Biomarkers of fibrosis and inflammation and the risk of arrhythmia recurrence after elective electrical cardioversion in patients with atrial fibrillation and metabolic syndrome

Abstract

Aim. To evaluate the effect of blood concentrations of biomarkers of inflammation and fibrosis, obesity parameters, and parameters characterizing cardiac remodeling on the risk of recurrent atrial fibrillation (AF) within 6 months after elective electrical cardioversion (ECV) in patients with metabolic syndrome (MS).Materials and methods. The study included patients with AF and MS (n=60) and with AF without MS (n=41), who underwent elective ECV. Prospective observation was carried out for 6 months.Results. Arrhythmia recurrence within 6 months after ECV in patients with AF in combination with MS is higher than without MS (34/60 and 9/41, p = 0.003). Among echocardiographic parameters, left atrial volume and volume index, and epicardial adipose tissue thickness (EAT) are associated with arrhythmia resumption in patients with MS and AF. Blood concentrations of galectin-3 (17.4 (12.8-19.6) and 13.3 (5.1-14.9), p=0.0001), connective tissue growth factor (CTGF) (163, 1 (134.1-232.2) and 156.7 (104.7 - 189.1), p=0.002), growth differentiation factor 15 (GDF-15) (2343.9 (1206.1-3254.2 ) and 986.1 (812.5-1775.5), p=0.0001) and interleukin-6 (IL-6) (3.8 (2.3-7.3) and 2.3 (1, 3-3.4), p=0001) in patients with MS with recurrent arrhythmia is higher than without arrhythmia. According to the ROC analysis of EAT, the concentration of galectin-3 and IL-6 in the blood was most predictive of relapse of AF in MS; threshold values of the predictors were established: EAT more than 6.1 mm, IL-6 more than 2.8 pg/ml, galectin-3 more than 15.9 ng/ml.Conclusion. In patients with AF combined with MS, the frequency of maintaining sinus rhythm after effective ECV for 6 months is lower than in patients without MS. Epicardial adipose tissue thickness, high concentrations of galectin-3 and IL-6 are associated with relapse of AF in patients with MS.