Clementy Nicolas, Benhenda Nazih, Piver Eric, Pierre Bertrand, Bernard Anne, Fauchier Laurent, Pages Jean-Christophe, Babuty Dominique
Cardiology Department, Trousseau Hospital, François Rabelais University, Tours, France.
Biochemistry Department, Trousseau Hospital, François Rabelais University, Tours, France.
Sci Rep. 2016 Sep 28;6:34357. doi: 10.1038/srep34357.
Galectin-3 is a biomarker of fibrosis and atrial remodeling, involved in the mechanisms of initiation and maintenance of atrial fibrillation (AF). We sought to study the accuracy of galectin-3 level in predicting recurrences of AF after ablation. Serum concentrations of galectin-3 were determined in a consecutive series of patients addressed for AF ablation in our center. After a 3-month blanking period, recurrences of atrial arrhythmias were collected during the first year in all patients, using Holter monitoring at 3, 6 months and 12 months. A total of 160 patients were included, with a mean galectin-3 rate was 14.4 ± 5.6 ng/mL. At 12-month, 55 patients (34%) had reexperienced sustained atrial arrhythmia. Only higher galectin-3 level (HR = 1.07 [1.01-1.12], p = 0.02) and larger left atrial diameter (HR = 1.07 [1.03-1.12], p = 0.001) independently predicted recurrence. Patients with both galectin-3 level <15 ng/mL and left atrial diameter <40 millimeters had a 1-year arrhythmia-free survival rate - after a single procedure without anti-arrhythmic drug - of 91%, as compared with 41% in patients with galectin-3 ≥ 15 and left trial diameter ≥40 (p < 0.0001), whether AF was paroxysmal or persistent. Galectin-3 and left atrial diameters, rather than clinical presentation of AF, predict recurrences after ablation.
半乳凝素-3是纤维化和心房重构的生物标志物，参与心房颤动（AF）的起始和维持机制。我们旨在研究半乳凝素-3水平预测消融术后AF复发的准确性。在我们中心，对一系列连续接受AF消融治疗的患者测定血清半乳凝素-3浓度。经过3个月的空白期后，在所有患者的第一年期间，于3、6和12个月使用动态心电图监测收集房性心律失常的复发情况。共纳入160例患者，平均半乳凝素-3水平为14.4±5.6 ng/mL。在12个月时，55例患者（34%）再次出现持续性房性心律失常。只有较高的半乳凝素-3水平（HR = 1.07 [1.01 - 1.12]，p = 0.02）和较大的左心房直径（HR = 1.07 [1.03 - 1.12]，p = 0.001）可独立预测复发。半乳凝素-3水平<15 ng/mL且左心房直径<40毫米的患者，在单次手术且未使用抗心律失常药物的情况下，1年无心律失常生存率为91%，而半乳凝素-3≥15且左心房直径≥40的患者为41%（p < 0.0001），无论AF是阵发性还是持续性。半乳凝素-3和左心房直径而非AF的临床表现可预测消融术后的复发情况。
