Changes in biomarkers of endothelial function after the onset of atrial fibrillation in hypertensives / 解放军医学杂志

ABSTRACT

Objective To assess endothelial function before and after pharmacological cardioversion for acute onset of atrial fibrillation(AF)in the patients with hypertension.Methods 37 consecutive hypertensive patients with acute AF were investigated,in whom sinus rhythm was restored by pharmacological cardioversion within 48 hours of arrhythmia onset without anticoagulant treatment.Of these 37 patients,17 cases treated with ACEI/ARB drugs were assigned to acute AF group 1,20 cases without using ACEI/ARB drugs were assigned to acute AF group 2.20 hypertensive patients with sinus rhythm were included as control group.Plasma markers of endothelial damage/dysfunction [von Willebrand factor(vWF),endothelin(ET)and nitric oxide(NO)] and E-selectin(E-sel,an index of endothelial activation)were measured in acute AF at baseline(pre-cardioversion)and on days 1,7,14,and 30 after cardioversion.The detected results were compared with the levels of controls.Results Plasma concentrations of ET,vWF and E-sel in acute AF group were significantly higher than those of control group;plasma level of NO in acute AF group was significantly lower compared to that of control group.After cardioversion,the plasma levels of ET decreased gradually to the levels of controls by the 7th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2,and the plasma levels of vWF decreased to approach that of controls by the 14th day post-cardioversion in acute AF group 1 and 30th day in acute AF group 2.The NO level gradually increased to that of controls by the 14th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2.Plasma level of E-sel returned to normal by the 7th day in the both groups of acute AF.Conclusion There were evidences of endothelial damage or dysfunction at acute onset of AF among the patients with hypertension,which persisted up to 30 days after cardioversion,and the use of ACEI/ARB might improve the normalization of endothelial function after cardioversion.