循环半乳糖凝集素-3和醛固酮预测射频导管消融后房颤复发

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics Pub Date : 2022-05-23 DOI:10.1155/2022/6993904

Z. Ruan, Run-feng Gao, Fei Wang, Gecai Chen, Jun-Guo Zhu, Yin Ren, Li Zhu

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The recurrence group had significantly higher preoperative serum levels of Gal-3 and ALD than the nonrecurrence group. Univariate and multivariate analysis showed that Gal-3 (HR = 1.28, 95% CI: 1.04-1.56, p = 0.02) and ALD (OR = 1.02, 95% CI: 1.00-1.03, p < 0.03) were significantly associated with AF recurrence after RFCA. The area under the curve (AUC) of preoperative serum Gal-3, ALD, and 2 combined to predict the recurrence of AF patients after RFCA was 0.636, 0.798, and 0.893, respectively, while sensitivity was 65.32%, 71.69%, and 88.61%, respectively and specificity was 77.46%, 78.53%, and 86.0%, respectively. Patients with Gal-3 above the cutoff value of 14.57 pg/ml had higher frequent AF recurrence than the patients with Gal − 3 ≤ 14.57 pg/ml (35% vs. 12%, p < 0.001) during a follow-up. Meanwhile, patients with ALD above the cutoff value of 243.61 pg/ml also had a higher AF recurrence rate than those with ALD ≤ 243.61 pg/ml (37% vs. 11%, p < 0.001) during a follow-up. The recurrence rate in patients with Gal − 3 > 14.57 pg/ml + ALD > 243.61 pg/ml was higher than that in patients with baseline Gal − 3 > 14.57 pg/ml or ALD > 243.61 pg/ml and patients with Gal − 3 ≤ 14.57 pg/ml + ALD ≤ 243.61 pg/ml (57% vs. 14% vs. 9%, p < 0.01, respectively). 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引用次数: 7

摘要

循环半乳糖凝集素-3 (Gal-3)和醛固酮(ALD)参与了纤维化和炎症。然而，它们作为射频导管消融(RFCA)后房颤(AF)复发预测因子的潜在价值尚不清楚或存在争议。因此，本研究的目的是评估基线Gal-3、ALD水平和行RFCA患者房颤复发之间的关系。方法对153例连续行RFCA的患者进行回顾性分析。在基线时测量Gal-3和ALD。进行单因素和多因素Cox回归来确定房颤复发的预测因素。采用受试者工作特征(ROC)曲线和Kaplan-Meier (K-M)曲线评估预测因子的价值。结果术后房颤复发35例(22.88%)。复发组术前血清Gal-3和ALD水平明显高于未复发组。单因素和多因素分析显示，Gal-3 (HR = 1.28, 95% CI: 1.04-1.56, p = 0.02)和ALD (OR = 1.02, 95% CI: 1.00-1.03, p < 0.03)与RFCA术后AF复发显著相关。术前血清Gal-3、ALD、2联合预测AF术后复发的曲线下面积(AUC)分别为0.636、0.798、0.893，敏感性分别为65.32%、71.69%、88.61%，特异性分别为77.46%、78.53%、86.0%。在随访期间，Gal-3高于临界值14.57 pg/ml的患者比Gal-3≤14.57 pg/ml的患者有更高的AF复发率(35% vs 12%， p < 0.001)。同时，在随访期间，ALD高于临界值243.61 pg/ml的患者的房颤复发率也高于ALD≤243.61 pg/ml的患者(37% vs. 11%， p < 0.001)。Gal - 3 > 14.57 pg/ml + ALD > 243.61 pg/ml患者的复发率高于基线Gal - 3 > 14.57 pg/ml或ALD > 243.61 pg/ml患者和Gal - 3≤14.57 pg/ml + ALD≤243.61 pg/ml患者(57%比14%比9%，p < 0.01)。结论RFCA术后AF复发有较高的基线Gal-3和ALD水平，术前较高的循环Gal-3和ALD水平是RFCA术后AF复发的独立预测因素，而术前Gal-3和ALD水平联合预测AF复发的准确性更高。

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Circulating Galectin-3 and Aldosterone for Predicting Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Background Circulating galectin-3 (Gal-3) and aldosterone (ALD) are involved in fibrosis and inflammation. However, their potential value as predictors of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) is unknown or controversial. Therefore, the aim of this study was to assess the relationship between baseline Gal-3, ALD levels, and AF recurrence in patients performing RFCA. Methods 153 consecutive patients undergoing RFCA were included. Gal-3 and ALD were measured at baseline. Univariate and multivariate Cox regressions were performed to determine the predictors of AF recurrence. Receiver operating characteristic (ROC) curve and Kaplan-Meier (K-M) curve were used to assess the value of predictors. Results There were 35 (22.88%) cases of AF recurrence after RFCA. The recurrence group had significantly higher preoperative serum levels of Gal-3 and ALD than the nonrecurrence group. Univariate and multivariate analysis showed that Gal-3 (HR = 1.28, 95% CI: 1.04-1.56, p = 0.02) and ALD (OR = 1.02, 95% CI: 1.00-1.03, p < 0.03) were significantly associated with AF recurrence after RFCA. The area under the curve (AUC) of preoperative serum Gal-3, ALD, and 2 combined to predict the recurrence of AF patients after RFCA was 0.636, 0.798, and 0.893, respectively, while sensitivity was 65.32%, 71.69%, and 88.61%, respectively and specificity was 77.46%, 78.53%, and 86.0%, respectively. Patients with Gal-3 above the cutoff value of 14.57 pg/ml had higher frequent AF recurrence than the patients with Gal − 3 ≤ 14.57 pg/ml (35% vs. 12%, p < 0.001) during a follow-up. Meanwhile, patients with ALD above the cutoff value of 243.61 pg/ml also had a higher AF recurrence rate than those with ALD ≤ 243.61 pg/ml (37% vs. 11%, p < 0.001) during a follow-up. The recurrence rate in patients with Gal − 3 > 14.57 pg/ml + ALD > 243.61 pg/ml was higher than that in patients with baseline Gal − 3 > 14.57 pg/ml or ALD > 243.61 pg/ml and patients with Gal − 3 ≤ 14.57 pg/ml + ALD ≤ 243.61 pg/ml (57% vs. 14% vs. 9%, p < 0.01, respectively). Conclusion AF recurrence after RFCA had higher baseline Gal-3 and ALD levels, and higher preoperative circulating Gal-3 and ALD levels were independent predictors of AF recurrence for patients undergoing RFCA, while combination of preoperative Gal-3 and ALD levels has higher prediction accuracy.

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来源期刊

Cardiovascular Therapeutics 医学-心血管系统

CiteScore

5.60

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.