1: Circulation. 2003 Nov 18;108(20):2446-9. Epub 2003 Nov 10. 

Effect of atrial fibrillation on hematopoietic progenitor cells: a novel
pathophysiological role of the atrial natriuretic peptide?

Goette A, Jentsch-Ullrich K, Lendeckel U, Rocken C, Agbaria M, Auricchio A,
Mohren M, Franke A, Klein HU.

University Hospital Magdeburg, Division of Cardiology, Leipziger Str 44, 39120
Magdeburg, Germany. andreas.goette@medizin.uni-magdeburg.de

BACKGROUND: Injury to the heart causes hematopoietic progenitor cells (HPCs) to
migrate to the site of damage and to undergo cell differentiation. Studies
suggest that myocardial progenitor cells invade atrial tissue. So far it is
unclear, however, whether an atrial disease per se affects circulating HPCs.
METHODS AND RESULTS: Seventeen patients with persistent atrial fibrillation
(persistAF), 12 with paroxysmal AF (paroxAF), and 17 matched patients with sinus
rhythm (SR) were studied. HPCs (CD34+ and CD34+/CD117+) were quantified with the
use of a fluorescence-activated cell sorter; stromal cell-derived factor-1alpha
(SDF-1alpha), vascular endothelium growth factor (VEGF), and atrial natriuretic
peptide (ANP) were determined by immunoassays. In patients with persistAF, blood
samples were obtained before as well as 10 minutes, 24 hours, and 48 hours after
electrical cardioversion. CD34+HPCs (AF, 7.0+/-2.3x10(3)/mL versus SR,
5.0+/-1.6x10(3)/mL; P<0.01) were increased during persistAF only. Highest
SDF-1alpha levels were also observed during persistAF. Successful and
unsuccessful cardioversion decreased CD34+HPCs temporarily (7.0+/-2.3x10(3)/mL
versus 24 hours: 5.0+/-1.5x10(3)/mL; P<0.05). Forty-eight hours after successful
cardioversion, SDF-1alpha and CD34+HPC levels started to decline, reaching
control levels after 59+/-19 days. CD34+/CD117+ and VEGF levels, however, were
increased by DC energy but not by AF. ANP levels correlated with CD34+HPC
(r=0.76; P<0.01) and SDF-1alpha (r=0.56; P<0.01). HPCs from patients with AF had
a greater tendency to differentiate into cells expressing (cardio)myocyte
markers ANP and myocyte enhancer factor-2. CONCLUSIONS: PersistAF appears to
increase the potential of HPCs for (cardio)myogenesis. Restitution of CD34+HPC
levels, mediated by SDF-1alpha and possibly ANP, occurs within several weeks
after successful cardioversion.

Publication Types:
    Clinical Trial
    Controlled Clinical Trial

PMID: 14610014 [PubMed - indexed for MEDLINE]


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