THE ROLE OF TRANSFORMING GROWTH FACTOR BETA-1 AND GALECTIN-3 IN FORMATION OF THE LEFT ATRIUM FIBROSIS IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION AND METABOLIC SYNDROME

Aim. To evaluate the prominence of fibrosis of the left atrium myocardium and to define the value of transforming growth factor beta 1 (TGF-beta1) and galectin-3 in development of myocardial fibrosis in atrial fibrillation (AF) patients with metabolic syndrome (MS).

Material and methods. Totally, 58 patients with AF included, of those 27 with MS. Controls were 50 almost healthy participants. Levels of galectin-3 and TGF-beta1 in blood serum were measured by immune enzyme assay. For fibrosis assessment, the anatomical and amplitude charts of the left atrium (LA) were built up with nonfluoroscopic system of electroanatomical charting CARTO3 (Biosense Webster, USA) and catheter measurement of the contact power with myocardium of LA  (Smart Touch Thermocool, Biosense Webster, USA). In “off-line” regimen the evaluation performed of the zones of low voltage in amplitude specters 0,2-0,5 mV and 0,2-1,0 mV with the area measurement by navigation software function “area measurement”.

Results. Volume of LA and volume index of LA in AF with MS were higher than in AF with no MS: 78,0±20,4 mL and 60,4±19,8 mL (p=0,005) and 37,8±9,5 mL/m² and 30,4±9,0 mL/m² (p=0,005), respectively. The percent of LA fibrosis area in AF with MS was higher than in AF with no MS (16,1 [12,8;20,5]% and 10,5 [7,3;16,2]%, respectively, p=0,028). The positive correlations revealed of the level of galectin-3 (r=0,410, р<0,001) and TGF-beta1 (r=0,594, р<0,001) in blood serum with the percentage of LA fibrosis in AF patients. By the linear regression, the influence found of galectin-3 levels (β=0,549, p<0,001) and of TGF-beta1 (β=0,297, p=0,025) on the area of LA fibrosis in AF patients.

Conclusion. The area of fibrosis in the LA myocardium in AF patients with MS is larger than in AF no MS patients. Myocardial fibrosis markers evaluation (galectin-3, TGF-beta1) in blood serum may have diagnostic significance in prediction of AF fibrosis severity in AF patients.

galectin-3, transforming growth factor beta-1, myocardial fibrosis, amplitude map, metabolic syndrome, atrial fibrillation

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