Serum relaxin level predicts recurrence of atrial fibrillation after radiofrequency catheter ablation.
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.
['Qu|Xiang|X|', 'Chen|Lingzhi|L|', 'Sun|Lingyue|L|', 'Chen|Changxi|C|', 'Gao|Zhan|Z|', 'Huang|Weijian|W|', 'Zhou|Hao|H|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001281:Atrial Fibrillation D017115:Catheter Ablation D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D011237:Predictive Value of Tests D016016:Proportional Hazards Models D011446:Prospective Studies D012372:ROC Curve D012008:Recurrence D012065:Relaxin D012307:Risk Factors D016896:Treatment Outcome
Relaxin Recurrence Atrial fibrillation Ablation