Abstract：
BACKGROUND: Serum bone morphogenetic protein 10 (BMP10) blood levels are a marker for history of atrial fibrillation (AF) and for major adverse cardiovascular events in patients with AF, including stroke, AF recurrences after catheter ablations, and mortality. The predictive value of BMP10 in patients undergoing cardiac surgery and association with morphologic properties of atrial tissues are unknown.
OBJECTIVE: This study sought to study the correlation between BMP10 levels and preoperative clinical traits, occurrence of early and late postoperative atrial fibrillation (POAF), and atrial fibrosis in patients undergoing cardiac surgery.
METHODS: Patients with and without preoperative AF history undergoing first cardiac surgery were included (RACE V, n = 147). Preoperative blood biomarkers were analyzed, left (n = 114) and right (n = 125) atrial appendage biopsy specimens were histologically investigated after WGA staining, and postoperative rhythm was monitored continuously with implantable loop recorders (n = 133, 2.5 years).
RESULTS: Adjusted multinomial logistic regression indicated that BMP10 accurately reflected a history of persistent AF (OR: 1.24, 95% CI: 1.10-1.40, P = 0.001), similar to NT-pro-BNP. BMP10 levels were associated with increased late POAF90 occurrence after adjustment for age, sex, AF history, and early POAF occurrence (HR: 1.07 [per 0.1 ng/mL increase], 95% CI: 1.00-1.14, P = 0.041). Left atrial endomysial fibrosis (standardized β = 0.22, P = 0.041) but not overall fibrosis (standardized Β = 0.12, P = 0.261) correlated with circulating BMP10 after adjustment for age, sex, AF history, reduced LVF, and valvular surgery indication.
CONCLUSIONS: Increased BMP10 levels were associated with persistent AF history, increased late POAF incidence, and LAA endomysial fibrosis in a diverse sample of patients undergoing cardiac surgery.
OBJECTIVE: This study sought to study the correlation between BMP10 levels and preoperative clinical traits, occurrence of early and late postoperative atrial fibrillation (POAF), and atrial fibrosis in patients undergoing cardiac surgery.
METHODS: Patients with and without preoperative AF history undergoing first cardiac surgery were included (RACE V, n = 147). Preoperative blood biomarkers were analyzed, left (n = 114) and right (n = 125) atrial appendage biopsy specimens were histologically investigated after WGA staining, and postoperative rhythm was monitored continuously with implantable loop recorders (n = 133, 2.5 years).
RESULTS: Adjusted multinomial logistic regression indicated that BMP10 accurately reflected a history of persistent AF (OR: 1.24, 95% CI: 1.10-1.40, P = 0.001), similar to NT-pro-BNP. BMP10 levels were associated with increased late POAF90 occurrence after adjustment for age, sex, AF history, and early POAF occurrence (HR: 1.07 [per 0.1 ng/mL increase], 95% CI: 1.00-1.14, P = 0.041). Left atrial endomysial fibrosis (standardized β = 0.22, P = 0.041) but not overall fibrosis (standardized Β = 0.12, P = 0.261) correlated with circulating BMP10 after adjustment for age, sex, AF history, reduced LVF, and valvular surgery indication.
CONCLUSIONS: Increased BMP10 levels were associated with persistent AF history, increased late POAF incidence, and LAA endomysial fibrosis in a diverse sample of patients undergoing cardiac surgery.
摘要：
背景：血清骨形态发生蛋白10（BMP10）血液水平是房颤（AF）病史和房颤患者主要不良心血管事件的标志，包括中风,导管消融后房颤复发,和死亡率。BMP10在接受心脏手术的患者中的预测价值以及与心房组织形态特性的关系尚不清楚。
目的：本研究旨在研究BMP10水平与术前临床特征之间的相关性。术后早期和晚期心房颤动（POAF）的发生，心脏手术患者的心房纤维化。
方法：包括有和没有术前房颤史的首次心脏手术患者（RACEV，n=147)。术前血液生物标志物分析，左（n=114）和右（n=125）心耳活检标本在WGA染色后进行组织学研究，使用植入式环路记录仪连续监测术后节律(n=133,2.5年).
结果：调整后的多项逻辑回归表明BMP10准确反映了持续性房颤的病史（OR：1.24，95％CI：1.10-1.40，P=0.001），类似于NT-pro-BNP。调整年龄后，BMP10水平与POAF90晚期发生率增加相关，性别,AF历史记录,和早期POAF发生(HR：1.07[每0.1ng/mL增加]，95%CI:1.00-1.14,P=0.041)。调整年龄后，左心房肌内纤维化（标准化β=0.22，P=0.041）而不是总体纤维化（标准化Β=0.12，P=0.261）与循环BMP10相关，性别,AF历史记录,降低LVF,瓣膜手术指征.
结论：BMP10水平升高与持续性房颤病史相关，晚期POAF发病率增加，接受心脏手术的不同患者样本中的LAA内肌纤维化。
目的：本研究旨在研究BMP10水平与术前临床特征之间的相关性。术后早期和晚期心房颤动（POAF）的发生，心脏手术患者的心房纤维化。
方法：包括有和没有术前房颤史的首次心脏手术患者（RACEV，n=147)。术前血液生物标志物分析，左（n=114）和右（n=125）心耳活检标本在WGA染色后进行组织学研究，使用植入式环路记录仪连续监测术后节律(n=133,2.5年).
结果：调整后的多项逻辑回归表明BMP10准确反映了持续性房颤的病史（OR：1.24，95％CI：1.10-1.40，P=0.001），类似于NT-pro-BNP。调整年龄后，BMP10水平与POAF90晚期发生率增加相关，性别,AF历史记录,和早期POAF发生(HR：1.07[每0.1ng/mL增加]，95%CI:1.00-1.14,P=0.041)。调整年龄后，左心房肌内纤维化（标准化β=0.22，P=0.041）而不是总体纤维化（标准化Β=0.12，P=0.261）与循环BMP10相关，性别,AF历史记录,降低LVF,瓣膜手术指征.
结论：BMP10水平升高与持续性房颤病史相关，晚期POAF发病率增加，接受心脏手术的不同患者样本中的LAA内肌纤维化。
