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Poster Abstract PresentationsSession Title: Poster Session 2

Abstract 198: Noninvasive Approach Assessing Atrial Mechanics and Serum Biomarkers of Collagen Turnover Provides a Surrogate for Fibrosis and Atrial Fibrillation

Mahek Mirza, Farhan Rizvi, Melissa Albrecht, Anton Strunets, Larisa Emelyanova, Ekhson Holmuhamedov, Paul H. Werner, David C. Kress, Bijoy K. Khandheria, Jasbir Sra, Arshad Jahangir
Circulation Research. 2014;115:A198
Mahek Mirza
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Farhan Rizvi
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Melissa Albrecht
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Anton Strunets
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Larisa Emelyanova
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Ekhson Holmuhamedov
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Paul H. Werner
Aurora Med Group-Cardiovascular and Thoracic Surgery, Aurora St. Luke’s Med Cntr, Milwaukee, WI
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David C. Kress
Aurora Med Group-Cardiovascular and Thoracic Surgery, Aurora St. Luke’s Med Cntr, Milwaukee, WI
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Bijoy K. Khandheria
Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Med Cntrs, Univ of Wisconsin Sch of Medicine and Public Health, Milwaukee, WI
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Jasbir Sra
Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Med Cntrs, Univ of Wisconsin Sch of Medicine and Public Health, Milwaukee, WI, United States, Milwaukee, WI
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Arshad Jahangir
Cntr for Integrative Rsch in Cardiovascular Aging, Aurora Univ of Wisconsin Med Group, Milwaukee, WI
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Abstract

Introduction: Atrial fibrosis alters myocardial electrophysiological properties, increasing susceptibility to postoperative atrial fibrillation (PoAF); however, its estimation is problematic. We hypothesized that a noninvasive approach using history of AF (HxAF), LA mechanics and serum biomarkers of collagen turnover provides a surrogate for the extent of interstitial atrial fibrosis to identify patients at risk for PoAF.

Methods: In patients undergoing cardiac surgery from April-Dec 2013, concentrations of biomarkers reflecting collagen synthesis/degradation and extracellular matrix remodeling were determined in serum from preoperative blood using an enzyme-linked immunosorbent assay, and echocardiographic evaluation was performed using M-mode, 2D, Doppler and 3D speckle tracking.

Results: Of 66 patients (68 ±11 y, 67% men), 15 had HxAF and 11 of 51 with no HxAF (22%) developed new onset PoAF. In patients with HxAF, biomarkers for collagen turnover were elevated (Fig A) and correlated with a reduction in LA ejection fraction and global and regional relaxation of the LA wall (p=0.01, Fig B). In patients with no HxAF, procollagen type III (PIIINP) was significantly different in those who developed PoAF (p=0.01) and correlated with reduction in contractility in the posterior LA roof (p=<0.001) with a prolonged time to peak end-diastolic volume (p=0.03). LA size or ventricular structure and function were not different between groups.

Conclusion: Surrogate serum and imaging biomarkers correlate with the substrate abnormality that promotes AF. These results need to be validated in larger cohorts to assess the power of these parameters in predicting new onset PoAF.


Embedded Image
  • Fibrosis
  • Atrial fibrillation
  • Biomarkers
  • Author Disclosures: M. Mirza: None F. Rizvi: None M. Albrecht: None A. Strunets: None L. Emelyanova: None E. Holmuhamedov: None P. Werner: None D. Kress: None B. Khandheria: None J. Sra: None A. Jahangir: None.

  • © 2014 by American Heart Association, Inc.
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July 18, 2014, Volume 115, Issue Suppl 1
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    Abstract 198: Noninvasive Approach Assessing Atrial Mechanics and Serum Biomarkers of Collagen Turnover Provides a Surrogate for Fibrosis and Atrial Fibrillation
    Mahek Mirza, Farhan Rizvi, Melissa Albrecht, Anton Strunets, Larisa Emelyanova, Ekhson Holmuhamedov, Paul H. Werner, David C. Kress, Bijoy K. Khandheria, Jasbir Sra and Arshad Jahangir
    Circulation Research. 2014;115:A198, originally published November 6, 2014

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    Abstract 198: Noninvasive Approach Assessing Atrial Mechanics and Serum Biomarkers of Collagen Turnover Provides a Surrogate for Fibrosis and Atrial Fibrillation
    Mahek Mirza, Farhan Rizvi, Melissa Albrecht, Anton Strunets, Larisa Emelyanova, Ekhson Holmuhamedov, Paul H. Werner, David C. Kress, Bijoy K. Khandheria, Jasbir Sra and Arshad Jahangir
    Circulation Research. 2014;115:A198, originally published November 6, 2014
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