Cardiotrophin-1: A new predictor of atrial fibrillation relapses after successful cardioversion

Ibrahim Altun; Burak Pamukcu; Cenk Eray Yildiz; Selda Can Arkaya; Goksel Guz; Akar Yilmaz; Ahmet Kaya Bilge; Umit Mutlu Turkoglu; Kamil Adalet

doi:10.17305/bjbms.2015.503

Authors

Ibrahim Altun Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology
Burak Pamukcu Istanbul University, Istanbul Medical Faculty, Department of Cardiology
Cenk Eray Yildiz Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery
Selda Can Arkaya Istanbul University, Istanbul Medical Faculty, Department of Biochemistry
Goksel Guz Istanbul University, Istanbul Medical Faculty, Department of Cardiology
Akar Yilmaz Istanbul University, Istanbul Medical Faculty, Department of Cardiology
Ahmet Kaya Bilge Istanbul University, Istanbul Medical Faculty, Department of Cardiology
Umit Mutlu Turkoglu Istanbul University, Istanbul Medical Faculty, Department of Biochemistry
Kamil Adalet Istanbul University, Istanbul Medical Faculty, Department of Cardiology

DOI:

https://doi.org/10.17305/bjbms.2015.503

Keywords:

Atrial fibrillation, cardioversion, cardiotrophin-1

Abstract

We aimed to investigate whether or not cardiotrophin-1 (CT-1) can be used as a predictor of sinus rhythm constancy in patients with atrial fibrillation (AF) converted to sinus rhythm. Thirty two patients with AF (48-78 years), without any structural heart disease were enrolled for the study. The control group consisted of 32, age and gender matched healthy persons. Measurements of CT-1 were made after transthoracic and transesophageal echocardiography prior to cardioversion (CV). Relapses of AF were investigated by monthly electrocardiograms (ECGs) and ambulatory ECGs at 1^st, 3^rd, and 6^th month. At the end of 6^th month, measurements of CT-1 were repeated. At the beginning patients with AF had increased CT-1 levels when compared to controls (0.94 ± 0.32 pg/mL vs. 0.30 ± 0.12 pg/mL, [p < 0.001]). At the end of follow-up of the 32 patients, 17 (53%) had AF relapse. Age, initial duration of AF, left ventricle diameters, ejection fraction, left atrium appendix flow rates were similar among patients with and without AF relapse. However, basal left atrium diameter (4.24 ± 0.14 cm vs. 4.04 ± 0.22 cm, p = 0.005), pulmonary artery pressure (32.82 ± 5 vs. 28.60 ± 6.23 mmHg, p = 0.004) and CT-1 values (1.08 ± 0.37 vs. 0.82 ± 0.16 pg/mL, p = 0.02) were significantly increased in patients with AF relapse. Furthermore, patients with relapsed AF had higher CT-1 levels at 6^th month when compared to those in sinus rhythm (1.00 ± 0.40 vs. 0.71 ± 0.23 pg/mL). We conclude that post-CV, AF relapses are more frequent among patients with increased baseline CT-1 levels, and CT-1 may be a potential predictor of AF relapse.

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