Canpolat Uğur, Oto Ali, Yorgun Hikmet, Sunman Hamza, Şahiner Levent, Kaya Ergün Barış, Özer Necla, Aytemir Kudret
Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2015 Apr;43(3):259-68. doi: 10.5543/tkda.2015.83893.
Atrial fibrosis is one of the main components of atrial fibrillation (AF) pathophysiology and culminates in structural, electrical and contractile remodelling. Fibronectin is one of the well-known mediators of fibrogenesis. However, the association of plasma fibronectin with atrial remodelling has not been studied previously. Therefore, the aim of this study was to assess the relationship between plasma fibronectin level and atrial electrical and structural remodelling in patients with lone paroxysmal AF.
A total of 51 lone paroxysmal AF patients and 40 age-, gender- and body mass index-matched healthy control subjects were enrolled. Plasma levels of fibronectin and high sensitive C-reactive protein (hs-CRP) were measured and transthoracic echocardiography for assessment of total atrial conduction time (TACT) and left atrial (LA) volume index was performed on all study participants.
Plasma fibronectin, hs-CRP, TACT, LA diameter and LA volume index were significantly higher in lone paroxysmal AF group compared to healthy controls (p<0.05). Also, there was a positive correlation between plasma fibronectin level and TACT (r=0.362, p<0.001) and LA volume index (r=0.371, p<0.001). In multivariate logistic regression analysis, age, plasma fibronectin level (Odds ratio - OR: 1.003, 95% CI: 1.001-1.005, p=0.026) and hs-CRP (OR: 2.312, 95% CI: 1.503-6.459, p=0.017) were found to be the predictors of LA structural remodelling; however, only plasma fibronectin level (OR: 1.003, 95% CI: 1.001-1.005, p=0.032) and hs-CRP (OR: 3.212, 95% CI: 1.214-5.752, p=0.033) were found as the predictors of LA electrical remodelling.
Our study results showed that profibrotic and proinflammatory biomarkers were associated with left atrial structural and electrical remodelling in lone paroxysmal AF patients.
心房纤维化是心房颤动（AF）病理生理学的主要组成部分之一，最终导致结构、电和收缩重塑。纤连蛋白是一种众所周知的纤维化介质。然而，血浆纤连蛋白与心房重塑之间的关联此前尚未得到研究。因此，本研究的目的是评估孤立性阵发性AF患者血浆纤连蛋白水平与心房电和结构重塑之间的关系。
共纳入51例孤立性阵发性AF患者和40例年龄、性别和体重指数相匹配的健康对照者。测量所有研究参与者的血浆纤连蛋白和高敏C反应蛋白（hs-CRP）水平，并进行经胸超声心动图检查以评估全心房传导时间（TACT）和左心房（LA）容积指数。
与健康对照组相比，孤立性阵发性AF组的血浆纤连蛋白、hs-CRP、TACT、LA直径和LA容积指数显著更高（p<0.05）。此外，血浆纤连蛋白水平与TACT（r=0.362，p<0.001）和LA容积指数（r=0.371，p<0.001）之间存在正相关。在多因素逻辑回归分析中，年龄、血浆纤连蛋白水平（比值比-OR：1.003，95%可信区间：1.001-1.005，p=0.026）和hs-CRP（OR：2.312，95%可信区间：1.503-6.459，p=0.017）被发现是LA结构重塑的预测因素；然而，只有血浆纤连蛋白水平（OR：1.003，95%可信区间：1.001-1.005，p=0.032）和hs-CRP（OR：3.212，95%可信区间：1.214-5.752，p=0.033）被发现是LA电重塑的预测因素。
我们的研究结果表明，促纤维化和促炎生物标志物与孤立性阵发性AF患者的左心房结构和电重塑相关。
