarding the role of inflammatory activation in atrial fibrillation (AF). Coronary sinus (CS) thermography assesses myocardial heat production and is correlated with inflammatory states. The purpose of this study was to investigate in patients (pts) with AF whether
there is increased CS blood temperature and
the correlation of heat production with systemic inflammation.
Methods: We included pts with AF and subjects with sinus rhythm (controls). C-reactive protein (CRP) levels were measured in all pts. CS and right atrium (RA) blood temperature measurements were performed by a dedicated 7F thermography catheter. ΔT was calculated by subtracting RA from CS blood temperature.
Results: We included 70 pts: 47 with lone AF and 23 controls. We stratified pts with AF into two groups: normotensive (AFN; n=25) and hypertensive (AFH; n=22). Heart rate was similar between the three groups (AFH: 72.91±4.11/min, AFN: 72.84±4.50/min control:72.52±4.19/min, p=0.89). Mean blood temperature was lower in the RA compared with the CS in AFH (37.27±0.52°C vs 37.47±0.54°C, p<0.01), in AFN (37.13±0.53°C vs 37.34±0.54°C, p<0.01), and in controls (37.41±0.69°C vs 37.55±0.68°C, p<0.01). ΔT was greater in AFH, and AFN compared to controls (0.20±0.07°C, 0.20±0.08°C, vs 0.14±0.06°C, p<0.01 for both comparisons). ΔT was similar between AFH and AFN (p=0.95). CRP was higher in AFH and AFN compared to controls (1.72±0.85mg/Dl, 1.69±0.94mg/dL vs 0.98±0.71 mg/dL, p<0.01). CRP was similar between AFH and AFN (p=0.87). Pts with high ΔT (≥0.15°C) had significantly higher CRP compared to pts with low ΔT (1.73±0.95mg/dL vs 1.01±0.57 mg/dL, p=0.01). A correlation between CRP levels with ΔT was observed in AFH and AFN (R=0.58, p<0.01, R=0.44, p=0.02, respectively). Multiple linear regression analysis confirmed that pts with lone AF (b±SE: 0.07±0.02, p=0.01) and pts with hypertension and AF (b±SE: 0.07±0.03, p=0.03) had higher ΔT compared to the control group.
Conclusions: Pts with AF have increased myocardial heat production, which is correlated to the systemic inflammation. CS blood temperature measurement may provide significant information for the pathogenesis of AF.