Plasma FABP4 levels are associated with left atrial fat volume in persistent atrial fibrillation and predict recurrence after catheter ablation

Abstract

Background: Imaging techniques have shown the association between left atrial adipose tissue (LAAT) volume and atrial fibrillation (AF) risk.

Purpose: To analyze 1) adipokines in peripheral and atrial plasma from patients undergoing AF ablation; 2) its association with LAAT volume measured by multislice CT and 3) its predictive value for AF recurrence.

Methods: Seventy consecutive patients undergoing AF catheter ablation were screened. Blood samples were extracted from the left atrium and peripheral vein before catheter ablation. Multiplex fluorimetric immunoassay, enzyme-linked immunoassay and Western blot techniques were used for analyzing some adipokines, fatty acid binding protein 4 (FABP4), and leptin and perilipin analysis, respectively. Patients were followed up with clinical visits until one year after ablation. Generalized additive regression (GAM) was used for determining the best indicator of LAAT volume. Logistic regression analysis determined the best predictor of AF recurrence after persistent AF catheter ablation.

Results: Our results showed 1) differences in the levels of FABP4 between peripheral and left atrial blood samples. 2) persistent AF patients had higher LAAT volume than those with paroxysmal AF (5.12 ± 2.76 vs. 3.82 ± 1.81 mL; p < 0.036). FABP4 was the best adipokine associated with LAAT in persistent AF (p < 0.01) 3) and predictive value for AF recurrence after catheter ablation (AUC-ROC 0.883 with 95% CI 0.739-1.028).

Conclusions: Plasma FABP4 levels, which were associated with LAAT volume in persistent AF, can be predictors of recurrence after catheter ablation. Whether persistent AF patients require more intensive management and monitoring according to FABP4 deserves further investigation.