Atrial Tissue Pro‐Fibrotic M2 Macrophage Marker CD163+, Gene Expression of Procollagen and B‐Type Natriuretic Peptide

Chris J. Watson, Nadezhda Glezeva, Stephen Horgan, Joe Gallagher, Dermot Phelan, Ken McDonald, Michael Tolan, John Baugh, Pat Collier, Mark Ledwidge

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Atrial tissue fibrosis is linked to inflammatory cells, yet is incompletely understood. A growing body of literatureassociates peripheral blood levels of the antifibrotic hormone BNP (B-type natriuretic peptide) with atrial fibrillation (AF). Weinvestigated the relationship between pro-fibrotic tissue M2 macrophage marker Cluster of Differentiation (CD)163+, atrialprocollagen expression, and BNP gene expression in patients with and without AF.

METHODS AND RESULTS: In a cross-sectional study design, right atrial tissue was procured from 37 consecutive, consenting,stable patients without heart failure or left ventricular systolic dysfunction, of whom 10 had AF and 27 were non-AF controls.Samples were analyzed for BNP and fibro-inflammatory gene expression, as well as fibrosis and CD163+. Primary analysesshowed strong correlations (all P<0.008) between M2 macrophage CD163+ staining, procollagen gene expression, and myocardial BNP gene expression across the entire cohort. In secondary analyses without multiplicity adjustments, AF patients hadgreater left atrial volume index, more valve disease, higher serum BNP, and altered collagen turnover markers versus controls(all P<0.05). AF patients also showed higher atrial tissue M2 macrophage CD163+, collagen volume fraction, gene expressionof procollagen 1 and 3, as well as reduced expression of the BNP clearance receptor NPRC (all P<0.05). Atrial procollagen 3gene expression was correlated with fibrosis and BNP gene expression was correlated with serum BNP.

CONCLUSIONS: Elevated atrial tissue pro-fibrotic M2 macrophage CD163+ is associated with increased myocardial gene expression of procollagen and anti-fibrotic BNP and is higher in patients with AF. More work on modulation of BNP signaling fortreatment and prevention of AF may be warranted.
Original languageEnglish
Article numbere013416
Number of pages12
JournalJ Am Heart Assoc
Issue number11
Early online date20 May 2020
Publication statusPublished - 02 Jun 2020


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