Pericardial NT-Pro-BNP and GDF-15 as Biomarkers of Atrial Fibrillation and Atrial Matrix Remodeling in Aortic Stenosis.

Mariana Fragão-Marques,Jennifer Mancio,Isaac Barroso,João Rocha-Neves,João T Guimarães,Isabel M Miranda,Diana Martins,Adelino Leite-Moreira,Inês Falcão-Pires,Rui Farinha

doi:10.3390/diagnostics11081422

Mariana Fragão-Marques, Jennifer Mancio + Show 8 more

Open Access

https://doi.org/10.3390/diagnostics11081422

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Journal: Diagnostics	Publication Date: Aug 5, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: University of Porto, Hospital de São João

Abstract

Aims: This study aimed to evaluate the association of GDF-15 and NT-pro-BNP in two different biological matrices with AF in severe aortic stenosis patients undergoing aortic valve replacement surgery (AVR), its association with atrial matrix remodeling, as well as with 30-day postoperative outcomes. Main Methods: One hundred and twenty-six patients between 2009 and 2019 with severe aortic stenosis undergoing AVR surgery in a tertiary hospital were assessed. Key Findings: pericardial fluid GDF-15 and pericardial fluid and serum NT-pro-BNP were increased in AF patients with aortic stenosis. COL1A1 and COL3A1 gene expression increased when pericardial fluid NT-pro-BNP values were higher. TIMP4 was positively correlated with pericardial fluid GDF-15. Significance: GDF-15 and NT-pro-BNP in the pericardial fluid are biomarkers of atrial fibrillation in aortic stenosis and correlate with atrial matrix remodeling. AKI is predicted by both serum and pericardial fluid GDF-15.

Highlights

Atrial fibrillation (AF) is the most common sustained arrhythmia with adverse clinical outcomes [1]
This study aimed to evaluate the association of Growth Differentiation Factor 15 (GDF-15) and NT-pro-BNP in two different biological matrices with AF in severe aortic stenosis patients undergoing aortic valve replacement surgery (AVR), its association with atrial matrix remodeling, and 30-day postoperative outcomes
GDF-15 was only increased in AF patients with aortic stenosis when measured in the pericardial fluid (median (Q1–Q3) 775.6 (660.0–1274.8) ng/L vs. 616.2 (401.7–983.9) ng/L, p = 0.031); serologic GDF-15 remained similar between groups (1697.0 (1040.5–2727.5) ng/L vs. 1102.0 (764.7–1835.8) ng/L, p = 0.124)

Summary

Introduction

Atrial fibrillation (AF) is the most common sustained arrhythmia with adverse clinical outcomes [1]. It is estimated that AF affects 2% to 4% of the general population, having increased its prevalence over time [2]. Some mechanisms of AF pathophysiology are widely recognized, namely, rapid ectopic firing, early and delayed after-depolarisations, rotors and electrical and structural remodeling, individual risk factors for AF are associated with specific pathophysiological mechanisms [3]. Aortic stenosis induces pressure overload in left cardiac chambers and shares multiple risk factors with AF, namely, age and hypertension. The prevalence of pre-existing AF in aortic stenosis patients undergoing aortic valve replacement surgery (AVR) ranges from 8% to 13% [4]. Specific mechanisms of AF in this subset of patients are still unclear, age and hypertension have been associated with structural remodeling [3]

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