İlk Atak Non-valvular Atrial Fibrilasyonlu Orta Yaşlı Hastalarda Galectin-3

Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Cevat KIRMA, Ali YAMAN, Emrah ACAR, Alev KILIÇGEDİK, Mehmet Fatih YILMAZ, Süleyman Çağan EFE, Ahmet Seyfettin GÜRBÜZ, İbrahim Akın İZGİ, Gökhan KAHVECİ

Abstract

Introduction: Recent studies have shown a significant association between left atrial (LA) global longitudinal strain (GLS) and the progression of atrial fibrillation (AF) with significantly decreased LA GLS in patients with paroxysmal AF. Significantly higher levels of serum galectin-3 have also been found in patients with non-valvular AF. This study aimed to examine the relationship of the early stage of atrial fibrosis and reduced atrial deformation with serum galectin-3 concentration in middle-aged patients with a first episode of nonvalvular AF Patients and Methods: This study prospectively enrolled 34 patients who were admitted to our emergencydepartment and required either a medical or electrical cardioversion due to the first episode of AF, withoutany structural or coronary heart disease and with normal LA size. Additionally, 31 control subjects were alsoenrolled. The diameter, volume, and mechanical function of LA, including strain (S) and strain rate (SR), andserum galectin-3 levels were measured.Results: The average age was 48.5 ± 10.4 years. Galectin-3 values were not significantly different between theAF and control groups (r= 0.42; p= 0.51) and were found to correlate inversely with peak negative SR on apicalfour chamber (r= −0.31, p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the controlgroup, the AF group had significantly lower values of peak systolic S on four chamber view (p= 0.037), peaklate diastolic S (p= 0.04), peak positive SR on apical four-chamber view (p= 0.04), and peak late negative SRon apical four chamber (p= 0.03) and two-chamber (p= 0.02) views.Conclusion: Middle-aged patients with the first episode of AF and normal LA sizes had reduced LA reservoirand active atrial functions. Although beginning signs of LA functional remodeling were shown on S and SRimaging, these were not completely reflected by serum galectin-3 levels.

Özet

Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)'lu orta yaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresi arasındaki ilişkiyi araştırdık Hastalar ve Yöntem: Bu çalışmaya acil servisimize ilk atak AF ile başvuran, medikal ya da elektriki kardiyoversiyonyapılmış, yapısal ya da koroner kalp hastalığı olmayan normal LA boyuta sahip 34 hasta ve 31kontrol hastası prospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındı ve serum galectindüzeyleri ekokardiyografi öncesi alınan kan örneklerinden ölçüldü.Bulgular: Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AF ve kontrol grubu arasındaanlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikal dört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntü-den (r= -0.25 , p= 0.04) pik negatif SR ile negatif korele bulundu. Kontrol grubu ile karşılaştırıldığında, AFgrubunda dört boşluk görüntüden pik sistolik strain (p= 0.037), pik geç diastolik strain (p= 0.04), pik positifSR (p= 0.04) ve pik geç negatif SR apikal dört (p= 0.03) ve iki boşluk (p= 0.02) görüntüden değerleri anlamlıolarak daha düşük olarak bulunmuştur.Sonuç: İlk atak AF'li orta yaşlı ve normal LA boyutuna sahip hastalarda LA rezervuar ve aktif atriyal fonksiyonlarazalmıştır. Strain ve SR görüntüleme ile gösterilmiş LA fonksiyonel remodeling belirtileri başlamışolmasına rağmen bu durum serum galectin düzeyleri ile tam olarak gösterilememiştir.