Atrial Fibrosis and Inflammation in Postoperative Atrial Fibrillation

作者：Sandrine Parent, Jennifer St Amant, Sophie Van Remortel, Saad Kahn, Venkata Ramana Vaka, David W. Courtman, Duncan J. Stewart, Darryl R. Davis · 发表于：JACC. Clinical electrophysiology · 年份：2024 · DOI：10.1016/j.jacep.2024.02.019 · 被引用次数：11 · 研究领域：Extracellular vesicles in disease、Atrial Fibrillation Management and Outcomes、Cardiac Fibrosis and Remodeling

BACKGROUND: Extracellular vesicles (EVs) isolated from human heart-derived cells have shown promise in suppressing inflammation and fibroblast proliferation. However, their precise benefits in atrial fibrillation (AF) prevention and the role of their antifibrotic/anti-inflammatory properties remain unclear. OBJECTIVES: The purpose of this study was to conduct a head-to-head comparison of antiarrhythmic strategies to prevent postoperative AF using a rat model of sterile pericarditis. Specifically, we aimed to assess the efficacy of amiodarone (a classic antiarrhythmic drug), colchicine (an anti-inflammatory agent), and EVs derived from human heart-derived cells, which possess anti-inflammatory and antifibrotic properties, on AF induction, inflammation, and fibrosis progression. METHODS: Heart-derived cells were cultured from human atrial appendages under serum-free xenogen-free conditions. Middle-aged Sprague Dawley rats were randomized into different groups, including sham operation, sterile pericarditis with amiodarone treatment, sterile pericarditis with colchicine treatment (2 dose levels), and sterile pericarditis with intra-atrial injection of EVs or vehicle. Invasive electrophysiological testing was performed 3 days after surgery before sacrifice. RESULTS: Sterile pericarditis increased the likelihood of inducing AF. Colchicine and EVs exhibited anti-inflammatory effects, but only EV treatment significantly reduced AF probability, whereas colchicine showed a positive tr...