Increased serum lysyl oxidase-like 2 levels correlate with the degree of left atrial fibrosis in patients with atrial fibrillation.

Yingming Zhao,Jin Yang,Xu Tianbao,Dianfu Li,Junhong Wang,Kangting Tang

doi:10.1042/bsr20171332

Abstract

Atrial fibrillation (AF) progression is generally accompanied by increased atrial fibrosis and atrial structural remodeling. Lysyl oxidase-like 2 (LOXL2) is known to play an important role in many fibrotic conditions, including cardiac fibrosis. The present study aimed to explore the relationship between serum LOXL2 levels and AF. Fifty-four AF patients and 32 control subjects were enrolled in the study. High-density three-dimensional electroanatomic mapping was performed, and mean bipolar voltage was assessed in AF patients. LOXL2 levels were measured by enzyme-linked immunosorbent assay. All patients underwent echocardiography to assess left atrium size and left ventricle function. Serum LOXL2 levels were significantly elevated in AF patients compared with the control group (526.81 ± 316.82 vs 240.94 ± 92.51 pg/ml, P<0.01). In addition, serum LOXL2 level was significantly correlated with the size of the left atrium (LAD) (r2 = 0.38, P<0.01). Furthermore, the serum LOXL2 levels were significantly higher in AF patients with LAD ≥ 40 mm compared with those with LAD < 40 mm (664.34 ± 346.50 vs 354.90 ± 156.23 pg/ml, P<0.01). And the Spearman’s correlation analysis further revealed that the mean bipolar left atrial voltage was inversely correlated with the LOXL2 (r2 = −0.49, P<0.01) in AF patients. Multivariate regression analysis further demonstrated that serum LOXL2 [odds ratio (OR) 1.013, 95% confidence interval (CI) 1.002–1.024, P<0.05] and LAD (OR 1.704, 95% CI 1.131–2.568, P<0.01) were independent predictors of AF. In conclusion, serum LOXL2 levels were significantly elevated and were correlated with the degree of left atrial fibrosis in AF patients.

Highlights

Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with increased morbidity and mortality [1]
Multivariate regression analysis further demonstrated that serum Lysyl oxidase-like-2 (LOXL2) and left atrial diameter (LAD) were independent predictors of AF in this patient group (Table 2)
The present study reported the following results: (1) serum LOXL2 was significantly elevated in patients with AF compared with patients without AF. (2) LAD was independently correlated with serum LOXL2 levels in patients with AF

Summary

Introduction

Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with increased morbidity and mortality [1]. The association between AF and atrial fibrosis has been highlighted in several studies [4,5]. LOXL2 was proposed to function to LOX in the extracellular matrix by promoting crosslinking of collagen and elastin [6,7]. One recent study focused on the association between LOXL2 levels and cardiac fibrosis in heart failure (HF) [8]. The present study showed that LOXL2 is up-regulated in the cardiac interstitium in diseased human hearts. LOXL2 levels were correlated with collagen crosslinking and cardiac dysfunction. The study suggests a pathogenic role of LOXL2 in cardiac fibrosis and human HF

Methods

Results

Conclusion