Abstract
BackgroundAtrial fibrillation (AF) is a common arrhythmia in patients with hypertension. ELABELA, which has cardioprotective effects, is decreased in the plasma of patients with hypertension and might be associated with AF in the hypertensive population. This study aims to measure the ELABELA plasma levels in hypertension patients with and without AF and to analyse the related factors.MethodsA total of 162 hypertension patients with or without AF were recruited for our monocentric observational study. Subjects were excluded if they had a history of valvular heart disease, rheumatic heart disease, cardiomyopathy, thyroid diseases, or heart failure. The patients’ histories were recorded, and laboratory examinations were conducted. Plasma ELABELA was detected by immunoassay. Echocardiographs were performed, and parameters were collected by two experienced doctors. Binary logistic regression analysis was used to identify the association between ELABELA plasma level and AF in patients with hypertension.ResultsPlasma ELABELA levels were lower in hypertension patients with AF than in those without AF (2.0 [1.5, 2.8] vs. 4.0 [3.4, 5.0] ng/ml, P < 0.001). ELABELA levels were correlated with age, heart rate, BNP levels and left atrial dimension. In addition to the left atrial dimension, ELABELA plasma levels were associated with AF in patients with hypertension (OR 0.081, 95% CI 0.029–0.224, P < 0.001). ELABELA levels were further decreased in the persistent AF subgroup compared with the paroxysmal AF subgroup (1.8 [1.4, 2.5] vs. 2.2 [1.8, 3.0] ng/ml, P = 0.012) and correlated with HR, BNP and ESR levels.ConclusionsELALABELA levels were decreased in hypertension patients with AF and further lowered in the persistent AF subgroup. Decreased ELABELA plasma levels were associated with AF in hypertension patients and may be an underlying risk factor.
Highlights
Atrial fibrillation (AF) is a common arrhythmia in patients with hypertension
Higher ELABELA levels were observed in the HT group than in the HF + AF group (4.0 [3.4, 5.0] vs. 2.0 [1.5, 2.8] ng/ml, P < 0.001) (Fig. 1a)
Echocardiographic data revealed that the mean value of left atrial diameter (LAD) was much larger in the HT + AF group than in the HT group
Summary
Atrial fibrillation (AF) is a common arrhythmia in patients with hypertension. ELABELA, which has car‐ dioprotective effects, is decreased in the plasma of patients with hypertension and might be associated with AF in the hypertensive population. This study aims to measure the ELABELA plasma levels in hypertension patients with and without AF and to analyse the related factors. ELABELA plasma levels were reduced in hypertension patients [10], and those with low levels of ELABELA tended to develop hypertension [6]. Experimental evidence has revealed that ELABELA has positive inotropic action and plays anti-remodelling, anti-inflammatory and antifibrotic roles in the cardiovascular system [9], helping to attenuate the effects of risk factors for AF development including atrial enlargement, myocardial fibrosis and inflammatory response, and to reduce the incidence and burden of AF. There has been no clinical study investigating the correlation between ELABELA plasma levels and AF in patients with hypertension
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