Plasma myeloperoxidase: association with atrial fibrillation progression and recurrence after catheter ablation

Jingmeng Liu; Changjian Lin; Taojie Zhou; Yangyang Bao; Yun Xie; Yue Wei; Qingzhi Luo; Tianyou Ling; Wenqi Pan; Ning Zhang; Lin Lu; Liqun Wu; Qi Jin

doi:10.3389/fcvm.2023.1150324

Plasma myeloperoxidase: association with atrial fibrillation progression and recurrence after catheter ablation

Front Cardiovasc Med. 2023 Aug 31:10:1150324. doi: 10.3389/fcvm.2023.1150324. eCollection 2023.

Authors

Jingmeng Liu^#¹, Changjian Lin^#¹, Taojie Zhou^#¹, Yangyang Bao¹, Yun Xie¹, Yue Wei¹, Qingzhi Luo¹, Tianyou Ling¹, Wenqi Pan¹, Ning Zhang¹, Lin Lu^{1

2}, Liqun Wu¹, Qi Jin¹

Affiliations

¹ Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Institute of Cardiovascular Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Background: Myeloperoxidase (MPO), released by activated neutrophils, is significantly increased in atrial fibrillation (AF). MPO may play a role in the progression of atrial fibrillation and further involved in AF recurrence after catheter ablation. We compared plasma MPO levels in paroxysmal and persistent AF and explored their role in AF recurrence after catheter ablation.

Methods: Plasma MPO levels were measured in consecutive patients with paroxysmal AF (n = 225) and persistent AF (n = 106). Samples of patients were collected from the femoral vein during catheter ablation and all patients included were followed up after catheter ablation.

Results: Plasma MPO levels increased from paroxysmal AF to persistent AF patients (56.31 [40.33-73.51] vs. 64.11 [48.65-81.11] ng/ml, p < 0.001). MPO significantly correlated with left atrium volume (LAV) and there existed a significant interaction between the two in relation to AF recurrence (p for interaction <0.05). During a median follow-up of 14 months, 28 patients with paroxysmal AF (12.44%) and 27 patients with persistent AF (25.47%) presented with recurrence after catheter ablation. The percentage of recurrence increased stepwise with increasing tertiles of MPO levels in both paroxysmal AF and persistent AF. MPO levels remained independently associated with AF recurrence after adjusting for potential confounding variables.

Conclusion: MPO levels were higher in persistent AF than in paroxysmal AF and MPO was positively correlated with LAV in AF. Elevated MPO levels may predispose a switch in AF phenotype and AF recurrence after catheter ablation.

Keywords: atrial fibrillation; catheter ablation; left atrial volume; myeloperoxidase; recurrence.

Grants and funding

This research was funded by the National Natural Science Foundation of China (grant no. 81900290, 82100329, 81870250) and Clinical Research Plan for Shanghai Hospital Development Center (grant no. SHD2020CR4096).