Key result
Women with paroxysmal AF and abnormal body mass exhibit worse endothelial dysfunction than men.
Why the study?
Endothelial dysfunction promotes and maintains AF, but which patients have more pronounced endothelial dysfunction when evaluated by CHA2DS2-VASc score and sex remained to be determined.
Does endothelial dysfunction differ between women and men with paroxysmal atrial fibrillation and abnormal body mass based on CHA2DS2-VASc score?
Observational (n=95)
Does endothelial dysfunction differ between women and men with paroxysmal atrial fibrillation and abnormal body mass based on CHA2DS2-VASc score?
Women with paroxysmal AF and abnormal body mass exhibit more pronounced endothelial dysfunction than men, regardless of CHA2DS2-VASc score.
Answers are grounded in this paper and cite their sources.
Endothelial markers may flag higher-risk women with paroxysmal AF and abnormal body mass; hypothesis-generating and requires prospective validation before clinical use.
Endothelial dysfunction (ED) promotes and maintains atrial fibrillation (AF). Using a CHA2DS2-VASc score in women and men with paroxysmal AF, we aimed to determine which patients’ ED would be more pronounced. We recruited 47 females and 48 males (mean BMI 31 kg/m2 and 30 kg/m2, respectively) with paroxysmal AF and abnormal body mass and divided them into those with low (F < 3; M < 2) and high (F ≥ 3; M ≥ 2) CHA2DS2-VASC score. The blood samples were taken before AF ablation. Using Elisa tests, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), vascular cell adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule (sICAM-1), von Willebrand factor (vWF), and thrombomodulin (sTM). ED was more pronounced in females, expressed by higher endothelial cell marker concentrations: sVCAM-1 and sTM in low scores and sICAM-1 in high scores, CHA2DS2-VASc. Females were characterized by postmenopausal status, higher risk of thrombosis, lower GFR, and more frequent treatment with antiarrhythmic drugs. In contrast, males have only higher suppression of tumorigenicity 2 (ST2). In conclusion, women with paroxysmal AF exhibited more pronounced ED compared to men, regardless of their CHA2DS2-VASc scores. The soluble pro-inflammatory adhesion molecules and thrombomodulin emerge as the most sensitive biomarkers of ED elevated in females.
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Sikora et al. (2025) conducted an observational in Paroxysmal atrial fibrillation and abnormal body mass (n=95). Female sex vs. Male sex was evaluated on Endothelial cell biomarker concentrations (t-PA, PAI-1, sVCAM-1, sICAM-1, vWF, and sTM). Women with paroxysmal AF and abnormal body mass exhibited more pronounced endothelial dysfunction compared to men, regardless of CHA2DS2-VASc scores, driven by elevated adhesion molecules and sTM.
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