Skip to main content
SpringerLink
Log in

Plasma YKL-40 is elevated in patients with recurrent atrial fibrillation after catheter ablation

  • Original Research Paper
  • Published:
Inflammation Research Aims and scope Submit manuscript

Abstract

Aim

To study plasma YKL-40 in patients with atrial fibrillation (AF) treated with radiofrequency (RF) catheter ablation and to assess the predictive role of plasma YKL-40 and its changes after restoration of sinus rhythm (SR).

Methods

Forty-six patients (mean age 55 years, range 31–81) with paroxysmal/persistent AF were treated with RF catheter ablation; Holter monitoring for 14 days was performed before ablation and after 3 months. Recurrent symptomatic AF or atrial tachycardia >10 min was considered failure, and the patients were offered a second ablation session. YKL-40 was determined in plasma samples taken prior to ablation and at follow-up visits up to 12 months after ablation.

Results

After a maximum of two ablations, 19 patients (41%) had SR without recurrence of AF after 12 months. The patients with no recurrence of AF had significantly lower baseline plasma levels of YKL-40 prior to ablation compared to patients with recurrence of AF (31 vs. 62 μg/l, P = 0.029). Plasma YKL-40 was not an independent predictor of recurrence of AF after ablation. No significant changes in plasma YKL-40 levels were seen from baseline to follow-up at 12 months.

Conclusion

In patients with paroxysmal or persistent AF treated with catheter ablation, high plasma YKL-40 before ablation is associated with recurrence of AF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch Intern Med. 1995;155:469–73.

    Article  CAS  PubMed  Google Scholar 

  2. Friberg J, Scharling H, Gadsboll N, Jensen GB. Sex-specific increase in the prevalence of atrial fibrillation (the Copenhagen City Heart Study). Am J Cardiol. 2003;92:1419–23.

    Article  PubMed  Google Scholar 

  3. Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96:1180–4.

    CAS  PubMed  Google Scholar 

  4. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92:1954–68.

    CAS  PubMed  Google Scholar 

  5. Chung MK, Martin DO, Sprecher D, Wazni O, Kanderian A, Carnes CA, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001;104:2886–91.

    Article  CAS  PubMed  Google Scholar 

  6. Engelmann MD, Svendsen JH. Inflammation in the genesis and perpetuation of atrial fibrillation. Eur Heart J. 2005;26:2083–92.

    Article  CAS  PubMed  Google Scholar 

  7. Kallergis EM, Manios EG, Kanoupakis EM, Mavrakis HE, Kolyvaki SG, Lyrarakis GM, et al. The role of the post-cardioversion time course of hs-CRP levels in clarifying the relationship between inflammation and persistence of atrial fibrillation. Heart. 2008;94:200–4.

    Article  CAS  PubMed  Google Scholar 

  8. Loricchio ML, Cianfrocca C, Pasceri V, Bianconi L, Auriti A, Calo L, et al. Relation of C-reactive protein to long-term risk of recurrence of atrial fibrillation after electrical cardioversion. Am J Cardiol. 2007;99:1421–4.

    Article  CAS  PubMed  Google Scholar 

  9. Watanabe E, Arakawa T, Uchiyama T, Kodama I, Hishida H. High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion. Int J Cardiol. 2006;108:346–53.

    Article  PubMed  Google Scholar 

  10. Henningsen KM, Nilsson B, Bruunsgaard H, Chen X, Pedersen BK, Svendsen JH. Prognostic impact of hs-CRP and IL-6 in patients undergoing radiofrequency catheter ablation for atrial fibrillation. Scand Cardiovasc J. 2008;43:285–91.

    Google Scholar 

  11. Renkema GH, Boot RG, Au FL, Donker-Koopman WE, Strijland A, Muijsers AO, et al. Chitotriosidase, a chitinase, and the 39-kDa human cartilage glycoprotein, a chitin-binding lectin, are homologues of family 18 glycosyl hydrolases secreted by human macrophages. Eur J Biochem. 1998;251:504–9.

    Article  CAS  PubMed  Google Scholar 

  12. Volck B, Price PA, Johansen JS, Sorensen O, Benfield TL, Nielsen HJ, et al. YKL-40, a mammalian member of the chitinase family, is a matrix protein of specific granules in human neutrophils. Proc Assoc Am Physicians. 1998;110:351–60.

    CAS  PubMed  Google Scholar 

  13. Malinda KM, Ponce L, Kleinman HK, Shackelton LM, Millis AJ. Gp38k, a protein synthesized by vascular smooth muscle cells, stimulates directional migration of human umbilical vein endothelial cells. Exp Cell Res. 1999;250:168–73.

    Article  CAS  PubMed  Google Scholar 

  14. Shackelton LM, Mann DM, Millis AJ. Identification of a 38-kDa heparin-binding glycoprotein (gp38k) in differentiating vascular smooth muscle cells as a member of a group of proteins associated with tissue remodeling. J Biol Chem. 1995;270:13076–83.

    Article  CAS  PubMed  Google Scholar 

  15. Boot RG, van Achterberg TA, van Aken BE, Renkema GH, Jacobs MJ, Aerts JM, et al. Strong induction of members of the chitinase family of proteins in atherosclerosis: chitotriosidase and human cartilage gp-39 expressed in lesion macrophages. Arterioscler Thromb Vasc Biol. 1999;19:687–94.

    CAS  PubMed  Google Scholar 

  16. Baeten D, Boots AM, Steenbakkers PG, Elewaut D, Bos E, Verheijden GF, et al. Human cartilage gp-39+, CD16+ monocytes in peripheral blood and synovium: correlation with joint destruction in rheumatoid arthritis. Arthritis Rheum. 2000;43:1233–43.

    Article  CAS  PubMed  Google Scholar 

  17. Johansen JS, Baslund B, Garbarsch C, Hansen M, Stoltenberg M, Lorenzen I, et al. YKL-40 in giant cells and macrophages from patients with giant cell arteritis. Arthritis Rheum. 1999;42:2624–30.

    Article  CAS  PubMed  Google Scholar 

  18. Junker N, Johansen JS, Andersen CB, Kristjansen PE. Expression of YKL-40 by peritumoral macrophages in human small cell lung cancer. Lung Cancer. 2005;48:223–31.

    Article  PubMed  Google Scholar 

  19. Kucur M, Isman FK, Karadag B, Vural VA, Tavsanoglu S. Serum YKL-40 levels in patients with coronary artery disease. Coron Artery Dis. 2007;18:391–6.

    Article  PubMed  Google Scholar 

  20. Nojgaard C, Host NB, Christensen IJ, Poulsen SH, Egstrup K, Price PA, et al. Serum levels of YKL-40 increases in patients with acute myocardial infarction. Coron Artery Dis. 2008;19:257–63.

    Article  PubMed  Google Scholar 

  21. Wang Y, Ripa RS, Johansen JS, Gabrielsen A, Steinbruchel DA, Friis T, et al. YKL-40 a new biomarker in patients with acute coronary syndrome or stable coronary artery disease. Scand Cardiovasc J. 2008;42:295–302.

    Article  CAS  PubMed  Google Scholar 

  22. Henningsen KM, Therkelsen ST, Johansen JS, Bruunsgaard H, Svendsen JH. YKL-40, a new biomarker for atrial fibrillation? Europace. 2009;11:1032–6.

    Article  PubMed  Google Scholar 

  23. Kastrup J, Johansen JS, Winkel P, Hansen JF, Hildebrandt P, Jensen GB, et al. High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease. Eur Heart J. 2009;30:1066–72.

    Article  CAS  PubMed  Google Scholar 

  24. Nilsson B, Chen X, Pehrson S, Kober L, Hilden J, Svendsen JH. Recurrence of pulmonary vein conduction and atrial fibrillation after pulmonary vein isolation for atrial fibrillation: a randomized trial of the ostial versus the extraostial ablation strategy. Am Heart J. 2006;152:537–8.

    Article  PubMed  Google Scholar 

  25. Haissaguerre M, Jais P, Shah DC, Garrigue S, Takahashi A, Lavergne T, et al. Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Circulation. 2000;101:1409–17.

    CAS  PubMed  Google Scholar 

  26. Pappone C, Oreto G, Rosanio S, Vicedomini G, Tocchi M, Gugliotta F, et al. Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation: efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation. Circulation. 2001;104:2539–44.

    Article  CAS  PubMed  Google Scholar 

  27. Ober C, Tan Z, Sun Y, Possick JD, Pan L, Nicolae R, et al. Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma, and lung function. N Engl J Med. 2008;358:1682–91.

    Article  CAS  PubMed  Google Scholar 

  28. Johansen JS. Studies on serum YKL-40 as a biomarker in diseases with inflammation, tissue remodelling, fibroses and cancer. Dan Med Bull. 2006;53:172–209.

    CAS  PubMed  Google Scholar 

  29. Erzin Y, Uzun H, Karatas A, Celik AF. Serum YKL-40 as a marker of disease activity and structure formation in patients with Crohn’s disease. J Gastroenterol Hepatol. 2008;23:357–62.

    Article  Google Scholar 

  30. Vind I, Johansen JS, Price PA, Munkholm P. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease. Scand J Gastroenterol. 2003;38:599–605.

    Article  CAS  PubMed  Google Scholar 

  31. Nielsen AR, Erikstrup C, Johansen JS, Fischer CP, Plomgaard P, Krogh-Madsen R, et al. Plasma YKL-40: a BMI-independent marker of type 2 diabetes. Diabetes. 2008;57:3078–82.

    Article  CAS  PubMed  Google Scholar 

  32. Rathcke CN, Persson F, Tarnow L, Rossing P, Vestergaard H. YKL-40, a marker of inflammation and endothelial dysfunction, is elevated in patients with type 1 diabetes and increases with levels of albuminuria. Diabetes Care. 2009;32:323–8.

    Article  CAS  PubMed  Google Scholar 

  33. Johansen JS, Jensen BV, Roslind A, Nielsen D, Price PA. Serum YKL-40, a new prognostic biomarker in cancer patients? Cancer Epidemiol Biomarkers Prev. 2006;15:194–202.

    Article  CAS  PubMed  Google Scholar 

  34. Mehta P, Ploutz-Snyder R, Nandi J, Rawlins SR, Sanderson SO, Levine RA. Diagnostic accuracy of serum hyaluronic acid, FIBROSpect II, and YKL-40 for discriminating fibrosis stages in chronic hepatitis C. Am J Gastroenterol. 2008;103:928–36.

    Article  PubMed  Google Scholar 

  35. Pungpapong S, Nunes DP, Krishna M, Nakhleh R, Chambers K, Ghabril M, et al. Serum fibrosis markers can predict rapid fibrosis progression after liver transplantation for hepatitis C. Liver Transpl. 2008;14:1294–302.

    Article  PubMed  Google Scholar 

  36. Johansen JS, Milman N, Hansen M, Garbarsch C, Price PA, Graudal N. Increased serum YKL-40 in patients with pulmonary sarcoidosis—a potential marker of disease activity? Respir Med. 2005;99:396–402.

    Article  PubMed  Google Scholar 

  37. Lee CG, Hartl D, Lee GR, Koller B, Matsuura H, Da Silva CA, et al. Role of breast regression protein 39 (BRP-39)/chitinase 3-like-1 in Th2 and IL-13-induced tissue responses and apoptosis. J Exp Med. 2009;206:1149–66.

    Article  CAS  PubMed  Google Scholar 

  38. Ling H, Recklies AD. The chitinase 3-like protein human cartilage glycoprotein 39 inhibits cellular responses to the inflammatory cytokines interleukin-1 and tumour necrosis factor-alpha. Biochem J. 2004;380:651–9.

    Article  CAS  PubMed  Google Scholar 

  39. Recklies AD, White C, Ling H. The chitinase 3-like protein human cartilage glycoprotein 39 (HC-gp39) stimulates proliferation of human connective-tissue cells and activates both extracellular signal-regulated kinase- and protein kinase B-mediated signalling pathways. Biochem J. 2002;365:119–26.

    Article  CAS  PubMed  Google Scholar 

  40. Recklies AD, Ling H, White C, Bernier SM. Inflammatory cytokines induce production of CHI3L1 by articular chondrocytes. J Biol Chem. 2005;280:41213–21.

    Article  CAS  PubMed  Google Scholar 

  41. Chupp GL, Lee CG, Jarjour N, Shim YM, Holm CT, He S, et al. A chitinase-like protein in the lung and circulation of patients with severe asthma. N Engl J Med. 2007;357:2016–27.

    Article  CAS  PubMed  Google Scholar 

  42. Johansen JS, Hoyer PE, Larsen LA, Price PA, Mollgard K. YKL-40 protein expression in the early developing human musculoskeletal system. J Histochem Cytochem. 2007;55:1213–28.

    Article  CAS  PubMed  Google Scholar 

  43. Letuve S, Kozhich A, Arouche N, Grandsaigne M, Reed J, Dombret MC, et al. YKL-40 is elevated in patients with chronic obstructive pulmonary disease and activates alveolar macrophages. J Immunol. 2008;181:5167–73.

    CAS  PubMed  Google Scholar 

  44. Saidi A, Javerzat S, Bellahcene A, De Vos J, Bello L, Castronovo V, et al. Experimental anti-angiogenesis causes upregulation of genes associated with poor survival in glioblastoma. Int J Cancer. 2008;122:2187–98.

    Article  CAS  PubMed  Google Scholar 

  45. Therkelsen SK, Groenning BA, Svendsen JH, Jensen GB. Atrial and ventricular volume and function evaluated by magnetic resonance imaging in patients with persistent atrial fibrillation before and after cardioversion. Am J Cardiol. 2006;97(8):1213–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by grants from Toyota-Fonden, Denmark, The Danish Heart Foundation (08-10-R68-A2150-B841-22518), The Research Foundation at the Heart Centre at Rigshospitalet, Augustinus Fonden, The John and Birthe Meyer Foundation, Direktør Ib Henriksens Fond, Aase og Ejnar Danielsens Fond, Arvid Nilssons Fond, Lægernes Forsikringsforening af 1891, and Direktør Kurt Bønnelycke og Hustru fru Grethe Bønnelyckes Fond. Quidel provided the study with the YKL-40 ELISA kits. Quidel had no role in the study design, statistical analysis, data interpretation, manuscript drafting, manuscript revision, or the decision to submit this manuscript for publication. The authors had full access to all the data in the study and had the final responsibility for the decision to submit the manuscript for publication. We thank Tonni Løve Hansen and Debbie Nadelmann, Herlev Hospital, for excellent technical assistance with the YKL-40 analysis.

Author information

Authors and Affiliations

  1. Department of Cardiology, Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, University of Copenhagen, 2100, Copenhagen Ø, Denmark

    Kristoffer Mads Henningsen, Brian Nilsson, Xu Chen, Steen Pehrson & Jesper Hastrup Svendsen

  2. The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark

    Kristoffer Mads Henningsen & Jesper Hastrup Svendsen

  3. Department of Medicine O, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark

    Julia S. Johansen

  4. Department of Surgery and Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    Jesper Hastrup Svendsen

Authors
  1. Kristoffer Mads Henningsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian Nilsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julia S. Johansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xu Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Steen Pehrson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jesper Hastrup Svendsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jesper Hastrup Svendsen.

Additional information

Responsible Editor: C. Kasserra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Henningsen, K.M., Nilsson, B., Johansen, J.S. et al. Plasma YKL-40 is elevated in patients with recurrent atrial fibrillation after catheter ablation. Inflamm. Res. 59, 463–469 (2010). https://doi.org/10.1007/s00011-009-0146-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00011-009-0146-z

Keywords

Search

Navigation