Why the study?
Staging of AF is essential to understanding disease progression and therapy failure, and blood-based HSP levels may enable AF staging and identify patients at higher risk of recurrence after treatment.
Do serum heat shock protein levels correlate with the presence, stage, or recurrence of atrial fibrillation after electrocardioversion or pulmonary vein isolation?
Do serum heat shock protein levels correlate with the presence, stage, or recurrence of atrial fibrillation after electrocardioversion or pulmonary vein isolation?
Baseline serum heat shock protein levels do not predict AF presence or recurrence, but post-PVI elevations in HSP27 may be associated with AF recurrence.
HSP27 post-PVI monitoring should not yet inform AF recurrence risk; leaves open a hypothesis-generating biomarker role needing prospective validation.
Background: Staging of atrial fibrillation (AF) is essential to understanding disease progression and the accompanied increase in therapy failure. Blood-based heat shock protein (HSP) levels may enable staging of AF and the identification of patients with higher risk for AF recurrence after treatment. Objective: This study evaluates the relationship between serum HSP levels, presence of AF, AF stage and AF recurrence following electrocardioversion (ECV) or pulmonary vein isolation (PVI). Methods: To determine HSP27, HSP70, cardiovascular (cv)HSP and HSP60 levels, serum samples were collected from control patients without AF and patients with paroxysmal atrial fibrillation (PAF), persistent (PeAF) and longstanding persistent (LSPeAF) AF, presenting for ECV or PVI, prior to intervention and at 3-, 6- and 12-months post-PVI. Results: The study population (n = 297) consisted of 98 control and 199 AF patients admitted for ECV (n = 98) or PVI (n = 101). HSP27, HSP70, cvHSP and HSP60 serum levels did not differ between patients without or with PAF, PeAF or LSPeAF. Additionally, baseline HSP levels did not correlate with AF recurrence after ECV or PVI. However, in AF patients with AF recurrence, HSP27 levels were significantly elevated post-PVI relative to baseline, compared to patients without recurrence. Conclusions: No association was observed between baseline HSP levels and the presence of AF, AF stage or AF recurrence. However, HSP27 levels were increased in serum samples of patients with AF recurrence within one year after PVI, suggesting that HSP27 levels may predict recurrence of AF after ablative therapy.
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Marion et al. (2020) studied this question.
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