A Case-Control Study assessing Serum Galectin 3 level in Atrial Fibrillation Patients

Abstract

As a worldwide issue of concern, atrial fibrillation (AF) casts a huge burden on the health care system. Not only being an arrhythmia of high frequency and prevalence, but also due to the chronicity of some its types. It is imperative to increase the understanding of the pathophysiological basis behind atrial fibrillation or at least the processes that sub serves as a prerequisite for its development. Cardiac remodeling and fibrotic changes may derange the conductive properties of the myocardium and hence import an arrhythmogenic conditioning state. Galectin-3 (Gal-3) has a wide spectrum of biological activities. It can be utilized as a tool for screening many cardiac conditions especially those associated with fibrotic states. Aim of study: this study was designated to explore the association between atrial fibrillation and serum galectin-3 levels. It was of a case-control type that comprised a cohort of 58 patients with atrial fibrillation, together with 30 controls without it. Patients were categorized into two categories depending upon whether they have a persistent or permanent atrial fibrillation. Serum galectin-3 was measured using ELISA technique, and the results were compared among the three groups. Results: The Gal-3 was found to be higher in patients with permanent AF (p < .0001) where it recorded 19.27 ± 4.58 ng/ml. The rise in the marker concentration was statistically significant when compared to the 13.54 ± 4.9 ng/ml and 12.14 ± 4.69 ng/ml for the persistent AF and control groups, respectively. Likewise, patients with permanent AF had significantly higher values of left atrial diameter (LAD) (p < .0001) with a mean of 4.68 ± 0.37 cm, 4.09 ± 0.3, and 3.54 ± 0.32, for the permanent AF, persistent AF, and the control groups, respectively. Additionally, the LAD revealed a slight positive correlation with the Gal-3 level, r (56) = 0.386, p < 0.003, with an r2 of 0.149. On the other hand, there was a significant reduction in the left ventricular ejection fraction (LVEF %) in patients with permanent AF, p < 0.0001. The LVEF% was 53.27 ± 7.35 %, versus 62.13 ± 6.75 %, and 63.39 ± 5.77% for permanent AF, persistent AF, and control groups, respectively. In conclusion, serum Gal-3 is elevated in conditions of both, long-standing AF as well as newly diagnosed AF. The marker correlated positively with the LAD and negatively with LVEF%. Furthermore, LVEF% revealed a moderate negative correlation with serum Gal-3 concentrations. The study concluded that as the left atrium increases in size, this will impose a deleterious effect on the left ventricle and will be reflected as an increasing level of the marker. Hence, Gal-3 can be used as a tool for evaluating fibrotic changes in patients with AF especially the chronic types.