PMID- 30575179
OWN - NLM
STAT- MEDLINE
DCOM- 20200720
LR  - 20200720
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 30
IP  - 4
DP  - 2019 Apr
TI  - Clinical impact of insulin resistance on pulmonary vein isolation outcome in 
      patients with paroxysmal atrial fibrillation.
PG  - 479-486
LID - 10.1111/jce.13827 [doi]
AB  - INTRODUCTION: The relationship between insulin resistance and atrial fibrillation 
      (AF) recurrence after pulmonary vein isolation (PVI) remains unclear. METHODS: 
      Drug-refractory 114 paroxysmal AF patients (89 males, 62 +/- 8 years) who underwent 
      successful PVI were enrolled. Homeostasis model assessment of insulin resistance 
      (HOMA-IR) was calculated and a value of >/=2.5 was defined as insulin resistant. 
      The left atrial volume index (LAVI) was measured using echocardiography before 
      and 1 year after PVI. Tumor necrosis factor-alpha (TNF-alpha) and TGF-beta1 serum levels 
      were measured before PVI, and the left atrium (LA) conduction velocity was 
      calculated. The patients were divided into two groups (group 1: HOMA-IR < 2.5, 
      n = 81; group 2: HOMA-IR >/= 2.5, n = 33). RESULTS: The LAVI between the two groups 
      before PVI did not significantly differ (P > 0.05), nor did TNF-alpha (7.7 +/- 2.0 vs 
      7.5 +/- 1.0 pg/mL; P = 0.149) or TGF-beta1 (28.4 +/- 12.0 vs 27.6 +/- 10.3 ng/mL; 
      P = 0.757). LAVI before and 1 year after PVI in each group did not change. The 
      conduction velocity of group 2 was slower than that of group 1 (0.7 +/- 0.1 vs 
      1.1 +/- 0.3 m/s, P < 0.001). Kaplan-Meier analysis showed significantly higher AF 
      recurrence in group 2 than that in group 1 ( P = 0.019). Cox multivariable 
      analysis revealed that insulin resistance was an independent predictor of 
      recurrence (hazard ratio 1.287, P = 0.004). CONCLUSION: Our results suggest that 
      insulin resistance promotes LA electrical remodeling and might be related to AF 
      recurrence after PVI.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Hijioka, Naoko
AU  - Hijioka N
AUID- ORCID: 0000-0001-6983-436X
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Kamioka, Masashi
AU  - Kamioka M
AUID- ORCID: 0000-0001-6588-0764
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Matsumoto, Yoshiyuki
AU  - Matsumoto Y
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Nodera, Minoru
AU  - Nodera M
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Yamada, Shinya
AU  - Yamada S
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Kaneshiro, Takashi
AU  - Kaneshiro T
AUID- ORCID: 0000-0002-5284-9538
AD  - Department of Arrhythmia and Cardiac Pacing, Fukushima Medical University, 
      Fukushima, Japan.
FAU - Yoshihisa, Akiomi
AU  - Yoshihisa A
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Ishida, Takafumi
AU  - Ishida T
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
FAU - Takeishi, Yasuchika
AU  - Takeishi Y
AD  - Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, 
      Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190107
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Action Potentials
MH  - Aged
MH  - Atrial Fibrillation/diagnosis/physiopathology/*surgery
MH  - Biomarkers/blood
MH  - Blood Glucose/metabolism
MH  - *Catheter Ablation/adverse effects
MH  - Female
MH  - Heart Rate
MH  - Humans
MH  - Insulin/blood
MH  - *Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Veins/physiopathology/*surgery
MH  - Recurrence
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - atrial fibrillation
OT  - catheter ablation
OT  - cryoablation
OT  - diabetes
OT  - insulin resistance
OT  - metabolic syndrome
OT  - pulmonary vein isolation
EDAT- 2018/12/24 06:00
MHDA- 2020/07/21 06:00
CRDT- 2018/12/22 06:00
PHST- 2018/10/23 00:00 [received]
PHST- 2018/12/10 00:00 [revised]
PHST- 2018/12/18 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2020/07/21 06:00 [medline]
PHST- 2018/12/22 06:00 [entrez]
AID - 10.1111/jce.13827 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2019 Apr;30(4):479-486. doi: 10.1111/jce.13827. Epub 
      2019 Jan 7.