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Europace Advance Access published online on November 30, 2009
Europace, doi:10.1093/europace/eup382
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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.

CLINICAL RESEARCH

Relationship of circulating endothelial progenitor cells to the recurrence of atrial fibrillation after successful conversion and maintenance of sinus rhythm

Chung-Wah Siu1,2, Timothy Watson3, Wing-Hon Lai1,2, Yee-Ki Lee1,2, Yap-Hang Chan1, Kwong-Man Ng1,2, Chu-Pak Lau1,2, Gregory Y.H. Lip3 and Hung-Fat Tse1,2,*

1 Cardiology Division, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China; 2 Research Center of Heart, Brain, Hormone and Healthy Aging, Hematology, University of Hong Kong, Hong Kong, China; 3 University Department of Medicine, City Hospital, Birmingham, UK

Aims: To determine whether the number of circulating endothelial progenitor cells (EPCs) in patients with persistent atrial fibrillation (AF) predicts arrhythmia recurrence after direct current cardioversion (DCCV).

Methods and results: The numbers of circulating CD34+/KDR+ EPCs were determined with flow cytometry in 51 consecutive patients with persistent AF [the mean age: 67 ± 1.3 years, male (65%)] prior to DCCV and were compared with that of age- and sex-matched controls, and cohorts of patients with coronary artery disease and ischaemic stroke. The AF recurrence rate at 1 year was also determined. The EPCs in patients with persistent AF, patients with coronary artery disease, and patients with ischaemic stroke were significantly lower than that of the age- and sex-matched controls (P < 0.01). One year after successful DCCV, patients with high EPC count (50th to 100th percentile) had a higher recurrence rate of AF when compared with those with low EPC count (less than 50th percentile) (73 vs. 40%, P = 0.02). Cox regression analysis revealed the high EPC count was the only independent predictors for the AF recurrence (HR: 2.29, P = 0.047).

Conclusion: The number of EPCs is reduced in patients with persistent AF and predicts the recurrence of AF after successful DCCV.

Key Words: Atrial fibrillation, Electrical cardioversion, Endothelial progenitor cells

* Corresponding author. Tel: +86 852 2855 3598, Fax: +86 852 2818 6304, Email: hftse{at}hkucc.hku.hk

Manuscript submitted 16 July 2009. Accepted after revision 3 November 2009.


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