Publication: Von Willebrand factor is associated with atrial fibrillation development in ischaemic patients after cardiac surgery
Authors
Lahoz, Álvaro ; Roldan, Vanessa ; Jover, Eva ; Romero Aniorte, Ana I. ; Jara Rubio, Rubén ; Arribas, José María ; García Alberola, Arcadio ; Cánovas López, Sergio ; Valdés, Mariano ; Marín, Francisco ; Martínez Cáceres, Carlos Manuel ; Hernández Romero, Diana
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Publisher
Oxford University Press
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DOI
https://doi.org/10.1093/europace/euv354
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info:eu-repo/semantics/article
Description
© The Author 2015. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
This document is the Published version of a Published Work that appeared in final form in EP Europace. To access the final edited and published work see https://doi.org/10.1093/europace/euv354
Abstract
Aims
Atrial fibrillation (AF) is associated with an increased morbidity and mortality after cardiac surgery. Von Willebrand factor (vWF) has been proposed as a biomarker of endothelial damage/dysfunction. We hypothesized that vWF levels could be used as valuable biomarker for AF occurrence after cardiac surgery. Moreover, we explored the potential association between vWF and tissue remodelling as possible implication in post-surgical AF.
Methods and results
We prospectively recruited 100 consecutive patients who undergoing programmed cardiac surgery with cardiopulmonary bypass and with no previous history of AF. Plasma vWF levels were determined from citrated plasma samples. Right atrial appendage tissue was obtained during cardiac surgery, and vWF expression as well as interstitial fibrosis was analysed by immunostaining and Masson's trichrome, respectively. We found raised vWF plasma levels in ischaemic vs. valvular patients (200.2 ± 66.3 vs. 157.2 ± 84.3 IU/dL; P = 0.015). Fibrosis degree was associated with plasma vWF levels. Plasma vWF was an independent prognostic marker for AF development in ischaemic patients [odds ratio, OR 6.44 (95% confidence interval, CI 1.40–36.57), P = 0.035].
Conclusion
Plasma vWF levels are associated with tissue fibrosis in patients undergoing cardiac surgery and with post-surgical AF development in ischaemic patients. These findings suggest an association among vWF levels, atrial remodelling, and AF development. It is supported by higher vWF expression in right atrial tissue in ischaemic patients, who developed post-surgical AF.
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Citation
EP Europace, 2016, Vol. 18, Issue 9, pp. 1328-1334
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