title: Novel fibro-inflammation markers in assessing left atrial remodeling in non-valvular atrial fibrillation.
abstract: BACKGROUND
  Structural remodeling is associated with the fibroinflammatory process in the atrial extracellular matrix. In the present study we aimed to investigate whether serum levels of new circulating remodeling markers differ in patients with atrial fibrillation (AF) compared to patients with sinus rhythm.
  
  
  METHODS
  The study population included 52 patients diagnosed with non-valvular AF and 33 age-matched patients with sinus rhythm. Serum levels of Galectin-3, matrix metalloproteinase-9 (MMP-9), lipocalin-2 (Lcn2/NGAL), N-terminal propeptide of type III procollagen (PIIINP), Hs-Crp, and neutrophil-to-lymphocyte ratio (NLR) were measured. The left atrial volume (LAV) was calculated by echocardiographic method and LAV index was calculated.
  
  
  RESULTS
  Galectin-3, MMP-9, and PIIINP levels were significantly higher in AF patients except NGAL levels (1166 pg/ml (1126-1204) and 1204 pg/ml (1166-1362) p=0.001, 104 (81-179) pg/ml and 404 (162-564) pg/ml p<0.0001, and 1101 (500-1960) pg/ml and 6710 (2370-9950) pg/ml p<0.0001, respectively). The NLR and Hs-CRP levels were also higher in AF (2.1 ± 1.0 and 2.7 ± 1.1 p=0.02 and 4.2 ± 1.9 mg/L and 6.0 ± 4.7 mg/L p=0.04, respectively). In correlation analyses, NLR showed a strongly significant correlation with LAVi, but Hs-CRP did not (p=0.007 r=0.247, Pearson test and p=0.808 r=0.025, Pearson test, respectively). Moreover, Galectin-3, MMP-9, and PIIINP had a strong positive correlation with LAVi (p=0.021 r=640, Spearman test and p=0.004 r=0.319 Pearson test, and p=0.004 r=0.325 Pearson test, respectively).
  
  
  CONCLUSIONS
  Novel fibrosis and inflammation markers in AF are correlated with atrial remodeling. Several unexplained mechanisms of atrial remodeling remain, but the present study has taken the first step in elucidating the mechanisms involving fibrosis and inflammation markers.
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Sonmez
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
authors.forename: Furkan U
authors.initials: FU
authors.lastname: Ertem
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Vatankulu
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Erdogan
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Sıtkı
authors.initials: S
authors.lastname: Kucukbuzcu
authors.affiliation: Department of Cardiology, BezmiAlem Vakif University, Faculty of Medicine, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Goktekin
mesh_terms: D000209:Acute-Phase Proteins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D064752:Atrial Remodeling; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D004562:Electrocardiography; D005260:Female; D005355:Fibrosis; D006351:Heart Valves / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000473:pathology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011518:Proto-Oncogene Proteins / Q000097:blood; D014463:Ultrasonography
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D010446:Peptide Fragments; D011347:Procollagen; D011518:Proto-Oncogene Proteins; C041876:procollagen Type III-N-terminal peptide; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9