Renal dysfunction results in the accumulation of various uremic toxins, including indoxyl sulphate (IS), and is a major risk factor for atrial fibrillation (AF). Experimental studies have demonstrated that IS exacerbates atrial remodelling via oxidative stress, inflammation, and fibrosis. However, its clinical impact on AF-promoting cardiac remodelling has not been described. Therefore, the purpose of this study was to clarify the relationship between basal IS levels and the 1-year outcomes after catheter ablation for the treatment of AF. Our prospective observational study included data from 125 patients with AF who underwent catheter ablation. Over a 1-year follow-up period, AF recurrence was identified in 21 patients. The 1-year AF-free survival was significantly lower in patients with high serum IS levels (≥0.65 μg/mL) than in those with low IS levels (60.1 ± 10.4% versus 85.2 ± 3.9%, P = 0.007). Univariable analysis identified that an IS concentration ≥ 0.65 μg/mL was associated with AF recurrence (hazard ratio [HR] = 3.10 [1.26-7.32], P = 0.015), and this association was maintained in multivariate analysis (HR = 3.67 [1.13-11.7], P = 0.031). Thus, in patients undergoing AF ablation, serum IS levels at baseline independently predict the recurrence of arrhythmia.

中文翻译：

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导管消融后，硫酸吲哚酚与心房颤动复发有关。

肾功能不全导致各种尿毒症毒素的积累，包括吲哚酚硫酸盐（IS），并且是房颤（AF）的主要危险因素。实验研究表明，IS通过氧化应激，炎症和纤维化加剧了心房重构。但是，尚未描述其对促进房颤的心脏重塑的临床影响。因此，本研究的目的是阐明基础IS水平与导管消融治疗房颤1年预后之间的关系。我们的前瞻性观察研究包括来自125例接受导管消融的房颤患者的数据。在1年的随访期内，发现21例房颤复发。血清IS水平高（≥0）的患者的1年无AF生存率显着降低。低于低IS水平（60.1±10.4％对85.2±3.9％，P = 0.007）的那些）。单因素分析确定IS浓度≥0.65μg/ mL与AF复发相关（危险比[HR] = 3.10 [1.26-7.32]，P = 0.015），这种关联在多变量分析中得以维持（HR = 3.67 [1.13] -11.7]，P = 0.031）。因此，在进行AF消融的患者中，基线时的血清IS水平可独立预测心律失常的复发。