RESUMEN
Background: Hyperuricemia (HU) has been reported to be associated with a high incidence of atrial fibrillation (AF). However, the relationship between HUA and recurrent AF after catheter ablation (CA) is unclear. Methods: Four hundred consecutive AF patients (paroxysmal/persistent AF [PAF/PsAF]: 200/200) who underwent the initial CA were retrospectively enrolled. HU was defined as serum uric acid (SUA) level >7.0 mg/dL. We measured SUA levels 1 day before (pre-CA) and 1 month after CA (post-CA). A second-generation 28 mm cryoballoon was used for pulmonary vein isolation (PVI) for PAF, while PVI plus linear ablation (roof and mitral isthmus lines) by radiofrequency catheter was conducted for PsAF. Results: During 57 ± 24 months of follow-up, AF recurred in 16% and 42% in PAF and PsAF patients (p < .0001). Pre-CA SUA level in PsAF was significantly higher than that in PAF (6.5 ± 1.3 vs. 5.8 ± 1.3 mg/dL, p < .001). SUA level was significantly decreased after CA in both PAF and PsAF (5.8 ± 1.3 vs. 5.6 ± 1.3 mg/dL; p < .01 and 6.5 ± 1.3 vs. 6.1 ± 1.2 mg/dL; p < .0001, respectively). The association between pre-/post-CA HU and recurrent AF was not identified in PAF, while the incidence of post-CA HU was significantly higher in patients with recurrent AF than those without in PsAF (36% vs. 15%, p < .001). In multivariable analysis, longer AF duration and the presence of post-CA HU were identified as independent predictors of AF recurrence in PsAF (OR:1.01, 95%CI:1.003-1.011, p = .0001 and OR:2.77, 95%CI:1.333-5.755, p = .007, respectively). Conclusions: SUA level was significantly higher in PsAF than PAF patients. The presence of post-CA HU was strongly related to AF recurrence in PsAF patients.
RESUMEN
The diabetogenic action of alloxan is thought to be initiated by generation of reactive oxygen species (ROS). Ascorbate can be an antioxidant in a predominantly aqueous environment, such as plasma and extracellular fluids. We have investigated the generation of ROS in the interaction of alloxan with ascorbate. Rapid oxygen consumption was observed in the reactin system of alloxan with ascorbate. The oxygen consumption was suppressed by superoxide dismutase and catalase, suggesting that superoxide and hydrogen peroxide could be generated in the reaction system. In addition, the generation of alloxan radical, an electron reductance of alloxan, and ascorbate free radical (AFR), an electron oxidant of ascorbate, was observed using electron spin resonance (ESR). Under anaerobic conditions, the ESR signal intensity of alloxan radical was significantly increased in comparison with that under aerobic conditions, whereas the intensity of AFR was significantly decreased. These results suggest that alloxan radical and AFR were generated in the reaction system of alloxan with ascorbate, and that the alloxan radical but not AFR reacted with molecular oxygen, resulting in the generation of ROS.