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Background <p>Bone morphogenetic protein 10 (BMP10), involved in myocardial development and fibrosis, has an unclear relationship with the extent of the left atrial low-voltage zone (LVZ), a key substrate for atrial fibrillation (AF).</p> Objective <p>This study aimed to investigate the association between serum BMP10 levels and left atrial LVZ area and their predictive value for outcomes following catheter ablation.</p> Methods <p>A prospective cohort of 104 patients undergoing first-time AF ablation was enrolled. Preoperative serum BMP10 levels were measured for patient stratification. Left atrial LVZ area was assessed during the procedure, and predictive analyses were conducted using regression and receiver operating characteristic (ROC) methods.</p> Results <p>Participants were stratified into three groups based on preoperative serum BMP10 concentration levels: high BMP10 group (≥ 2.12&#xa0;ng/mL, n = 34), intermediate BMP10 group (1.47–2.12&#xa0;ng/mL, n = 35), and low BMP10 group (≤ 1.47&#xa0;ng/mL, n = 35). The high-BMP10 group exhibited significantly larger LVZ area (P = 0.045), and BMP10 levels were positively correlated with LVZ area (R = 0.328, P &lt; 0.001). During a median follow-up of 274&#xa0;days, AF recurrence occurred in 21.2% (22/104) of the total cohort. No recurrences were observed in the low-BMP10 group, compared to 22.9% (8/35) in the intermediate group and 41.1% (14/34) in the high group (P &lt; 0.001). Univariate Cox regression analysis identified BMP10 (HR = 2.603, 95% CI 1.590–4.260, P &lt; 0.001) and female sex (HR = 3.179, 95% CI 1.355–7.459, P = 0.008) as significant predictors of atrial fibrillation recurrence. In multivariable analyses adjusting for various clinical factors, BMP10 significantly associated with AF recurrence as an independent marker. ROC analysis demonstrated that BMP10 had promising predictive performance (AUC = 0.85), outperforming traditional risk scores.</p> Conclusion <p>Elevated serum BMP10 is independently associated with extensive left atrial LVZ and an increased risk of AF recurrence, suggesting that BMP10 serves as a surrogate marker of pre-existing atrial structural disease. The absence of recurrence in the low-BMP10 group highlights its potential for risk stratification.</p>

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Serum BMP10 levels are associated with left atrial low-voltage zones and predict atrial fibrillation recurrence: a prospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年5月15日

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  • Yihui Cao,
  • Nanqing Xiong,
  • Liang Hu,
  • Wen Gao,
  • Wentao Gu,
  • Maocheng Gu,
  • Jiesong Pan,
  • Xinping Luo,
  • Yikai Zhao,
  • Jian Li

摘要

Background

Bone morphogenetic protein 10 (BMP10), involved in myocardial development and fibrosis, has an unclear relationship with the extent of the left atrial low-voltage zone (LVZ), a key substrate for atrial fibrillation (AF).

Objective

This study aimed to investigate the association between serum BMP10 levels and left atrial LVZ area and their predictive value for outcomes following catheter ablation.

Methods

A prospective cohort of 104 patients undergoing first-time AF ablation was enrolled. Preoperative serum BMP10 levels were measured for patient stratification. Left atrial LVZ area was assessed during the procedure, and predictive analyses were conducted using regression and receiver operating characteristic (ROC) methods.

Results

Participants were stratified into three groups based on preoperative serum BMP10 concentration levels: high BMP10 group (≥ 2.12 ng/mL, n = 34), intermediate BMP10 group (1.47–2.12 ng/mL, n = 35), and low BMP10 group (≤ 1.47 ng/mL, n = 35). The high-BMP10 group exhibited significantly larger LVZ area (P = 0.045), and BMP10 levels were positively correlated with LVZ area (R = 0.328, P < 0.001). During a median follow-up of 274 days, AF recurrence occurred in 21.2% (22/104) of the total cohort. No recurrences were observed in the low-BMP10 group, compared to 22.9% (8/35) in the intermediate group and 41.1% (14/34) in the high group (P < 0.001). Univariate Cox regression analysis identified BMP10 (HR = 2.603, 95% CI 1.590–4.260, P < 0.001) and female sex (HR = 3.179, 95% CI 1.355–7.459, P = 0.008) as significant predictors of atrial fibrillation recurrence. In multivariable analyses adjusting for various clinical factors, BMP10 significantly associated with AF recurrence as an independent marker. ROC analysis demonstrated that BMP10 had promising predictive performance (AUC = 0.85), outperforming traditional risk scores.

Conclusion

Elevated serum BMP10 is independently associated with extensive left atrial LVZ and an increased risk of AF recurrence, suggesting that BMP10 serves as a surrogate marker of pre-existing atrial structural disease. The absence of recurrence in the low-BMP10 group highlights its potential for risk stratification.