Key result
Successful sinus rhythm restoration via electrical cardioversion significantly reduced serum CICP levels at 2 months compared to baseline (63.74 vs 85.08 ng/mL, P=0.003).
Why the study?
Does restoration of sinus rhythm via electrical cardioversion affect serum markers of collagen turnover in patients with persistent atrial fibrillation?
Cohort (n=164)
Does restoration of sinus rhythm via electrical cardioversion affect serum markers of collagen turnover in patients with persistent atrial fibrillation?
Restoration and maintenance of sinus rhythm in persistent AF patients reduces collagen synthesis markers, suggesting a potential reversal or halting of atrial fibrotic processes.
Sinus rhythm maintenance after cardioversion was associated with reduced CICP; extends evidence linking rhythm control to attenuated atrial fibrosis but remains hypothesis-generating.
AIMS: Collagen turnover and atrial fibrosis have been implicated in the generation and perpetuation of atrial fibrillation (AF). We evaluated the importance of serum markers of collagen turnover in predicting the outcome of electrical cardioversion (CV) of persistent AF and the relationship between AF and fibrosis. METHODS AND RESULTS: Serum C-terminal pro-peptide of collagen type-I (CICP) and C-terminal telopeptide of collagen type-I (CITP) were measured in 164 patients with AF before and 2 months after CV. All the patients were successfully cardioverted to sinus rhythm (SR) although in 38 of them AF recurred. Baseline CICP levels were comparable in patients in SR 60 days after CV and in those who experienced a relapse of AF (85.08 ± 16.99 vs. 87.55 ± 10.43 ng/mL, respectively, P = ns). Baseline CITP levels were significantly higher in patients with AF recurrence compared with those who remained in SR (0.48 ± 0.16 vs. 0.32 ± 0.17 ng/mL, respectively, P < 0.0001). In the 126 patients who maintained the SR, CICP levels were significantly lower at the end of the study as compared with the baseline (63.74 ± 15.92 vs. 85.08 ± 16.99 ng/mL P = 0.003), while there was a mild increase in plasma CITP levels (0.36 ± 0.21 vs. 0.32 ± 0.17 ng/mL, respectively, P = 0.03). CONCLUSION: Atrial fibrillation 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.
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Kallergis et al. (2014) conducted a cohort in persistent atrial fibrillation (n=164). Electrical cardioversion vs. Baseline (pre-cardioversion) and AF recurrence was evaluated on Changes in serum markers of collagen turnover (CICP and CITP) and AF recurrence (p=0.003). Successful sinus rhythm restoration via electrical cardioversion significantly reduced serum CICP levels at 2 months compared to baseline (63.74 vs 85.08 ng/mL, P=0.003).
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