Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Abstract

Introduction: Recent studies have shown a significant association between left atrial (LA) global longitudinal strain (GLS) and the progression of atrial fibrillation (AF) with significantly decreased LA GLS in patients with paroxysmal AF. Significantly higher levels of serum galectin-3 have also been found in patients with non-valvular AF. This study aimed to examine the relationship of the early stage of atrial fibrosis and reduced atrial deformation with serum galectin-3 concentration in middle-aged patients with a first episode of non-valvular AF.

Patients and Methods: This study prospectively enrolled 34 patients who were admitted to our emergency department and required either a medical or electrical cardioversion due to the first episode of AF, without any structural or coronary heart disease and with normal LA size. Additionally, 31 control subjects were also enrolled. The diameter, volume, and mechanical function of LA, including strain (S) and strain rate (SR), and serum galectin-3 levels were measured.

Results: The average age was 48.5 ± 10.4 years. Galectin-3 values were not significantly different between the AF and control groups (r= 0.42; p= 0.51) and were found to correlate inversely with peak negative SR on apical four chamber (r= −0.31, p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the control group, the AF group had significantly lower values of peak systolic S on four chamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR on apical four-chamber view (p= 0.04), and peak late negative SR on apical four chamber (p= 0.03) and two-chamber (p= 0.02) views.

Conclusion: Middle-aged patients with the first episode of AF and normal LA sizes had reduced LA reservoir and active atrial functions. Although beginning signs of LA functional remodeling were shown on S and SR imaging, these were not completely reflected by serum galectin-3 levels.

Keywords

• Atrial fibrillation,strain,strain rate,galectin-3

İlk Atak Non-valvular Atrial Fibrilasyonlu Orta Yaşlı Hastalarda Galectin-3

Abstract

Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)’lu orta yaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresi arasındaki ilişkiyi araştırdık.

Hastalar ve Yöntem: Bu çalışmaya acil servisimize ilk atak AF ile başvuran, medikal ya da elektriki kardiyoversiyon yapılmış, yapısal ya da koroner kalp hastalığı olmayan normal LA boyuta sahip 34 hasta ve 31 kontrol hastası prospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındı ve serum galectin düzeyleri ekokardiyografi öncesi alınan kan örneklerinden ölçüldü.

Bulgular: Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AF ve kontrol grubu arasında anlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikal dört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntüden (r= -0.25 , p= 0.04) pik negatif SR ile negatif korele bulundu. Kontrol grubu ile karşılaştırıldığında, AF grubunda dört boşluk görüntüden pik sistolik strain (p= 0.037), pik geç diastolik strain (p= 0.04), pik positif SR (p= 0.04) ve pik geç negatif SR apikal dört (p= 0.03) ve iki boşluk (p= 0.02) görüntüden değerleri anlamlı olarak daha düşük olarak bulunmuştur.

Sonuç: İlk atak AF’li orta yaşlı ve normal LA boyutuna sahip hastalarda LA rezervuar ve aktif atriyal fonksiyonlar azalmıştır. Strain ve SR görüntüleme ile gösterilmiş LA fonksiyonel remodeling belirtileri başlamış olmasına rağmen bu durum serum galectin düzeyleri ile tam olarak gösterilememiştir.

Keywords

• Atriyal fibrilasyon,strain,strain rate,galectin

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