Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort
Background: Advances have been made in identifying biomarkers for atrial fibrillation (AF) outcomes. Objective: The link between clinical determinants, especially AF burden, and blood biomarkers remains underexplored. Methods: We conducted a cross-sectional analysis of AF patients scheduled for cath...
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Elsevier
2025-05-01
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| Series: | Heart Rhythm O2 |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501825000820 |
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| author | Zarina Habibi, MD Dominique V.M. Verhaert, MD, PhD Konstanze Betz, MD Ben J.M. Hermans, MD, PhD Joris Winters, MD, PhD Suzanne A.M. Philippens Sevasti-Maria Chaldoupi, MD, PhD Bart Maesen, MD, PhD Jos G. Maessen, MD, PhD Aaron Isaacs, PhD Sjoerd W. Westra, MD Robin Nijveldt, MD, PhD Ludovic Gillet, PhD Ursula-Henrike Wienhues-Thelen, PhD Merlin Koehler Stef Zeemering, PhD Kevin Vernooy, MD, PhD Dominik Linz, MD, PhD Ulrich Schotten, MD, PhD |
| author_facet | Zarina Habibi, MD Dominique V.M. Verhaert, MD, PhD Konstanze Betz, MD Ben J.M. Hermans, MD, PhD Joris Winters, MD, PhD Suzanne A.M. Philippens Sevasti-Maria Chaldoupi, MD, PhD Bart Maesen, MD, PhD Jos G. Maessen, MD, PhD Aaron Isaacs, PhD Sjoerd W. Westra, MD Robin Nijveldt, MD, PhD Ludovic Gillet, PhD Ursula-Henrike Wienhues-Thelen, PhD Merlin Koehler Stef Zeemering, PhD Kevin Vernooy, MD, PhD Dominik Linz, MD, PhD Ulrich Schotten, MD, PhD |
| author_sort | Zarina Habibi, MD |
| collection | DOAJ |
| description | Background: Advances have been made in identifying biomarkers for atrial fibrillation (AF) outcomes. Objective: The link between clinical determinants, especially AF burden, and blood biomarkers remains underexplored. Methods: We conducted a cross-sectional analysis of AF patients scheduled for catheter ablation in the ISOLATION study (July 2020–May 2022, NCT04342312). Patient characteristics and blood samples were collected before ablation. AF burden was assessed using hand-held electrocardiograms (ECGs) over 4 weeks. Blood samples were analyzed for biomarkers, including bone morphogenetic protein 10 (BMP10), angiopoietin-2 (Ang-2), fibroblast growth factor 23 (FGF23), and others. We trained elastic net regression models to identify the most important clinical determinants out of 64 available clinical features. Results: We analyzed blood samples from 508 patients with a mean age of 63 ±9 years; 31.1% were female. Of these, 70% had paroxysmal AF and 30% persistent AF. Heart failure was present in 15% of patients. In 140 patients (28%), AF was observed during blood draw. AF burden before ablation was available in 389 patients. After multivariable analysis, the following clinical determinants were independently associated with biomarker levels: AF burden, AF during blood draw, age, heart failure, decreased kidney function, and female sex. Most notably, AF burden and AF rhythm at the time of sampling were strongly associated with various biomarker levels. Female sex was positively associated with BMP10 and FGF23, but negatively associated with high sensitive Troponin-T (hs-TNT). Conclusions: AF burden is a strong determinant of many biomarkers, underpinning their relevance as covariates in biomarker studies. Pro-fibrotic biomarkers are increased in female patients, whereas male patients more often show elevated biomarkers of myocardial injury. |
| format | Article |
| id | doaj-art-aa92d69ed0f447bab5ca536343e792b9 |
| institution | OA Journals |
| issn | 2666-5018 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj-art-aa92d69ed0f447bab5ca536343e792b92025-08-20T02:33:18ZengElsevierHeart Rhythm O22666-50182025-05-016566167010.1016/j.hroo.2025.02.017Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation CohortZarina Habibi, MD0Dominique V.M. Verhaert, MD, PhD1Konstanze Betz, MD2Ben J.M. Hermans, MD, PhD3Joris Winters, MD, PhD4Suzanne A.M. Philippens5Sevasti-Maria Chaldoupi, MD, PhD6Bart Maesen, MD, PhD7Jos G. Maessen, MD, PhD8Aaron Isaacs, PhD9Sjoerd W. Westra, MD10Robin Nijveldt, MD, PhD11Ludovic Gillet, PhD12Ursula-Henrike Wienhues-Thelen, PhD13Merlin Koehler14Stef Zeemering, PhD15Kevin Vernooy, MD, PhD16Dominik Linz, MD, PhD17Ulrich Schotten, MD, PhD18Department of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Address reprint requests and correspondence: Zarina Habibi, Department of Physiology, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiology, Radboudumc, Nijmegen, The Netherlands; Department of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsDepartment of Cardiology, Maastricht UMC+, Maastricht, The Netherlands; Eifelklinik St. Brigida GmbH & CO KG, Simmerath, GermanyDepartment of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The NetherlandsDepartment of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The NetherlandsDepartment of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsCardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsCardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiothoracic Surgery, Maastricht UMC+, Maastricht, The NetherlandsDepartment of Cardiothoracic Surgery, Maastricht UMC+, Maastricht, The NetherlandsDepartment of Physiology, Maastricht University, Maastricht, The Netherlands; Maastricht Centre for Systems Biology (MaCSBio), Maastricht, The NetherlandsDepartment of Cardiology, Radboudumc, Nijmegen, The NetherlandsDepartment of Cardiology, Radboudumc, Nijmegen, The NetherlandsRoche Diagnostics International Ltd. Rotkreuz SwitzerlandRoche Diagnostics GmbH Penzberg GermanyDepartment of Physiology, Maastricht University, Maastricht, The NetherlandsDepartment of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The NetherlandsCardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsCardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsDepartment of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Cardiology, Maastricht UMC+, Maastricht, The NetherlandsBackground: Advances have been made in identifying biomarkers for atrial fibrillation (AF) outcomes. Objective: The link between clinical determinants, especially AF burden, and blood biomarkers remains underexplored. Methods: We conducted a cross-sectional analysis of AF patients scheduled for catheter ablation in the ISOLATION study (July 2020–May 2022, NCT04342312). Patient characteristics and blood samples were collected before ablation. AF burden was assessed using hand-held electrocardiograms (ECGs) over 4 weeks. Blood samples were analyzed for biomarkers, including bone morphogenetic protein 10 (BMP10), angiopoietin-2 (Ang-2), fibroblast growth factor 23 (FGF23), and others. We trained elastic net regression models to identify the most important clinical determinants out of 64 available clinical features. Results: We analyzed blood samples from 508 patients with a mean age of 63 ±9 years; 31.1% were female. Of these, 70% had paroxysmal AF and 30% persistent AF. Heart failure was present in 15% of patients. In 140 patients (28%), AF was observed during blood draw. AF burden before ablation was available in 389 patients. After multivariable analysis, the following clinical determinants were independently associated with biomarker levels: AF burden, AF during blood draw, age, heart failure, decreased kidney function, and female sex. Most notably, AF burden and AF rhythm at the time of sampling were strongly associated with various biomarker levels. Female sex was positively associated with BMP10 and FGF23, but negatively associated with high sensitive Troponin-T (hs-TNT). Conclusions: AF burden is a strong determinant of many biomarkers, underpinning their relevance as covariates in biomarker studies. Pro-fibrotic biomarkers are increased in female patients, whereas male patients more often show elevated biomarkers of myocardial injury.http://www.sciencedirect.com/science/article/pii/S2666501825000820BiomarkersAtrial fibrillationCatheter ablationPreprocedural atrial fibrillationBurdenSex differences |
| spellingShingle | Zarina Habibi, MD Dominique V.M. Verhaert, MD, PhD Konstanze Betz, MD Ben J.M. Hermans, MD, PhD Joris Winters, MD, PhD Suzanne A.M. Philippens Sevasti-Maria Chaldoupi, MD, PhD Bart Maesen, MD, PhD Jos G. Maessen, MD, PhD Aaron Isaacs, PhD Sjoerd W. Westra, MD Robin Nijveldt, MD, PhD Ludovic Gillet, PhD Ursula-Henrike Wienhues-Thelen, PhD Merlin Koehler Stef Zeemering, PhD Kevin Vernooy, MD, PhD Dominik Linz, MD, PhD Ulrich Schotten, MD, PhD Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort Heart Rhythm O2 Biomarkers Atrial fibrillation Catheter ablation Preprocedural atrial fibrillation Burden Sex differences |
| title | Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort |
| title_full | Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort |
| title_fullStr | Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort |
| title_full_unstemmed | Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort |
| title_short | Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort |
| title_sort | association of atrial fibrillation burden and clinical profile with blood biomarkers results from the isolation ablation cohort |
| topic | Biomarkers Atrial fibrillation Catheter ablation Preprocedural atrial fibrillation Burden Sex differences |
| url | http://www.sciencedirect.com/science/article/pii/S2666501825000820 |
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