Yonsei Med J.  2015 Nov;56(6):1530-1537. 10.3349/ymj.2015.56.6.1530.

Catheter Ablation of Atrial Fibrillation Raises the Plasma Level of NGF-beta Which Is Associated with Sympathetic Nerve Activity

• Park JH
• Hong SY
• Wi J
• Lee DL
• Joung B
• Lee MH
• Pak HN

• KMID: 2345879
• DOI: http://doi.org/10.3349/ymj.2015.56.6.1530

Abstract

PURPOSE
The expression of nerve growth factor-beta (NGF-beta) is related to cardiac nerve sprouting and sympathetic hyper innervation. We investigated the changes of plasma levels of NGF-beta and the relationship to follow-up heart rate variability (HRV) after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF).
MATERIALS AND METHODS
This study included 147 patients with AF (117 men, 55.8+/-11.5 years, 106 paroxysmal AF) who underwent RFCA. The plasma levels of NGF-beta were quantified using double sandwich enzyme linked immunosorbent assay method before (NGF-beta(pre)) and 1 hour after RFCA (NGF-beta(post-1hr)). HRV at pre-procedure (HRV(pre)), 3 months (HRV(post-3mo)), and 1 year post-procedure (HRV(post-1yr)) were analyzed and compared with plasma levels of NGF-beta.
RESULTS
1) The plasma levels of NGF-beta significantly increased after RFCA (20.05+/-11.09 pg/mL vs. 29.60+/-19.43 pg/mL, p<0.001). The patients who did not show increased NGF-beta(post-1hr) were older (p=0.023) and had greater left atrial volume index (p=0.028) than those with increased NGF-beta(post-1hr). 2) In patients with NGF-beta(pre) >18 pg/mL, low frequency components (LF)/high-frequency components (HF) (p=0.003) and the number of atrial premature contractions (APCs, p=0.045) in HRV(post-3mo) were significantly higher than those with < or =18 pg/mL. 3) The LF/HF at HRV(post-3mo) was linearly associated with the NGF-beta(pre) (B=4.240, 95% CI 1.114-7.336, p=0.008) and the NGF-beta(post-1hr) (B=7.617, 95% CI 2.106-13.127, p=0.007). 4) Both NGF-beta(pre) (OR=1.159, 95% CI 1.045-1.286, p=0.005) and NGF-beta(post-1hr) (OR=1.098, 95% CI 1.030-1.170, p=0.004) were independent predictors for the increase of LF/HF at HRV(post-3mo).
CONCLUSION
AF catheter ablation increases plasma level of NGF-beta, and high plasma levels of NGF-beta(pre) was associated with higher sympathetic nerve activity and higher frequency of APCs in HRV(post-3mo).

Keyword

Atrial fibrillation; catheter ablation; nerve growth factor; sympathetic nerve

MeSH Terms

Aged
Atrial Fibrillation/physiopathology/*surgery
Catheter Ablation/*methods
Female
*Heart Rate
Humans
Male
Middle Aged
Nerve Growth Factor
Nerve Growth Factors
Transforming Growth Factor beta/*metabolism
Treatment Outcome
Nerve Growth Factor
Nerve Growth Factors
Transforming Growth Factor beta

Figure

• 

  Fig. 1 (A) Plasma levels of NGF-β before and after AF ablation. (B) Correlation between pre- and post-ablation NGF-βs. (C) Mean heart rate in pre AF ablation, post 3 month AF ablation, and post 1 year AF ablation. (D) rMSSD in pre AF ablation, post 3 month AF ablation, and post 1 year AF ablation. (E) LF in pre AF ablation, post 3 month AF ablation, and post 1 year AF ablation. NGF-β, nerve growth factor-β; RFCA, radiofrequency catheter ablation; LF, low frequency components.

• 

  Fig. 2 Changes of mean heart rate and HRV after catheter ablation of AF. We compared the change of Mean heart rate (A), rMSSD (B), LF (C), HF (D), LF/HF ratio (E), and number of APCs (F) defending on the NGF-βpre plasma level. HRV, heart rate variability; AF, atrial fibrillation; HF, high-frequency components; LF, low frequency components; APCs, atrial premature contractions; NGF-β, nerve growth factor-β.

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