Abstract
Aim. To evaluate the prominence of fibrosis of the left atrium myocardium and to define the value of transforming growth factor beta 1 (TGF-beta1) and galectin-3 in development of myocardial fibrosis in atrial fibrillation (AF) patients with metabolic syndrome (MS). Material and methods. Totally, 58 patients with AF included, of those 27 with MS. Controls were 50 almost healthy participants. Levels of galectin-3 and TGF-beta1 in blood serum were measured by immune enzyme assay. For fibrosis assessment, the anatomical and amplitude charts of the left atrium (LA) were built up with nonfluoroscopic system of electroanatomical charting CARTO3 (Biosense Webster, USA) and catheter measurement of the contact power with myocardium of LA (Smart Touch Thermocool, Biosense Webster, USA). In “off-line” regimen the evaluation performed of the zones of low voltage in amplitude specters 0,2-0,5 mV and 0,2-1,0 mV with the area measurement by navigation software function “area measurement”. Results. Volume of LA and volume index of LA in AF with MS were higher than in AF with no MS: 78,0±20,4 mL and 60,4±19,8 mL (p=0,005) and 37,8±9,5 mL/m 2 and 30,4±9,0 mL/m 2 (p=0,005), respectively. The percent of LA fibrosis area in AF with MS was higher than in AF with no MS (16,1 [12,8;20,5]% and 10,5 [7,3;16,2]%, respectively, p=0,028). The positive correlations revealed of the level of galectin-3 (r=0,410, р<0,001) and TGF-beta1 (r=0,594, р<0,001) in blood serum with the percentage of LA fibrosis in AF patients. By the linear regression, the influence found of galectin-3 levels (β=0,549, p<0,001) and of TGF-beta1 (β=0,297, p=0,025) on the area of LA fibrosis in AF patients. Conclusion. The area of fibrosis in the LA myocardium in AF patients with MS is larger than in AF no MS patients. Myocardial fibrosis markers evaluation (galectin-3, TGF-beta1) in blood serum may have diagnostic significance in prediction of AF fibrosis severity in AF patients.
Highlights
Е. — врач функциональной диагностики клиники терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики с клиникой им
Профиброгенные факторы галектин-3 и трансформирующий фактор роста бета-1 коррелируют со степенью выраженности фиброза миокарда левого предсердия (ЛП) при пароксизмальной форме фибрилляцией предсердий (ФП)
Summary
АГ — артериальная гипертензия, АД — артериальное давление, ИБС — ишемическая болезнь сердца, ИМТ — индекс массы тела, КРЭ — Российский филиал института метаболического синдрома, ЛП — левое предсердие, МРТ — магнитно резонансная томография, МС — метаболический синдром, ОТ — окружность талии, РЧА — радиочастотная абляция, СРБ — с-реактивный белок, ТГ — триглицериды, ФП — фибрилляция предсердий, ХБП — хроническая болезнь почек, ХС ЛПВП — холестерин липопротеинов высокой плотности, ЭКГ — электрокардиография, СМЭКГ — суточное мониторирование электрокардиограммы, ЭхоКГ — эхокардиография, ATP III — Adult Treatment Panel III, ARIC — Atherosclerosis Risk in Communities Study, EHRA — European Heart Rhythm Association, JIS — Joint Interim Societies, IDF — International Diabetes Federation, TGF-beta1 — трансформирующего фактора роста-бета1. Цель данного исследования — изучение уровня галектина-3 и трансформирующего фактора роста-бета1 (TGF-beta1) в сыворотке крови и оценка их взаимосвязи с выраженностью фиброза миокарда ЛП у пациентов с МС для определения возможной роли этих факторов в возникновении ФП.
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