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Europace Advance Access originally published online on July 9, 2009
Europace 2009 11(8):1024-1031; doi:10.1093/europace/eup185
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Biomarkers in Atrial Fibrillation

Non-ischaemic titrated cardiac injury caused by radiofrequency catheter ablation of atrial fibrillation mobilizes CD34-positive mononuclear cells by non-stromal cell-derived factor-1{alpha} mechanism

Sook Kyoung Kim1, Hui-Nam Pak2,*, Jae Hyung Park2, Jong Il Choi1, Myung-Hyun Nam3, Yunjung Jo3 and Young-Hoon Kim1

1 Korea University Cardiovascular Center, Seoul, Republic of Korea; 2 Division of Cardiology, Yonsei University Hospital System, 250 Seongsan-no, Seodaemun-gu, Seoul 120-752, Republic of Korea; 3 Department of Laboratory Medicine, Korea University, Seoul, Republic of Korea

Aims: It has been known that myocardial ischaemia mobilizes CD34+ bone marrow-derived cells by the stromal cell-derived factor (SDF)-1{alpha} pathway. We hypothesized that non-ischaemic titrated cardiac injury caused by radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) recruits CD34+ cells by an alternative mechanism.

Methods and results: Fifty-six patients (39 males, 53.0 ± 13.5 years old) who underwent electrophysiology study (EPS; n = 10) or RFCA of AF (n = 46) were included. Peripheral blood CD34+ cell count and multiple serologic markers were evaluated before, immediately after, at 24 h, and 10 days after the procedure. The results are as follows: (i) the per cent increase in CD34+ cells (%{Delta}CD34+) was significant after RFCA compared with after EPS (P < 0.01), and correlated with RF duration and troponin I, respectively. (ii) In contrast, SDF-1{alpha} decreased after RFCA and had no correlation with %{Delta}CD34+ cells while matrix metalloproteinase (MMP)-9 (P < 0.0001) and GROβ (P < 0.001) increased after RFCA and had correlations with 24 h %{Delta}CD34+ cells.

Conclusion: Non-ischaemic titrated cardiac injury caused by AF ablation mobilizes CD34+ cells to the peripheral blood through a non-SDF-1{alpha} pathway associated with MMP-9 and GROβ.

Key Words: CD34+ mononuclear cell, Atrial fibrillation, Catheter ablation, Cardiac injury

* Corresponding author. Tel: +82 2 2228 8459, Fax: +82 2 393 2041, Email: hnpak{at}yuhs.ac

Manuscript submitted 16 March 2009. Accepted after revision 15 June 2009.


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