Impact of Inflammation on Atrial Fibrillation in patients with Metabolic Syndrome

Abstract

Background: Inflammation has been involved in the pathogenesis of both metabolic syndrome (MS) and atrial fibrillation (AF). The magnitude of elevations in plasma C-reactive protein (CRP) a marker of inflammation is probably related to atrial structural remodeling and impaired atrial function. In patient with MS, limited data exist regarding impact of plasma levels of inflammatory markers, such as C-reactive protein on the: type of AF and atrial structural and functional remodeling. Objective: We set to analyze the impact of degree of systemic inflammation (assessed according to CRP levels), on the type of AF, atrial functional and structural remodeling in patients with MS. Methods: We conducted a multicenter observational cross-sectional study. Recruited were 425 consecutive participants, with MS and AF(paroxysmal, persistent and permanent AF),who attended outpatient visits at 7 general cardiology Health Care Clinics, during 1 calendar year, stratified according CRP-levels:(211 participants with level of CRP ≥3mg/l, and 214, with level of CRP <3mg/l). Results: Permanent type of AF, was more common in participants with CRP-levels ≥3mg/l (54.6% vs.20.5%,p= 0.000),whereas parhoxysmal AF, was more common in participants with CRP-levels of <3 mg/l (9.9% vs.52.3%,p=0.000). Patients who had CRP levels above the cut-off of 3 mg/l, had increased dimension of left atrium {(LA),(4.2±0.3 vs. 3.7±0.2,p=0.000)},higher prevalence of enlargement of LA {defined as left atrial volume index(LAVI) ≥29ml/m2(84.1% vs.48.5%,p=0.002)} and inverse relationship of LA function(defined as left atrial emptying fraction(LAEF <45%, (30.8±3.4 vs.41.9±2.6, p=0.00).