Elevated liver fibrosis-4 index predicts recurrence after catheter ablation for atrial fibrillation in patients with heart failure.
Atrial fibrillation
Catheter ablation
Fibrosis-4 index
Heart failure
Non-paroxysmal atrial fibrillation
Journal
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966
Informations de publication
Date de publication:
19 Oct 2023
19 Oct 2023
Historique:
received:
23
08
2023
accepted:
02
10
2023
medline:
19
10
2023
pubmed:
19
10
2023
entrez:
19
10
2023
Statut:
aheadofprint
Résumé
The fibrosis-4 (FIB-4) index is a noninvasive scoring system that is used to assess the progression of liver fibrosis. This study aimed to assess whether the FIB-4 index is associated with recurrent atrial fibrillation (AF) after catheter ablation in patients with and without heart failure (HF). We included 1,184 patients who underwent initial AF catheter ablation between 2016 and 2021. The patients were classified into low-risk (< 1.3), intermediate-risk (1.3-2.67), and high-risk (> 2.67) groups based on their FIB-4 indices at baseline. The patients were divided into HF (n = 552) and non-HF groups (n = 632); the HF group was further divided into paroxysmal AF (PAF) and non-PAF groups. AF recurrence after catheter ablation was then compared among the groups. In the non-HF group, no significant differences in recurrence after ablation were observed between the low-(n = 219), intermediate-(n = 364), and high-risk (n = 49) groups. In contrast, in the HF group, the intermediate-(n = 341) and high-risk (n = 112) groups had significantly higher recurrence rates than the low-risk group (n = 99) (log-rank test, p = 0.005). This association remained significant after multivariate analysis (hazard ratio [HR]:1.374; p = 0.027). The FIB-4 index increased incrementally as the brain natriuretic peptide levels and severity of tricuspid regurgitation increased. The FIB-4 index was an independent predictor of recurrence in the non-PAF HF group (HR:1.498; p = 0.007) but not in the PAF group. The FIB-4 index may be a useful predictor of AF recurrence after catheter ablation in patients with HF, particularly in those with non-PAF.
Sections du résumé
BACKGROUND
BACKGROUND
The fibrosis-4 (FIB-4) index is a noninvasive scoring system that is used to assess the progression of liver fibrosis. This study aimed to assess whether the FIB-4 index is associated with recurrent atrial fibrillation (AF) after catheter ablation in patients with and without heart failure (HF).
METHODS
METHODS
We included 1,184 patients who underwent initial AF catheter ablation between 2016 and 2021. The patients were classified into low-risk (< 1.3), intermediate-risk (1.3-2.67), and high-risk (> 2.67) groups based on their FIB-4 indices at baseline. The patients were divided into HF (n = 552) and non-HF groups (n = 632); the HF group was further divided into paroxysmal AF (PAF) and non-PAF groups. AF recurrence after catheter ablation was then compared among the groups.
RESULTS
RESULTS
In the non-HF group, no significant differences in recurrence after ablation were observed between the low-(n = 219), intermediate-(n = 364), and high-risk (n = 49) groups. In contrast, in the HF group, the intermediate-(n = 341) and high-risk (n = 112) groups had significantly higher recurrence rates than the low-risk group (n = 99) (log-rank test, p = 0.005). This association remained significant after multivariate analysis (hazard ratio [HR]:1.374; p = 0.027). The FIB-4 index increased incrementally as the brain natriuretic peptide levels and severity of tricuspid regurgitation increased. The FIB-4 index was an independent predictor of recurrence in the non-PAF HF group (HR:1.498; p = 0.007) but not in the PAF group.
CONCLUSIONS
CONCLUSIONS
The FIB-4 index may be a useful predictor of AF recurrence after catheter ablation in patients with HF, particularly in those with non-PAF.
Identifiants
pubmed: 37855993
doi: 10.1007/s10840-023-01661-2
pii: 10.1007/s10840-023-01661-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Cordero A, Escribano D, Quintanilla MA, López-Ayala JM, Masiá MD, Cazorla D, et al. Prognostic value of liver fibrosis assessed by the FIB-4 index in patients with acute coronary syndrome. Rev Esp Cardiol (Engl Ed). 2023. https://doi.org/10.1016/j.rec.2022.12.013 .
doi: 10.1016/j.rec.2022.12.013
pubmed: 36669734
Itier R, Guillaume M, Ricci JE, Roubille F, Delarche N, Picard F, et al. Non-alcoholic fatty liver disease and heart failure with preserved ejection fraction: from pathophysiology to practical issues. ESC Heart Fail. 2021;8(2):789–98. https://doi.org/10.1002/ehf2.13222 .
doi: 10.1002/ehf2.13222
pubmed: 33534958
pmcid: 8006705
Liu X, Chen W, Shao W, Jiang Y, Cao Z, He W, et al. Liver fibrosis scores and atrial fibrillation incidence in heart failure with preserved ejection fraction. ESC Heart Fail. 2022;9(6):3985–94. https://doi.org/10.1002/ehf2.14087 .
doi: 10.1002/ehf2.14087
pubmed: 35996808
pmcid: 9773713
Maeda D, Kanzaki Y, Sakane K, Tsuda K, Akamatsu K, Hourai R, et al. Prognostic impact of a reduction in the fibrosis-4 index among patients hospitalized with acute heart failure. Heart Vessels. 2023. https://doi.org/10.1007/s00380-023-02273-6 .
doi: 10.1007/s00380-023-02273-6
pubmed: 37277568
Nakashima M, Tanakaya M, Miyoshi T, Saito T, Katayama Y, Sakuragi S, et al. The fibrosis-4 index predicts cardiovascular prognosis in patients with severe isolated tricuspid regurgitation. Circ J. 2022;86(11):1777–84. https://doi.org/10.1253/circj.CJ-22-0109 .
doi: 10.1253/circj.CJ-22-0109
pubmed: 35922937
Nakashima M, Sakuragi S, Miyoshi T, Takayama S, Kawaguchi T, Kodera N, et al. Fibrosis-4 index reflects right ventricular function and prognosis in heart failure with preserved ejection fraction. ESC Heart Fail. 2021;8(3):2240–7. https://doi.org/10.1002/ehf2.13317 .
doi: 10.1002/ehf2.13317
pubmed: 33760403
pmcid: 8120399
Shibata N, Kondo T, Kazama S, Kimura Y, Oishi H, Arao Y, et al. Impact of predictive value of fibrosis-4 index in patients hospitalized for acute heart failure. Int J Cardiol. 2021;324:90–5. https://doi.org/10.1016/j.ijcard.2020.09.056 .
doi: 10.1016/j.ijcard.2020.09.056
pubmed: 33007325
Tseng CH, Huang WM, Yu WC, Cheng HM, Chang HC, Hsu PF, et al. The fibrosis-4 score is associated with long-term mortality in different phenotypes of acute heart failure. Eur J Clin Invest. 2022;52(12): e13856. https://doi.org/10.1111/eci.13856 .
doi: 10.1111/eci.13856
pubmed: 35975623
Vallet-Pichard A, Mallet V, Pol S. FIB-4: a simple, inexpensive and accurate marker of fibrosis in HCV-infected patients. Hepatology (Baltimore, Md). 2006;44(3):769; author reply -70. https://doi.org/10.1002/hep.21334 .
Wang Z, Wang Y, Luo F, Zhai Y, Li J, Chen Y, et al. Impact of advanced liver fibrosis on atrial fibrillation recurrence after ablation in non-alcoholic fatty liver disease patients. Front Cardiovasc Med. 2022;9: 960259. https://doi.org/10.3389/fcvm.2022.960259 .
doi: 10.3389/fcvm.2022.960259
pubmed: 36277780
pmcid: 9583404
Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, et al. JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias. J Arrhythm. 2021;37(4):709–870. https://doi.org/10.1002/joa3.12491 .
doi: 10.1002/joa3.12491
pubmed: 34386109
pmcid: 8339126
Shah AG, Lydecker A, Murray K, Tetri BN, Contos MJ, Sanyal AJ. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7(10):1104–12. https://doi.org/10.1016/j.cgh.2009.05.033 .
doi: 10.1016/j.cgh.2009.05.033
pubmed: 19523535
pmcid: 3079239
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891–975. https://doi.org/10.1002/ejhf.592 .
Anand IS, Claggett B, Liu J, Shah AM, Rector TS, Shah SJ, et al. Interaction between spironolactone and natriuretic peptides in patients with heart failure and preserved ejection fraction: from the TOPCAT trial. JACC Heart Fail. 2017;5(4):241–52. https://doi.org/10.1016/j.jchf.2016.11.015 .
doi: 10.1016/j.jchf.2016.11.015
pubmed: 28359411
Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2013). Circ J. 2014;78(8):1997–2021. https://doi.org/10.1253/circj.cj-66-0092 .
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–962. https://doi.org/10.1093/eurheartj/ehw210 .
doi: 10.1093/eurheartj/ehw210
pubmed: 27567408
Su WW, Reddy VY, Bhasin K, Champagne J, Sangrigoli RM, Braegelmann KM, et al. Cryoballoon ablation of pulmonary veins for persistent atrial fibrillation: results from the multicenter STOP Persistent AF trial. Heart Rhythm. 2020;17(11):1841–7. https://doi.org/10.1016/j.hrthm.2020.06.020 .
doi: 10.1016/j.hrthm.2020.06.020
pubmed: 32590151
Mililis P, Kariki O, Saplaouras A, Bazoukis G, Dragasis S, Patsiotis IG, et al. Radiofrequency versus cryoballoon catheter ablation in patients with persistent atrial fibrillation: a randomized trial. J Cardiovasc Electrophysiol. 2023;34(7):1523–8. https://doi.org/10.1111/jce.15965 .
doi: 10.1111/jce.15965
pubmed: 37293822
Masuda M, Asai M, Iida O, Okamoto S, Ishihara T, Nanto K, et al. Additional low-voltage-area ablation in patients with paroxysmal atrial fibrillation: results of the randomized controlled VOLCANO trial. J Am Heart Assoc. 2020;9(13): e015927. https://doi.org/10.1161/jaha.120.015927 .
doi: 10.1161/jaha.120.015927
pubmed: 32578466
pmcid: 7670527
Morishima I, Okumura K, Morita Y, Kanzaki Y, Takagi K, Yoshida R, et al. High-normal thyroid-stimulating hormone shows a potential causal association with arrhythmia recurrence after catheter ablation of atrial fibrillation. J Am Heart Assoc. 2018;7(14): e02707. https://doi.org/10.1161/jaha.118.009158 .
doi: 10.1161/jaha.118.009158
Kaitani K, Inoue K, Kobori A, Nakazawa Y, Ozawa T, Kurotobi T, et al. Efficacy of antiarrhythmic drugs short-term use after catheter ablation for atrial fibrillation (EAST-AF) trial. Eur Heart J. 2016;37(7):610–8. https://doi.org/10.1093/eurheartj/ehv501 .
doi: 10.1093/eurheartj/ehv501
pubmed: 26417061
Decoin R, Butruille L, Defrancq T, Robert J, Destrait N, Coisne A, et al. High liver fibrosis scores in metabolic dysfunction-associated fatty liver disease patients are associated with adverse atrial remodeling and atrial fibrillation recurrence following catheter ablation. Front Endocrinol. 2022;13: 957245. https://doi.org/10.3389/fendo.2022.957245 .
doi: 10.3389/fendo.2022.957245
Coppini R, Santini L, Palandri C, Sartiani L, Cerbai E, Raimondi L. Pharmacological inhibition of serine proteases to reduce cardiac inflammation and fibrosis in atrial fibrillation. Front Pharmacol. 2019;10:1420. https://doi.org/10.3389/fphar.2019.01420 .
doi: 10.3389/fphar.2019.01420
pubmed: 31956307
pmcid: 6951407
Mangi MA, Rehman H, Minhas AM, Rafique M, Bansal V, Constantin J. Non-Alcoholic fatty liver disease association with cardiac arrhythmias. Cureus. 2017;9(4): e1165. https://doi.org/10.7759/cureus.1165 .
doi: 10.7759/cureus.1165
pubmed: 28507837
pmcid: 5429146
Nattel S, Dobrev D. The multidimensional role of calcium in atrial fibrillation pathophysiology: mechanistic insights and therapeutic opportunities. Eur Heart J. 2012;33(15):1870–7. https://doi.org/10.1093/eurheartj/ehs079 .
doi: 10.1093/eurheartj/ehs079
pubmed: 22507975
Cosio FG, Palacios J, Vidal JM, Cocina EG, Gómez-Sánchez MA, Tamargo L. Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry. Am J Cardiol. 1983;51(1):122–30. https://doi.org/10.1016/s0002-9149(83)80022-8 .
Buxton AE, Waxman HL, Marchlinski FE, Josephson ME. Atrial conduction: effects of extrastimuli with and without atrial dysrhythmias. Am J Cardiol. 1984;54(7):755–61. https://doi.org/10.1016/s0002-9149(84)80203-9 .
doi: 10.1016/s0002-9149(84)80203-9
pubmed: 6486024
Chen PS, Chen LS, Fishbein MC, Lin SF, Nattel S. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circ Res. 2014;114(9):1500–15. https://doi.org/10.1161/circresaha.114.303772 .
doi: 10.1161/circresaha.114.303772
pubmed: 24763467
pmcid: 4043633
Nishio T, Taura K, Iwaisako K, Koyama Y, Tanabe K, Yamamoto G, et al. Hepatic vagus nerve regulates Kupffer cell activation via α7 nicotinic acetylcholine receptor in nonalcoholic steatohepatitis. J Gastroenterol. 2017;52(8):965–76. https://doi.org/10.1007/s00535-016-1304-z .
doi: 10.1007/s00535-016-1304-z
pubmed: 28044208
Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003;91(6a):2d–8d. https://doi.org/10.1016/s0002-9149(02)03373-8 .
doi: 10.1016/s0002-9149(02)03373-8
pubmed: 12670636
Tomaselli GF, Marbán E. Electrophysiological remodeling in hypertrophy and heart failure. Cardiovasc Res. 1999;42(2):270–83. https://doi.org/10.1016/s0008-6363(99)00017-6 .
doi: 10.1016/s0008-6363(99)00017-6
pubmed: 10533566
Melenovsky V, Hwang SJ, Lin G, Redfield MM, Borlaug BA. Right heart dysfunction in heart failure with preserved ejection fraction. Eur Heart J. 2014;35(48):3452–62. https://doi.org/10.1093/eurheartj/ehu193 .
doi: 10.1093/eurheartj/ehu193
pubmed: 24875795
pmcid: 4425842