Serum Vasoactive Intestinal Peptide as a Novel Biomarker for Low-Voltage Areas in Patients With Atrial Fibrillation.

IF 5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Heart Association Pub Date : 2025-04-01 Epub Date: 2025-03-21 DOI:10.1161/JAHA.124.039192

Kotaro Nishino, Taro Temma, Hiroyuki Natsui, Masaya Watanabe, Motoki Nakao, Masahiro Kawasaki, Kintaro Shimano, Kei Kawakami, Shota Saito, Jiro Koya, Daishiro Tatsuta, Takuya Koizumi, Takahide Kadosaka, Taro Koya, Satonori Tsuneta, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

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引用次数: 0

Abstract

Background: Low-voltage areas in the left atrium predict atrial fibrillation recurrence after catheter ablation and are associated with adverse outcomes like death, heart failure, and stroke. Detecting low-voltage areas (LVAs) typically requires invasive procedures, highlighting the need for a simple, minimally invasive marker. Vasoactive intestinal peptide (VIP), a neuropeptide released during parasympathetic stimulation, affects electrophysiological remodeling in atrial fibrillation. We hypothesized that serum VIP could serve as a biomarker for detecting LVAs in these patients.

Methods and results: This prospective, cross-sectional study was conducted at Hokkaido University Hospital between August 2021 and September 2023. We included 108 patients with atrial fibrillation scheduled for catheter ablation. Blood samples were collected during ablation to measure VIP using an ELISA. Electroanatomical mapping identified LVAs, defined as regions with bipolar voltage ≤0.5 mV and occupying >5% of the left atrial surface. Statistical analyses evaluated the relationship between VIP and LVAs. Fifty-one patients (47%) had LVAs, with significantly higher serum VIP levels than those without (335.1 versus 247.7 pg/mL, P<0.001). VIP levels and female sex were statistically significant factors of LVAs. Adding VIP to the existing score significantly improved its discrimination (area under the curve: 0.784 versus 0.707, P<0.001).

Conclusions: Serum VIP levels are higher in patients with atrial fibrillation with LVAs, suggesting its potential as a noninvasive biomarker for detecting these areas and improving clinical management.

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血清血管活性肠肽作为心房颤动患者低压区的新生物标志物。

背景：左心房低压区预测导管消融后房颤复发，并与死亡、心力衰竭和中风等不良结局相关。检测低压区（lva）通常需要侵入性手术，这突出了对简单、微创标记的需求。血管活性肠肽（VIP）是副交感神经刺激时释放的一种神经肽，影响心房颤动的电生理重构。我们假设血清VIP可以作为检测这些患者LVAs的生物标志物。方法和结果：这项前瞻性横断面研究于2021年8月至2023年9月在北海道大学医院进行。我们纳入108例心房颤动患者，计划行导管消融。消融过程中采集血液样本，用ELISA法测定VIP。电解剖图谱确定lva，定义为双极电压≤0.5 mV且占据左心房表面>5%的区域。统计学分析评价VIP与lva之间的关系。51例（47%）患者有LVAs，血清VIP水平明显高于无LVAs患者（335.1 pg/mL vs 247.7 pg/mL）。结论：伴有LVAs的房颤患者血清VIP水平较高，提示其有潜力作为检测这些区域和改善临床管理的无创生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

1.90%

发文量

1749

审稿时长

12 weeks

期刊介绍： As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.