Key result
In patients with stable CAD, chronic inflammation markers like IL-6 strongly correlated with the duration (r=0.98, P<0.01) and velocity (r=-0.86, P=0.03) of atrial depolarization.
Why the study?
The impact of low-grade chronic inflammation on the electrophysiological properties of the atria in stable CAD remains unknown.
Are circulating markers of chronic inflammation and ischemia associated with atrial electrical remodeling in patients with stable CAD undergoing CABG?
Observational (n=30)
Are circulating markers of chronic inflammation and ischemia associated with atrial electrical remodeling in patients with stable CAD undergoing CABG?
Effect estimate: r = 0.98 (for IL-6 and duration)
p-value: p=<0.01
In patients with stable CAD, markers of chronic inflammation and ischemia correlate with pro-arrhythmic atrial electrical remodeling, which may contribute to postoperative atrial arrhythmias.
May indicate inflammation-related atrial vulnerability in stable CAD; leaves open causal role and therapeutic implications.
The pathophysiology of coronary artery disease (CAD) includes low-grade chronic inflammation. At its turn, inflammation is known to promote myocardial structural remodeling and to increase vulnerability to atrial arrhythmias. Meanwhile, the impact of chronic inflammation on the electrophysiological properties of the atria remains unknown. We aimed to evaluate the impact of low-grade chronic inflammation on atrial electrophysiology in patients with stable CAD undergoing elective coronary artery bypass grafting (CABG). Circulating levels of several inflammatory, angiogenesis, and endothelial dysfunction markers were determined 1 day before CABG in 30 consecutive CAD patients. Right atrial appendage samples were collected during the CABG procedure; action potential recordings were performed in six study patients using the microelectrode technique. Interleukin (IL)-1b (r = 1.00, P = 0.01), IL-6 (r = 0.98, P < 0.01), vascular endothelial growth factor (VEGF) (r = 0.98, P < 0.01), and hemoglobin (r = 0.98, P < 0.01) levels significantly positively correlated with the duration of atrial depolarization. Consequently, IL-6, VEGF, and hemoglobin (r = -0.86, P = 0.03 for all) levels significantly negatively correlated with the velocity of atrial depolarization. There was no significant correlation between any of the studied markers levels and any of the other parameters of the action potential (all P > 0.05). The present study is the first to demonstrate that in patients with stable CAD, chronic inflammation and ischemia are associated with pro-arrhythmic atrial electrical remodeling. These changes may contribute to the increased propensity to postoperative atrial arrhythmias seen in some of the patients undergoing CABG.
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Scridon et al. (2019) conducted an observational in Stable coronary artery disease (n=30). Chronic inflammation and ischemia markers (IL-1b, IL-6, VEGF, hemoglobin) was evaluated on Duration and velocity of atrial depolarization (r = 0.98 (for IL-6 and duration), p=<0.01). In patients with stable CAD, chronic inflammation markers like IL-6 strongly correlated with the duration (r=0.98, P<0.01) and velocity (r=-0.86, P=0.03) of atrial depolarization.
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