Relationships of High-sensitive C-reactive Protein and P-wave Dispersion in Lone Atrial Fibrillation

Background: Current evidence links atrial fibrillation (AF) to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein (hs-CRP) have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion (P-d) remains unclear. Methods: The study consisted of 71 patients with lone paroxysmal AF (AF group) and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF (control group). Electrocardiography, P-d, hs-CRP, and other clinical characteristics were compared between the two groups. Results: There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter (44 +/- 7 vs 39 +/- 7 mm), P-d (49 +/- 13 vs 26 +/- 8 ms), and hs-CRP (2.17 [1.46-2.89] vs 1.12 [ 0.74-1.41] mg/L) were increased (P < 0.05), respectively. Linear regression identified hs-CRP as an independent correlation of Pd level both in the total population and the AF group (r = 0.464 and 0.313; P < 0.001, respectively). Multiple logistic regression revealed hs-CRP as an independent determinant of AF (odds ratio [OR] = 15.430, 95% confidence interval: 6.031-39.476: P < 0.001). Further adjusted for Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246. Conclusions: In lone AF, P-d and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by P-d, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.