title: Fibroblast growth factor-21 is positively associated with atrial fibrosis in atrial fibrillation patients with rheumatic heart disease.
abstract: OBJECTIVE
  Fibroblast growth factor-21 (FGF-21) has been discovered as a strong hormone, plays an important role in lipid metabolism, glucose metabolism, associated with several diseases such as obesity, metabolic syndrome, diabetes mellitus, and cardiovascular events; however, no evidence is available concerning the relationship of FGF-21 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD).
  
  
  METHODS
  Twenty-four rheumatic heart disease patients were divided into two groups, 12 cases with AF and 12 cases with sinus rhythm (SR). Clinical characteristics and blood samples were collected before surgery; right atrial appendage samples were taken in the surgery of valve replacement. HE staining was performed to determine cross-sectional area of atrial myocytes; Masson stained sections and mRNA levels of cardiac fibrosis biomarkers were used to evaluate the degree of cardiac fibrosis; the level of FGF-21 was evaluated via enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, and real-time polymerase chain reaction (PCR).
  
  
  RESULTS
  Compared with SR group, cross-sectional area of atrial myocytes and collagen volume fraction were significantly increased in the atrial tissue of AF group. The distribution of FGF-21 in the AF group was remarkably higher than SR group. In addition, plasma and mRNA levels of FGF-21 in atrial tissue of AF showed the same trend as the result of immunohistochemistry. Using linear correlation analysis, the expression level of FGF-21 was found to be positively related to the degree of atrial fibrosis.
  
  
  CONCLUSIONS
  FGF-21 might involve in the development and maintenance of atrial fibrosis in atrial fibrillation with rheumatic heart disease, and FGF-21 could be used as a novel biomarker to evaluate myocardial fibrosis in the future.
authors.affiliation: Department of Emergency, Renmin Hospital of Wuhan University Wuhan 430060, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan UniversityWuhan 430060, China; Cardiovascular Research Institute, Wuhan UniversityWuhan 430060, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yi
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan UniversityWuhan 430060, China; Cardiovascular Research Institute, Wuhan UniversityWuhan 430060, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan UniversityWuhan 430060, China; Cardiovascular Research Institute, Wuhan UniversityWuhan 430060, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005346:Fibroblast Growth Factors / Q000032:analysis / Q000378:metabolism*; D005355:Fibrosis / Q000209:etiology; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000473:pathology*
chemical_list: D015415:Biomarkers; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors
keywords: Fibroblast growth factor-21; atrial fibrillation; atrial fibrosis; rheumatic heart disease
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