Circulating intermediate monocytes and atrial structural remodeling associated with atrial fibrillation recurrence after catheter ablation

J Cardiovasc Electrophysiol. 2021 Apr;32(4):1035-1043. doi: 10.1111/jce.14929. Epub 2021 Feb 10.

Abstract

Background: Inflammation, such as that associated with intermediate CD14++ CD16+ monocytes and atrial structural remodeling (SRM), may be important in the recurrence of atrial fibrillation (AF) after catheter ablation. However, the relationship between the intermediate CD14++ CD16+ monocytes, SRM, and AF recurrence is unclear.

Methods: Twenty-four patients with AF were enrolled. The proportion of intermediate monocytes (PIM) was assessed before ablation by flow cytometry. As a surrogate marker of SRM, the volume ratio (VR) of signal intensity greater than 1 standard deviation on late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) was calculated. We investigated whether PIM correlated with SRM on LGE-MRI and determined the optimal cutoff value for predicting AF recurrence.

Results: Univariate analysis revealed positive correlations between PIM and BNP with SRM (PIM: r = .593, p = .002; BNP: r = .567, p = .004). Multivariable analysis revealed that PIM was independently associated with VR on LGE-MRI (β = .522; p = .033). The finding of an area under the receiver operating characteristic curve of 0.750 revealed that a VR ≥ 13.3% on LGE-MRI as the optimal cutoff value to predict AF recurrence with 80% sensitivity and 71% specificity, which was associated with PIM ≥ 10.0%.

Conclusion: Intermediate monocytes were significantly positively correlated with SRM. PIM ≥ 10% was associated with a VR ≥ 13.3% on LGE-MRI, which predicted AF recurrence after catheter ablation.

Keywords: atrial fibrillation; atrial structural remodeling; inflammation; intermediate monocytes; late-gadolinium enhancement magnetic resonance imaging.

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Atrial Remodeling*
  • Catheter Ablation* / adverse effects
  • Contrast Media
  • Gadolinium
  • Heart Atria / diagnostic imaging
  • Heart Atria / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Monocytes
  • Recurrence

Substances

  • Contrast Media
  • Gadolinium