Connection between сardiac fibrosis biomarkers and echocardiography parameters in patients with various forms of atrial fibrillation

Abstract

Introduction. Myocardial fibrosis is often found in atrial fibrillation (AF), but there are no data on its relationship with structural and functional heart damage in various forms of the latter.Aim. To determine the possible relationship between echocardiographic parameters and blood levels of cardiac fibrosis markers (C-terminal propeptide of procollagen type 1, PICP; N-terminal propeptide of procollagen type 1, P3NP; galectin 3; transforming growth factor beta 1, TGF-β1) in patients with different forms of AF.Materials and methods. The study included 50 patients with paroxysmal AF (median age 73 [65.8;76] years, 34 (68%) women) and 34 patients with persistent/permanent forms of AF (median age 77.5 [67.5;81.3] years, 21 (62%) women). Transthoracic echocardiography was performed in all patients using the speckle tracking technique and serum levels of PICP, P3NP, galectin 3 and TGF-β1 were determined.Results. Serum P3NP correlate with E/e’ media (p=0.048, R2 = 0.117) in patients with persistent/permanent forms of AF. PICP level correlated with the average strain of the left atrium (LA) in patients with persistent/permanent forms of AF (p = 0.01, R2 = 0.189). The blood level of galectin 3 correlated with E/e’ media in the general cohort of patients with AF and in the group of patients with persistent/permanent forms of AF (p = 0.005, R2 = 0.095 and p = 0.027, R2 = 0.144, respectively), and with global longitudinal strain of the left ventricle (LV) – in the group of patients with paroxysmal AF (p = 0.044, R2 = 0.084). The serum TGF-β1 correlated with E/e’ media (p = 0.013, R2 = 0.074) in the general cohort of patients with AF and with values of the global longitudinal LV strain (p = 0.027, R2 = 0.099) in the group of patients with paroxysmal AF.Conclusions. Serum levels of PICP, P3NP, galectin-3 and TGF-β1 correlate with the values of E/e’ media, global longitudinal LV strain and average LA strain. An integrated approach, including standard echocardiography, Speckle Tracking echocardiography, and determination of the level of fibrosis biomarkers in the blood can help to more accurately assess the degree of cardiac fibrosis in a noninvasive way in patients with various forms of AF.