Pre-operative serum PICP and PIIINP levels were significantly higher in patients developing post-operative AF versus normal sinus rhythm (PICP: 451.7 vs 293.3 ng/ml, p=0.006).
Observational (n=54)
Do pre-operative serum PICP and PIIINP levels correlate with left atrial fibrosis and predict post-operative atrial fibrillation in patients undergoing cardiac surgery?
Pre-operative serum PICP and PIIINP levels correlate with left atrial fibrosis and may serve as predictors for post-operative atrial fibrillation in patients without a prior history of the arrhythmia.
OBJECTIVES: This study sought to determine if serum markers for collagen I and III synthesis, the carboxyl terminal peptide from pro-collagen I (PICP) and the amino terminal peptide from pro-collagen III (PIIINP), correlate with left atrial (LA) fibrosis and post-operative atrial fibrillation (AF). BACKGROUND: AF after cardiac surgery is associated with adverse outcomes. We recently demonstrated that LA fibrosis is associated with post-operative AF in patients with no previous history of AF. METHODS: Fifty-four patients having cardiac surgery without a history of AF consented to left and right atrial biopsies and a pre-operative peripheral blood draw. Picrosirius red staining quantified the percentage of fibrosis, and reverse transcriptase polymerase chain reaction assessed atrial tissue messenger ribonucleic acid transcripts involved in the fibrosis pathway. PICP and PIIINP levels were measured using an enzyme immunosorbent assay. RESULTS: Eighteen patients developed AF, whereas 36 remained in normal sinus rhythm. LA fibrosis was higher in patients who developed AF versus normal sinus rhythm (6.13 ± 2.9% vs. 2.03 ± 1.9%, p = 0.03). LA messenger ribonucleic acid transcripts for collagen I, III, transforming growth factor, and angiotensin were 1.5- to 2.0-fold higher in AF patients. Serum PICP and PIIINP levels were highest in AF versus normal sinus rhythm (PICP: 451.7 ± 200 ng/ml vs. 293.3 ± 114 ng/ml, p = 0.006; PIIINP: 379 ± 286 pg/ml vs. 191.6 ± 162 pg/ml, p = 0.01). Furthermore, there was a linear correlation between LA fibrosis and serum PICP levels (R(2) = 0.2; p = 0.01), and of the markers, only PICP was independently associated with AF. CONCLUSIONS: This demonstrates that serum PICP and PIIINP levels correlate with the presence of LA fibrosis and may act as predictors for post-operative AF even in the absence of previous history of AF.
Swartz et al. (Mon,) conducted a observational in Cardiac surgery without history of atrial fibrillation (n=54). Pre-operative serum PICP and PIIINP levels was evaluated on Post-operative atrial fibrillation and left atrial fibrosis. Pre-operative serum PICP and PIIINP levels were significantly higher in patients developing post-operative AF versus normal sinus rhythm (PICP: 451.7 vs 293.3 ng/ml, p=0.006).