Electrophysiological correlation and prognostic impact of heat shock protein 27 in atrial fibrillation

Background-Heat shock protein (HSP) 27 is related to the pathogenesis of AF. However, the clinical relationship between HSP27 and AF is unclear. The present study was conducted to determine the clinical relationship between HSP27 and atrial fibrillation (AF). Methods and Results-A case-control study was conducted (AF, n=114; control, n=100). Serum HSP27 (HSP27S) levels were measured by ELISA, and its correlations with electrophysiological characteristics and catheter ablation outcomes were investigated. The patients with AF had a larger left atrial diameter (LAD), waist circumference, and body mass index, and a lower baseline HSP27S level, than controls. After logistic multivariate analysis, low baseline HSP27S was independently associated with AF. In patients with AF, those with paroxysmal AF (PAF) had higher baseline HSP27S levels compared with those without PAF. In patients with PAF, lower baseline HSP27S was associated with larger LAD, whereas baseline HSP27S was not correlated with LAD in controls. In PAF, low baseline HSP27S (≤3.85 ng/mL) was associated with low atrial voltage and nonpulmonary vein ectopies. In non-PAF, the mean fractionated interval had a good correlation with baseline HSP27S. After catheter ablation, a high baseline HSP27S level could predict sinus rhythm maintenance in the patients with PAF. Baseline HSP27S was also correlated with interleukin 10 and tumor necrosis factor-α levels. Analysis of buffy coat mRNA levels showed the same correlations. Conclusions-The HSP27S levels were correlated with LAD, left atrial voltage, and fractionated intervals, and predicted AF recurrence after catheter ablation. The mechanisms could be related to inflammation.