Author + information
- Osman Sonmez1,
- Furkan U Ertem2,
- Mehmet Akif Vatankulu1,
- Ercan Erdogan1,
- Abdurrahman Tasal1,
- Sıtkı Kucukbuzcu1 and
- Omer Goktekin1
Atrial fibrillation is the most common cardiac arrhythmia increasing the risk of stroke and death. Inflammation is an important factor involved in the initiation, maintenance and recurrence of AF and The abnormal inflammatory state may also cause a prothrombotic state resulting thromboembolism. In the present study we aim to investigate whether serum levels of galectin-3, Matrix Metalloproteinase 9 (MMP-9) and Procollagen III N-Terminal Propeptide (PIIINP),Human Lipocalin-2/NGAL and NLR differ in patients with AF compared to patients with sinus rhythm in the guidance of serum levels of MMP-9 and Hs-CRP. We also evaluated associations of these markers with atrial structural remodeling which was interpreted by measuring the left atrial volume index.
The study population included 85 patients who were seen in our outpatient clinic between March 2012 and January 2012. 52 patients who diagnosed with non-valvular AF recruited into AF group. End-stage hepatic or renal disease, malignancy, any prior blood transfusions, carotid artery disease, prior transient ischemic attack, ischemic or hemorrhagical stroke and oral anticoagulant usage were exclusion criteria in our study. 35 age-matched patients with sinus rhythm recruited into control group. Serum levels of Galectin-3, Matrix Metalloproteinase 9 (MMP-9) and Procollagen III N-Terminal Propeptide (PIIINP) were measured by using a commercial enzyme-linked immunoassay kits and each assay was carried out in duplicate. Galectin-3, NGAL, MMP-9 and PIIINP levels were measured by using sandwich ELISA (Human Galectin-3 ELISA kit, eBioscience; Lipocalin-2/NGAL Elisa kit, BioVendor Research and Diagnostic Products; Human Matrix Metalloproteinase 9, Bio-Medical Assay; Human Procollagen III N-Terminal Propeptid, Bio-Medical Assay).
There were significant differences between the groups in terms of inflammatory and remodeling markers except NGAL levels. We showed significantly higher levels of Galectin-3, MMP-9, PIIINP in in NVAF group compared to control group (1166 pg/ml (1126-1204) & 1204 pg/ml (1166-1362) p=0.001 Mann-Whitney U test, 146±88 pg/ml & 429±302 pg/ml p<0.0001 Student-t test, and 1426±Student-t test respectively). Hs1230 pg/ml & 6590±4594 pg/ml p<0.0001 -Crp and NLR level were also higher in NVAF (2.1±1.0 & 2.7±1.1 p=0.02 Student-t test and 4.2±1.9 mg/L & 6.0±4.7 mg/L p=0.04 Student-t test, respectively).
In correlation analyses, NLR showed quite significant correlation with LAVi whereas Hs-CRP did not (p=0.007 r=0.247, pearson test & p=0.808 r=0.025, pearson test,respectively). Moreover, Galectin-3, MMP-9, and PIIINP had strong positive correlation with LAVi (p=0.021 r=640, spearman test & p=0.004 r=0.319 pearson test, & p=0.004 r=0.325 pearson test,respectively).
As a result of this data we suggest that galectin-3 and PIIINP can be used as novel targets in AF patients in order to decrease degree of fibro-inflammation in the atria.