Serum relaxin level predicts recurrence of atrial fibrillation after radiofrequency catheter ablation
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Relaxin, an emerging biomarker in heart failure, is involved in fibrosis and inflammation. The value of relaxin in predicting recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA) is unknown and the subject of this study. We prospectively enrolled 248 consecutive patients with AF (paroxysmal in 127 and persistent in 121) who underwent RFCA at our center after measurement of circulating levels of relaxin by ELISA. Kaplan–Meier analysis with log-rank test and multivariate analysis were used to assess the association between pre-RFCA relaxin levels and post-RFCA AF recurrence at 18 months follow-up. At mean 16.3 ± 3.8 months post-RFCA, 195 (78.6%) patients maintained sinus rhythm, and their pre-RFCA relaxin level was lower than that in patients with AF recurrence (P < 0.001). From lowest to highest pre-RFCA relaxin level tertiles (T1; 82.10–< 234.36; T2; 234.36–< 342.26; and T3; 342.26–740.63 ng/L), AF recurrence rate increased significantly (8.5%, 20.5% and 34.9%, respectively; Kaplan–Meier analysis with log-rank test, χ2 = 18.44, P < 0.001). Using a cutoff of 285.4 ng/L, pre-RFCA relaxin level predicted AF recurrence during follow-up with sensitivity of 77.4% and specificity of 55.9% (area under the receiver operating characteristic curve = 0.71). On multivariate Cox proportional hazard model, relaxin level by tertile (T2, hazard ratio 2.678; 95% confidence interval 1.110–6.460; P = 0.028, and T3, hazard ratio 4.745; 95% confidence interval 2.075–10.854; P < 0.001, respectively compared with the T1) was the independent factor predicting recurrence. Elevated pre-RFCA relaxin level is associated with post-RFCA AF recurrence. A simple measurement of relaxin level therefore might help identify patients at high risk of AF recurrence after RFCA.
Clinical Trial Registration chictr.org.cn identifier: ChiCTR-OOC-15006130.
KeywordsAtrial fibrillation Ablation Recurrence Relaxin
Radiofrequency catheter ablation
- Ang II
Renin–angiotensin–aldosterone system and angiotensin II
Paroxysmal atrial fibrillation
Persistent atrial fibrillation
Estimated glomerular filtration rate
Brain natriuretic peptide
Left atrial diameter
Left ventricular mass index
Receiver operating characteristic
Area under the ROC curve
Low-density lipoprotein cholesterol
Left ventricular end-diastolic diameter
This research was supported by the National Natural Science Foundation of China [81570364, 81873468] and in part by the Science and Technology Planning Project of Wenzhou Science & Technology Bureau of Zhejiang Province of China [Y20150032, Y20160318, Y20170021].The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to disclose. No commercial party having a direct or indirect interest in the subject matter of this research conferred a benefit on the authors or on any organization with which the authors are associated. This material has not previously been presented in any form.
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