Journal article
A novel technique for vein of Marshall blood sampling and its application in assessing atrial remodeling in atrial fibrillation
Clinical research in cardiology
11/20/2025
DOI: 10.1007/s00392-025-02786-2
PMID: 41264011
Abstract
Atrial fibrillation (AF) involves structural and autonomic remodeling, yet direct biochemical assessment of the atrial microenvironment remains challenging due to limited access to atrial tissue.
To develop and validate a novel catheter-based technique for selectively sampling blood from the vein of Marshall (VOM), and to assess its utility in capturing atrial-specific molecular signals relevant to AF pathophysiology.
In 22 patients undergoing catheter ablation for AF, we collected blood from the VOM, anterior interventricular vein (AIV), coronary sinus (CS), and left atrial (LA) cavity using a fluoroscopy-guided over-the-wire balloon catheter approach. Atrial natriuretic peptide (ANP) and norepinephrine (NE) concentrations were measured by ELISA.
VOM blood exhibited significantly higher levels of ANP and NE compared to AIV and CS samples (p < 0.0001), indicating atrial-enriched biochemical content. ANP levels in the VOM were significantly elevated in patients with persistent versus paroxysmal AF (p = 0.0055) and correlated with left atrial diameter (r = 0.45, p = 0.036), suggesting a link to structural remodeling. While NE levels did not differ by AF subtype, the trans-atrial NE gradient (VOM-LA) was significantly higher in persistent AF (p < 0.05), suggesting localized sympathetic activation.
This study introduces a feasible and reproducible method for real-time biochemical profiling of the human atrium. VOM-derived blood provides a unique window into atrial remodeling, with ANP and NE offering complementary insights into structural and autonomic substrates of AF. This technique may serve as a platform for future mechanistic studies and biomarker discovery.
Details
- Title: Subtitle
- A novel technique for vein of Marshall blood sampling and its application in assessing atrial remodeling in atrial fibrillation
- Creators
- Jiali Yuan - Shanghai Jiao Tong UniversityHong Peng - Shanghai Jiao Tong UniversityJingqing Ma - Shanghai Jiao Tong UniversityZhengshuai Wang - Shanghai Jiao Tong UniversityWei Li - Shanghai Jiao Tong UniversityYaqin Han - Shanghai Jiao Tong UniversityYuepeng Wang - Shanghai Jiao Tong UniversityYihui Wang - Division of Cardiovascular Medicine, Department of Internal Medicine, Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, USA. yihui-wang@uiowa.eduQunshan Wang - Shanghai Jiao Tong UniversityYigang Li - Shanghai Jiao Tong University
- Resource Type
- Journal article
- Publication Details
- Clinical research in cardiology
- DOI
- 10.1007/s00392-025-02786-2
- PMID
- 41264011
- NLM abbreviation
- Clin Res Cardiol
- ISSN
- 1861-0692
- eISSN
- 1861-0692
- Publisher
- Springer Nature
- Grant note
- 82370316 / National Natural Science Foundation of China SHDC2022CRD044 / Shanghai Shenkang Hospital Development Center 82200350 / National Natural Science Foundation of China SHDC12025136 / Shanghai Shenkang Hospital Development Center GWVI-11.2-YQ15 / Three-year action plan for strengthening the construction of the public health system in Shanghai
- Language
- English
- Electronic publication date
- 11/20/2025
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985033877402771
Metrics
7 Record Views