Catheter Ablation of Atrial Fibrillation Raises the Plasma Level of NGF-beta Which Is Associated with Sympathetic Nerve Activity.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3349/ymj.2015.56.6.1530
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jae Hyung PARK
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sung Yu HONG
			        		
			        		;
		        		
		        		
		        		
			        		Jin WI
			        		
			        		;
		        		
		        		
		        		
			        		Da Lyung LEE
			        		
			        		;
		        		
		        		
		        		
			        		Boyoung JOUNG
			        		
			        		;
		        		
		        		
		        		
			        		Moon Hyoung LEE
			        		
			        		;
		        		
		        		
		        		
			        		Hui Nam PAK
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Cardiology, Yonsei University Health System, Seoul, Korea. hnpak@yuhs.ac, hongsy@yuhs.ac
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Atrial fibrillation;
			        		
			        		
			        		
				        		catheter ablation;
			        		
			        		
			        		
				        		nerve growth factor;
			        		
			        		
			        		
				        		sympathetic nerve
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Aged;
				        		
			        		
				        		
					        		Atrial Fibrillation/physiopathology/*surgery;
				        		
			        		
				        		
					        		Catheter Ablation/*methods;
				        		
			        		
				        		
					        		Female;
				        		
			        		
				        		
					        		*Heart Rate;
				        		
			        		
				        		
					        		Humans;
				        		
			        		
				        		
					        		Male;
				        		
			        		
				        		
					        		Middle Aged;
				        		
			        		
				        		
					        		Nerve Growth Factor;
				        		
			        		
				        		
					        		Nerve Growth Factors;
				        		
			        		
				        		
					        		Transforming Growth Factor beta/*metabolism;
				        		
			        		
				        		
					        		Treatment Outcome
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Yonsei Medical Journal
	            		
	            		 2015;56(6):1530-1537
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	PURPOSE: The expression of nerve growth factor-beta (NGF-beta) is related to cardiac nerve sprouting and sympathetic hyper innervation. We investigated the changes of plasma levels of NGF-beta and the relationship to follow-up heart rate variability (HRV) after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). MATERIALS AND METHODS: This study included 147 patients with AF (117 men, 55.8+/-11.5 years, 106 paroxysmal AF) who underwent RFCA. The plasma levels of NGF-beta were quantified using double sandwich enzyme linked immunosorbent assay method before (NGF-beta(pre)) and 1 hour after RFCA (NGF-beta(post-1hr)). HRV at pre-procedure (HRV(pre)), 3 months (HRV(post-3mo)), and 1 year post-procedure (HRV(post-1yr)) were analyzed and compared with plasma levels of NGF-beta. RESULTS: 1) The plasma levels of NGF-beta significantly increased after RFCA (20.05+/-11.09 pg/mL vs. 29.60+/-19.43 pg/mL, p<0.001). The patients who did not show increased NGF-beta(post-1hr) were older (p=0.023) and had greater left atrial volume index (p=0.028) than those with increased NGF-beta(post-1hr). 2) In patients with NGF-beta(pre) >18 pg/mL, low frequency components (LF)/high-frequency components (HF) (p=0.003) and the number of atrial premature contractions (APCs, p=0.045) in HRV(post-3mo) were significantly higher than those with < or =18 pg/mL. 3) The LF/HF at HRV(post-3mo) was linearly associated with the NGF-beta(pre) (B=4.240, 95% CI 1.114-7.336, p=0.008) and the NGF-beta(post-1hr) (B=7.617, 95% CI 2.106-13.127, p=0.007). 4) Both NGF-beta(pre) (OR=1.159, 95% CI 1.045-1.286, p=0.005) and NGF-beta(post-1hr) (OR=1.098, 95% CI 1.030-1.170, p=0.004) were independent predictors for the increase of LF/HF at HRV(post-3mo). CONCLUSION: AF catheter ablation increases plasma level of NGF-beta, and high plasma levels of NGF-beta(pre) was associated with higher sympathetic nerve activity and higher frequency of APCs in HRV(post-3mo).