Blood biomarkers and atrial remodeling in patients at risk of atrial fibrillation.

Abstract

Introduction: Arterial hypertension and endurance training are related to left atrial (LA) remodeling and risk of atrial fibrillation (AF). Serum blood biomarkers have been explored in relation to cardiovascular risk. Our aim was to assess the influence of patient and echocardiographic characteristics on serum blood biomarkers in individuals at risk for AF.

Methods: A population of 511 subjects was analyzed: 286 endurance athletes and 225 patients with arterial hypertension. Participants underwent 2D and 3D echocardiography with speckle-tracking analysis. Blood samples were obtained to evaluate biomarkers of myocardial damage (Brain Natriuretic Peptide, troponin I, Oncostatin M, heart-type Fatty Acid-Binding Protein and Placenta Growth Factor), vascular endothelial dysfunction (Endothelial cell-specific molecule 1), and fibrosis (Matrix Metalloproteinase 1, 2 and 9, C-X-C motif chemokine ligand 6 and 16, and Galectin-3 (Gal-3)). Linear regression models were fitted to discern the relationship of patient and echo characteristics and serum biomarker levels.

Results: The results revealed the significant influence of age, gender, body mass index and renal function on biomarker levels. Parameters of myocardial damage showed a limited range of values in our cohort with no differences between groups. Biomarkers of fibrosis were uniformly elevated in hypertension, with Gal-3 levels independently associated with LA reservoir strain.

Conclusion: Serum levels of fibrosis biomarkers differ between populations at risk for AF. In hypertension Gal-3 levels are associated with LA reservoir function, making it a potential biomarker for LA remodeling in this setting. Clinical follow-up is needed to relate these findings with clinical outcomes.