Abstract
Purpose Recent studies have indicated that N-acetylneuraminic acid (Neu5Ac) plays a key role in severe coronary artery diseases, involving RhoA signaling pathway activation, which is critically involved in cardiac fibrosis. There is convincing evidence from many studies that left atrium fibrosis is involved in the pathophysiology of AF. Therefore, we speculated that Neu5Ac may be associated with atrial fibrillation (AF) and involved in the development of AF. This study aims to investigate the clinical relationship between Neu5Ac and AF and left atrial enlargement. Methods Forty-five patients with AF (AF group) and forty-five patients with non-AF (control group) matched for age, sex, and hospitalization date were recruited for our study. Plasma concentrations of Neu5Ac from peripheral venous blood were analyzed using enzyme-linked immunosorbent assay (ELISA). The baseline characteristics, plasma level of Neu5Ac, and echocardiographic characteristics were evaluated. Results The plasma level of Neu5Ac was significantly higher in the AF group than in the control group (107.66 ± 47.50 vs 77.87 ± 39.09 ng/ml; P < 0.05); the left atrial diameters were positively correlated with the plasma Neu5Ac level (R = 0.255; P < 0.05). The plasma Neu5Ac level (R = 0.368; P < 0.05) and the left atrial diameters (R = 0.402; P < 0.05) were positively correlated with AF history times. Neu5Ac (odds ratio 1.018, 95% CI 1.003–1.032; P < 0.05) and the left atrial diameter (odds ratio 1.142, 95% CI 1.020–1.280; P < 0.05) were independent risk factors for AF in multivariate regression analysis. Conclusions Serum Neu5Ac is associated with atrial fibrillation, and the mechanism may involve left atrial enlargement.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia and the leading cause of cardiovascular morbidity and mortality in clinical practice worldwide
Recent studies have indicated that Neu5Ac plays a key role in severe coronary artery diseases, involving the activation of the RhoA signaling pathway, which is important for cardiac fibrosis [9,10,11]. erefore, we speculated that Neu5Ac may be associated with AF and involved in the development of Cardiology Research and Practice
E exclusion criteria were as follows: a history of prior AF catheter ablation, which might lead to atrial fibrosis and interfere with the results of study; atrial septal defect for occlusion or surgical treatment; severe coronary disease; heart valve disease; cardiac surgery, including heart transplantation and heart valve replacement; severe heart failure; recent or active malignancy; severe renal failure; shock and death during hospitalization and unwillingness or inability to sign the informed consent form
Summary
Atrial fibrillation (AF) is the most common arrhythmia and the leading cause of cardiovascular morbidity and mortality in clinical practice worldwide. Experimental and clinical data have indicated that the incidence and progression of AF are very complex pathophysiological processes involving a large number of significant players, including atrial enlargement, Ca2+ overload, inflammation, apoptosis, and fibrosis, autonomic nervous system changes [5,6,7]. Recent studies have indicated that Neu5Ac plays a key role in severe coronary artery diseases, involving the activation of the RhoA signaling pathway, which is important for cardiac fibrosis [9,10,11]. Erefore, we speculated that Neu5Ac may be associated with AF and involved in the development of Cardiology Research and Practice Recent studies have indicated that Neu5Ac plays a key role in severe coronary artery diseases, involving the activation of the RhoA signaling pathway, which is important for cardiac fibrosis [9,10,11]. erefore, we speculated that Neu5Ac may be associated with AF and involved in the development of Cardiology Research and Practice
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