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Erschienen in:
01.04.2008
Endothelin system and atrial fibrillation post-cardiac surgery
Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2008
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Objective
We investigated the relation between the endothelin system and atrial fibrillation.
Background
Endothelin has been implicated in the pathophysiology of atrial fibrillation, but the exact role of A- and B-receptors is unknown.
Methods
We obtained right atrial biopsies from patients in sinus rhythm and preserved left ventricular function, undergoing off-pump coronary artery bypass grafting. The expression of endothelin, A- and B-receptors was measured using real time reverse-transcribed polymerase chain reaction.
Results
We studied 52 patients (45 male, mean age 66 ± 1 years, mean ejection fraction 52 ± 1%). During a 5-day post-operative period, persistent atrial fibrillation occurred in 15 patients (28.8%). Endothelin mRNA expression was comparable in patients who subsequently developed atrial fibrillation and in those maintaining sinus rhythm. However, the former group displayed down-regulation of endothelin A- (by approximately 60%, p = 0.0059) and of B-receptors (by approximately 40%, p = 0.0084). The decreased endothelin A-receptor expression could predict atrial fibrillation occurrence (Wilks λ = 0.86, F = 6.16, p = 0.017).
Conclusion
Decreased endothelin A- and B-receptor expression is associated with atrial fibrillation after bypass surgery.