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

Introduction: Recentstudies have shown a significant association between left atrial (LA) globallongitudinal strain (GLS) and the progression of atrial fibrillation (AF) withsignificantly decreased LA GLS in patients with paroxysmal AF. Significantlyhigher levels of serum galectin-3 have also been found in patients with non-valvularAF. This study aimed to examine the relationship of the early stage of atrialfibrosis and reduced atrial deformation with serum galectin-3 concentration inmiddle-aged patients with a first episode of non-valvular AF.Patients and Methods:Thisstudy prospectively enrolled 34 patients who were admitted to our emergencydepartment and required either a medical or electrical cardioversion due to thefirst episode of AF, without any structural or coronary heart disease and withnormal LA size. Additionally, 31 control subjects were also enrolled. Thediameter, volume, and mechanical function of LA, including strain (S) andstrain rate (SR), and serum galectin-3 levels were measured.Results: Theaverage age was 48.5 ± 10.4 years. Galectin-3 values were not significantlydifferent between the AF and control groups (r= 0.42; p= 0.51) and were foundto correlate inversely with peak negative SR on apical four 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 fourchamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR onapical four-chamber view (p= 0.04), and peak late negative SR on apical fourchamber (p= 0.03) and two-chamber (p= 0.02) views.Conclusion: Middle-aged patients withthe first episode of AF and normal LA sizes had reduced LA reservoir and activeatrial functions. Although beginning signs of LA functional remodeling wereshown on S and SR imaging, these were not completely reflected by serumgalectin-3 levels.
Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)’lu ortayaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresiarasındaki ilişkiyi araştırdık.Hastalar veYöntem: Bu çalışmaya acil servisimize ilk atak AF ile başvuran,medikal ya da elektriki kardiyoversiyon yapılmış, yapısal ya da koroner kalphastalığı olmayan normal LA boyuta sahip 34 hasta ve 31 kontrol hastasıprospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındıve serum galectin düzeyleri ekokardiyografi öncesi alınan kan örneklerindenölçüldü.Bulgular: Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AFve kontrol grubu arasında anlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikaldört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntüden (r= -0.25 , p= 0.04)pik negatif SR ile negatif korele bulundu. Kontrol grubu ilekarşılaştırıldığında, AF grubunda dört boşluk görüntüden pik sistolik strain(p= 0.037), pik geç diastolik strain (p= 0.04), pik positif SR (p= 0.04) ve pikgeç negatif SR apikal dört (p= 0.03) ve iki boşluk (p= 0.02) görüntüdendeğerleri anlamlı olarak daha düşük olarak bulunmuştur.Sonuç: İlk atak AF’li orta yaşlıve normal LA boyutuna sahip hastalarda LA rezervuar ve aktif atriyalfonksiyonlar azalmıştır. Strain ve SR görüntüleme ile gösterilmiş LAfonksiyonel remodeling belirtileri başlamış olmasına rağmen bu durum serumgalectin düzeyleri ile tam olarak gösterilememiştir.