Abstract 12688: Extracellular Matrix Alterations after Sinus Rhythm Restoration in Patients with Persistent Atrial Fibrillation.
Collagen turnover and atrial fibrosis have been implicated in the generation and perpetuation of AF. To evaluate the importance of serum markers of collagen turnover in predicting the outcome of electrical cardioversion (CV) of persistent atrial fibrillation (AF) and to clarify the relationship between AF and fibrosis, serum C-terminal propeptide of collagen type I (CICP) and C-terminal telopeptide of collagen type I (CITP) were measured in 98 patients with AF before and two months after CV. All patients were successfully cardioverted to sinus rhythm (SR) although in 23 of them AF recurred. Baseline CICP levels were comparable in patients in sinus rhythm 60 days after CV and in those who experienced a relapse of AF (82.464±16.65 ng/ml vs. 86.45±10.95 ng/ml, respectively, p=0.18). Baseline CITP levels were significantly higher in patients with AF recurrence compared to those who remained in SR (0.47±0.15 ng/ml vs. 0.33±0.19 ng/ml,respectively, p=0.001). The restoration and maintenance of SR resulted in a decrease of CICP but not of CITP levels.In the 75 patients who maintained SR, CICP levels were significantly lower at the end of the study as compared to baseline, (61.89±14.18 ng/ml vs. 82.464±16.65 ng/ml p<0.001), while there was no difference in plasma CITP levels, (0.35±0.20 ng/ml vs. 0.33±0.19 ng/ml, respectively, p=0.477). In conclusion, AF can result in alterations in atrial structure and architecture that make the atrial myocardium more susceptible to the maintenance of the arrhythmia. Sinus rhythm restoration could affect the fibrotic process occurring or exacerbating during AF course.
- © 2010 by American Heart Association, Inc.