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Choi, Eue-Keun,Shen, Mark J.,Lin, Shien-Fong,Chen, Peng-Sheng,Oh, Seil WB SAUNDERS CO LTD 2014 EUROPACE -LONDON- Vol.16 No.7
<P><B>Aims</B></P><P>We hypothesized that carvedilol can effectively suppress autonomic nerve activity (ANA) in ambulatory dogs during sinus rhythm and atrial fibrillation (AF), and that carvedilol withdrawal can lead to rebound elevation of ANA. Carvedilol is known to block pre-junctional β2-adrenoceptor responsible for norepinephrine release.</P><P><B>Methods and results</B></P><P>We implanted radiotransmitters to record stellate ganglion nerve activity (SGNA), vagal nerve activity (VNA), and superior left ganglionated plexi nerve activity (SLGPNA) in 12 ambulatory dogs. Carvedilol (12.5 mg orally twice a day) was given for 7 days during sinus rhythm (<I>n</I> = 8). Four of the eight dogs and an additional four dogs were paced into persistent AF. Carvedilol reduced heart rate [from 103 b.p.m. (95% confidence interval (CI), 100–105) to 100 b.p.m. (95% CI, 98–102), <I>P</I> = 0.044], suppressed integrated nerve activities (Int-NAs, SGNA by 17%, VNA by 19%, and SLGPNA by 12%; all <I>P</I> < 0.05 vs. the baseline), and significantly reduced the incidence (from 8 ± 6 to 3 ± 3 episodes/day, <I>P</I> < 0.05) and total duration (from 68 ± 64 to 16 ± 21 s/day, <I>P</I> < 0.05) of paroxysmal atrial tachycardia (PAT). Following the development of persistent AF, carvedilol loading was associated with AF termination in three dogs. In the remaining five dogs, Int-NAs were not significantly suppressed by carvedilol, but SGNA significantly increased by 16% after carvedilol withdrawal (<I>P</I> < 0.001).</P><P><B>Conclusion</B></P><P>Carvedilol suppresses ANA and PAT in ambulatory dogs during sinus rhythm.</P>
Yang, P. S.,Kim, T. h.,Uhm, J. S.,Park, S.,Joung, B.,Lee, M. H.,Pak, H. N. WB SAUNDERS CO LTD 2016 EP Europace Vol. No.
<P>Atrial fibrillation (AF) is closely associated with metabolic syndrome, and the receptor for advanced glycation end products (RAGE) pathway is involved in insulin resistance and cardiac remodelling. We hypothesized that plasma level of soluble RAGE (sRAGE) would predict clinical outcome after radiofrequency catheter ablation for AF. We measured pre-procedural plasma level of sRAGE in 496 patients who underwent AF ablation (142 patients with diabetes, 354 patients without diabetes selected by matching them with diabetic patients according to age, sex, and AF type). (i) Plasma level of sRAGE was significantly higher in diabetic patients than in non-diabetics (580.0 +/- 576.4 vs. 435.8 +/- 280.7 pg/mL, P = 0.005), but there was no difference in sRAGE levels between patients with clinical recurrence of AF and those without. (ii) During 24.5 +/- 18.0 months of follow-up, the recurrence of AF was significantly lower in the diabetic patient group with high sRAGE (a parts per thousand yen418 pg/mL based on the median value) than the diabetic patient group with low sRAGE (log-rank P = 0.045). This was especially pronounced in patients with paroxysmal AF and diabetes (log-rank P = 0.016), but no association was found in non-diabetics. (iii) In multivariate Cox regression analysis, high sRAGE (HR 0.395, 95% CI 0.175-0.894, P = 0.026) and paroxysmal AF (HR 0.387, 95% CI 0.179-0.835, P = 0.016) were independently associated with the favourable clinical outcome of rhythm control after AF ablation in diabetic patients. High plasma level of sRAGE was independently associated with low AF recurrence after catheter ablation in diabetic patients, especially those with paroxysmal AF.</P>