TY - JOUR
T1 - Role of inflammation in initiation and maintenance of atrial fibrillation in rheumatic mitral stenosis – An analytical cross-sectional study
AU - Sharma, Gautam
AU - Ghati, Nirmal
AU - Sharique, Mohd
AU - Sharma, Shruti
AU - Shetkar, Sudhir
AU - Karmakar, Suman
AU - Naik, Nitish
AU - Lakshmy, Ramakrishnan
AU - Thakur, Bhaskar
AU - Agarwal, Aman
AU - Saxena, Anita
N1 - Funding Information:
The work was performed at All India Institute of Medical Sciences, New Delhi, India. This work was supported by Indian Council of Medical Research, New Delhi, India [5/4/1-3/12-NCD-II].
Funding Information:
The work was performed at All India Institute of Medical Sciences, New Delhi, India. This work was supported by Indian Council of Medical Research, New Delhi, India [5/4/1‐3/12‐NCD‐II].
Publisher Copyright:
© 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society
PY - 2020/12
Y1 - 2020/12
N2 - Background: Inflammation has been implicated in the initiation and perpetuation of non-valvular atrial fibrillation (AF). However, there is a lack of similar data on AF in rheumatic heart disease (RHD). The objective of this study was to analyze the association of inflammation as measured by serum inflammatory biomarkers with AF in rheumatic mitral stenosis (Rh-MS). Methods: A comparative cross-sectional analytical study was conducted on 181 Rh-MS patients in normal sinus rhythm (NSR; n = 69), subclinical transient AF (SCAF; detected by 24-hours Holter monitoring; n = 30) and chronic AF (n = 82). Serum hs-CRP, IL-6, and sCD-40L were assessed using ELISA immunoassay and compared in all groups of Rh-MS with or without AF. Results: We found significantly higher serum hs-CRP and sCD-40L levels in the overall AF (Chronic AF + SCAF) group (hs-CRP: 4.5 ± 3.4 vs 2.3 ± 2.9 mg/L, P <.01; sCD-40L: 6.4 ± 4.8 vs 3.1 ± 3.4 ng/mL, P <.01) and chronic AF subgroup (hs-CRP: 4.9 ± 3.4 vs 2.3 ± 2.9 mg/L, P <.01; sCD-40L: 6.9 ± 5.1 vs 3.1 ± 3.4 ng/mL, P <.01) compared to patients with sinus rhythm. There was a statistically significant graded increase of serum IL-6 level from the NSR to the SCAF (vs NSR: 6.8 ± 3.9 vs 4.0 ± 2.2 pg/mL, P =.03), and chronic AF subgroups (vs NSR: 9.3 ± 6.5 vs 4.0 ± 2.2 pg/mL, P <.01; vs SCAF: 9.3 ± 6.5 vs 6.8 ± 3.9, P =.05) of atrial fibrillation. Conclusions: Elevated levels of serum hs-CRP, IL-6, and sCD-40L were strongly associated with overall AF and also with SCAF and chronic AF in Rh-MS patients indicating a potential role of inflammation in the pathophysiology of rheumatic AF.
AB - Background: Inflammation has been implicated in the initiation and perpetuation of non-valvular atrial fibrillation (AF). However, there is a lack of similar data on AF in rheumatic heart disease (RHD). The objective of this study was to analyze the association of inflammation as measured by serum inflammatory biomarkers with AF in rheumatic mitral stenosis (Rh-MS). Methods: A comparative cross-sectional analytical study was conducted on 181 Rh-MS patients in normal sinus rhythm (NSR; n = 69), subclinical transient AF (SCAF; detected by 24-hours Holter monitoring; n = 30) and chronic AF (n = 82). Serum hs-CRP, IL-6, and sCD-40L were assessed using ELISA immunoassay and compared in all groups of Rh-MS with or without AF. Results: We found significantly higher serum hs-CRP and sCD-40L levels in the overall AF (Chronic AF + SCAF) group (hs-CRP: 4.5 ± 3.4 vs 2.3 ± 2.9 mg/L, P <.01; sCD-40L: 6.4 ± 4.8 vs 3.1 ± 3.4 ng/mL, P <.01) and chronic AF subgroup (hs-CRP: 4.9 ± 3.4 vs 2.3 ± 2.9 mg/L, P <.01; sCD-40L: 6.9 ± 5.1 vs 3.1 ± 3.4 ng/mL, P <.01) compared to patients with sinus rhythm. There was a statistically significant graded increase of serum IL-6 level from the NSR to the SCAF (vs NSR: 6.8 ± 3.9 vs 4.0 ± 2.2 pg/mL, P =.03), and chronic AF subgroups (vs NSR: 9.3 ± 6.5 vs 4.0 ± 2.2 pg/mL, P <.01; vs SCAF: 9.3 ± 6.5 vs 6.8 ± 3.9, P =.05) of atrial fibrillation. Conclusions: Elevated levels of serum hs-CRP, IL-6, and sCD-40L were strongly associated with overall AF and also with SCAF and chronic AF in Rh-MS patients indicating a potential role of inflammation in the pathophysiology of rheumatic AF.
KW - atrial fibrillation
KW - inflammation
KW - mitral stenosis
KW - rheumatic heart disease
KW - serum biomarkers
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U2 - 10.1002/joa3.12428
DO - 10.1002/joa3.12428
M3 - Article
C2 - 33335617
AN - SCOPUS:85090126976
SN - 1880-4276
VL - 36
SP - 1007
EP - 1015
JO - Journal of Arrhythmia
JF - Journal of Arrhythmia
IS - 6
ER -