alexa Left Atrial Enlargement Correlates with Inflammation and Oxidative Stress in Patients at High Risk for Atrial Fibrillation
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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Research Article

Left Atrial Enlargement Correlates with Inflammation and Oxidative Stress in Patients at High Risk for Atrial Fibrillation

Heather L. Bloom1*, Irfan Shukrullah2, William Jang3, Richard N. Vest III4 and Samuel C. Dudley2
1Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Georgia, USA
2University of Illinois at Chicago, Section of Cardiology Chicago, IL, USA
3Virginia Mason Medical Center, Seattle WA, USA
4Medical University of South Carolina, Charleston, SC, USA
Corresponding Author : Heather L Bloom, MD
Atlanta VAMC, Suite 111B
1670 Clairmont Dr, Decatur GA 30033
Tel: 404.321.6111 ex 6391
Fax: 404.329.2211
E-mail: [email protected]
Received August 03, 2010; Accepted August 29, 2010; Published August 29, 2010
Citation: Bloom HL, Shukrullah I, Jang W, Vest RN III, Dudley SC (2010) Left Atrial Enlargement Correlates with Infl ammation and Oxidative Stress in Patients at High Risk for Atrial Fibrillation. J Clinic Experiment Cardiol 1:101 doi: 10.4172/2155-9880.1000101
Copyright: © 2010 Bloom HL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Objective: To examine the relationship between enlarged left atrial volume and increased blood markers of oxidative stress in patients at high risk for atrial fibrillation. Design: This is a retrospective study where a single blood draw was taken from a cohort of patients with internal cardioverter-defibrillators, cardiomyopathy and ejection fraction (EF) = 30%, and sent for markers of oxidative stress and inflammation. Left atrial size was obtained from echocardiography. Setting: Single center, multi-hospital, cohort of 191 patients who underwent subgroup analysis; these patients are a subgroup of those enrolled in a larger, prospective trial, multicenter trial. Patients: See above Interventions: Single blood draw, retrospective database/chart review Outcome Measures: Levels of hsCRP, IL-6, TNF-?, nitrotyrosine, reduced to oxidized cysteine ratio, reduced to oxidized glutathione ratio, derivatives of reactive oxygen metabolites (DROMS) Results: Under univariate analysis, BMI (?= 0.003, r= 0.211), IL-6 (?=0.03, r= 0.192) and cysteine ratio (?=0.004, r=0.242) all correlated with LA enlargement. Binary logistic regression demonstrated that the single factor that best classified normal vs. enlarged LA is cysteine (?=.001). The binary logistic model itself is significantly predictive, as indicated by an omnibus test of model coefficients (?<.001). When analyzed as a continuous variable, rather than using a cut point, increasing IL-6 levels correlated to increasing LA diameter. Conclusions: These data suggest an association between IL-6, cysteine and left atrial enlargement (LAE). As LAE is associated with atrial fibrillation, reductions in inflammation and oxidative stress may lead to decreased risk of atrial fibrillation. Treatments to reduce oxidative stress may have potential to prevent development of atrial fibrillation.

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