Role of Inflammation and Oxidative Stress in Atrial Fibrillation

Overview

Journal Heart Rhythm

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2010 Feb 16

PMID 20153266

Citations 140

Authors

Jie Li

Joseph Solus

Qingxia Chen

Young Hee Rho

Ginger Milne

C Michael Stein

Dawood Darbar

Affiliations

Soon will be listed here.

Abstract

Background: Atrial fibrillation (AF) is the most common arrhythmia seen in clinical practice. Increasing evidence indicates that inflammation and oxidative stress contribute to the pathogenesis of AF, but their role remains poorly defined. In addition, whether inflammation and oxidative stress are associated with particular types of AF is unclear.

Objective: The purpose of this study was to define the role of inflammation and oxidative stress in AF.

Methods: Using a case-control study design, 305 patients with AF were compared with 150 control patients. AF was categorized into lone and typical AF and further subcategorized as paroxysmal, persistent, or permanent AF. Serum concentrations of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor (TNF)-alpha, monocyte chemoattractant protein (MCP)-1, vascular endothelial growth factor (VEGF), N-terminal pro-brain (B-type) natriuretic peptide (NTpBNP), and urinary F(2)-isoprostanes, a measure of oxidative stress, were measured.

Results: IL-6, IL-8, IL-10, TNF-alpha, MCP1, VEGF, and NTpBNP concentrations were independently associated with AF (all P <.05). However, F(2)-isoprostane excretion was not elevated (P = .50). Graded increases in TNF-alpha [median (interquartile range) 6.8 (3.4-11.3), 8.0 (5.6-10.9), 10.1 (5.7-12.4) pg/mL, P <.05] and NTpBNP [170.6 (67.3-481.9), 681.39 (310.3-1,439.0), 1,179.9 (653.1-2,096.0) pg/mL, P <.001] were seen among the subgroups of paroxysmal, persistent, and permanent AF, respectively.

Conclusion: Inflammatory biomarkers were significantly increased in patients with AF, supporting a strong association between inflammation and AF. Surprisingly, urinary F(2)-isoprostanes, a sensitive index of systemic oxidative stress in vivo, were not increased in AF overall or in different subtypes of AF.

Citing Articles

Causal association between varicose veins and atrial fibrillation: A 2-sample bidirectional Mendelian randomization study.

Chen W, Jing N, Liu Q, Mao H, Wang X, Chen B Medicine (Baltimore). 2025; 104(7):e41466.

PMID: 39960918 PMC: 11835076. DOI: 10.1097/MD.0000000000041466.

Causal effect of vascular endothelial growth factor on the risk of atrial fibrillation: a two-sample Mendelian randomization study.

Han S, Xue L, Chen C, Xie J, Kong F, Zhang F Front Cardiovasc Med. 2024; 11:1416412.

PMID: 39494233 PMC: 11527688. DOI: 10.3389/fcvm.2024.1416412.

Association Between the Aggregate Index of Systemic Inflammation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Study.

Jiang Y, Luo B, Lu W, Chen Y, Peng Y, Chen L J Inflamm Res. 2024; 17:7057-7067.

PMID: 39377046 PMC: 11457786. DOI: 10.2147/JIR.S481515.

Association of Diagonal Earlobe Crease with Risk of Atrial Fibrillation in Stable Patients with Coronary Artery Disease.

Jin M, Song C, Kim Y J Clin Med. 2024; 13(18).

PMID: 39337131 PMC: 11433253. DOI: 10.3390/jcm13185643.

The interaction between neutrophils and atrial myocytes in the occurrence and development of atrial fibrillation.

Li T, Wang Y, Wan J, Duan Y, Xu Y, Yang M BMC Cardiovasc Disord. 2024; 24(1):519.

PMID: 39333891 PMC: 11428612. DOI: 10.1186/s12872-024-04193-3.

References

Ommen S, ODell J, Stanton M . Atrial arrhythmias after cardiothoracic surgery. N Engl J Med. 1997; 336(20):1429-34. DOI: 10.1056/NEJM199705153362006. View

Morrow J . Quantification of isoprostanes as indices of oxidant stress and the risk of atherosclerosis in humans. Arterioscler Thromb Vasc Biol. 2004; 25(2):279-86. DOI: 10.1161/01.ATV.0000152605.64964.c0. View

Morrow J, Roberts 2nd L . Mass spectrometry of prostanoids: F2-isoprostanes produced by non-cyclooxygenase free radical-catalyzed mechanism. Methods Enzymol. 1994; 233:163-74. DOI: 10.1016/s0076-6879(94)33019-0. View

Chung M, Martin D, Sprecher D, Wazni O, Kanderian A, Carnes C . C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001; 104(24):2886-91. DOI: 10.1161/hc4901.101760. View

Conway D, Lip G . Atrial fibrillation, the prothrombotic state, inflammation, and gender. Am J Cardiol. 2005; 95(6):819. DOI: 10.1016/j.amjcard.2004.11.017. View

Mihm M, Yu F, Carnes C, Reiser P, McCarthy P, Van Wagoner D . Impaired myofibrillar energetics and oxidative injury during human atrial fibrillation. Circulation. 2001; 104(2):174-80. DOI: 10.1161/01.cir.104.2.174. View

Ellinor P, Low A, Patton K, Shea M, MacRae C . C-Reactive protein in lone atrial fibrillation. Am J Cardiol. 2006; 97(9):1346-50. DOI: 10.1016/j.amjcard.2005.11.052. View

Ulus A, Aksoyek A, Ozkan M, Katircioglu S, Basu S . Cardiopulmonary bypass as a cause of free radical-induced oxidative stress and enhanced blood-borne isoprostanes in humans. Free Radic Biol Med. 2003; 34(7):911-7. DOI: 10.1016/s0891-5849(03)00030-3. View

Neuman R, Bloom H, Shukrullah I, Darrow L, Kleinbaum D, Jones D . Oxidative stress markers are associated with persistent atrial fibrillation. Clin Chem. 2007; 53(9):1652-7. PMC: 3158654. DOI: 10.1373/clinchem.2006.083923. View

10.

Ramlawi B, Otu H, Mieno S, Boodhwani M, Sodha N, Clements R . Oxidative stress and atrial fibrillation after cardiac surgery: a case-control study. Ann Thorac Surg. 2007; 84(4):1166-72. DOI: 10.1016/j.athoracsur.2007.04.126. View

11.

Darbar D, Motsinger A, Ritchie M, Gainer J, Roden D . Polymorphism modulates symptomatic response to antiarrhythmic drug therapy in patients with lone atrial fibrillation. Heart Rhythm. 2007; 4(6):743-9. PMC: 1948880. DOI: 10.1016/j.hrthm.2007.02.006. View

12.

Milne G, Sanchez S, Musiek E, Morrow J . Quantification of F2-isoprostanes as a biomarker of oxidative stress. Nat Protoc. 2007; 2(1):221-6. DOI: 10.1038/nprot.2006.375. View

13.

Dai R, Dheen S, He B, Tay S . Differential expression of cytokines in the rat heart in response to sustained volume overload. Eur J Heart Fail. 2004; 6(6):693-703. DOI: 10.1016/j.ejheart.2003.11.014. View

14.

Todd D, Yee R . Lessons from the implantable atrial defibrillator. Am Heart J. 2003; 145(4):569-70. DOI: 10.1067/mhj.2003.94. View

15.

Kim Y, Kattach H, Ratnatunga C, Pillai R, Channon K, Casadei B . Association of atrial nicotinamide adenine dinucleotide phosphate oxidase activity with the development of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008; 51(1):68-74. DOI: 10.1016/j.jacc.2007.07.085. View

16.

Gabay C, Kushner I . Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999; 340(6):448-54. DOI: 10.1056/NEJM199902113400607. View

17.

Conway D, Buggins P, Hughes E, Lip G . Relationship of interleukin-6 and C-reactive protein to the prothrombotic state in chronic atrial fibrillation. J Am Coll Cardiol. 2004; 43(11):2075-82. DOI: 10.1016/j.jacc.2003.11.062. View

18.

Issac T, Dokainish H, Lakkis N . Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. J Am Coll Cardiol. 2007; 50(21):2021-8. DOI: 10.1016/j.jacc.2007.06.054. View

19.

Basu S, Nozari A, Liu X, Rubertsson S, Wiklund L . Development of a novel biomarker of free radical damage in reperfusion injury after cardiac arrest. FEBS Lett. 2000; 470(1):1-6. DOI: 10.1016/s0014-5793(00)01279-5. View

20.

Montuschi P, Barnes P, Roberts 2nd L . Isoprostanes: markers and mediators of oxidative stress. FASEB J. 2004; 18(15):1791-800. DOI: 10.1096/fj.04-2330rev. View