Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Abstract

Introduction: Recent studies have shown a significant association between left atrial (LA) global longitudinal strain (GLS) and the progression of atrial fibrillation (AF) with significantly decreased LA GLS in patients with paroxysmal AF. Significantly higher levels of serum galectin-3 have also been found in patients with non-valvular AF. This study aimed to examine the relationship of the early stage of atrial fibrosis and reduced atrial deformation with serum galectin-3 concentration in middle-aged patients with a first episode of non-valvular AF. Patients and Methods: This study prospectively enrolled 34 patients who were admitted to our emergency department and required either a medical or electrical cardioversion due to the first episode of AF, without any structural or coronary heart disease and with normal LA size. Additionally, 31 control subjects were also enrolled. The diameter, volume, and mechanical function of LA, including strain (S) and strain rate (SR), and serum galectin-3 levels were measured. Results: The average age was 48.5 ± 10.4 years. Galectin-3 values were not significantly different between the AF and control groups (r= 0.42; p= 0.51) and were found to correlate inversely with peak negative SR on apical four chamber (r= −0.31, p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the control group, the AF group had significantly lower values of peak systolic S on four chamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR on apical four-chamber view (p= 0.04), and peak late negative SR on apical four chamber (p= 0.03) and two-chamber (p= 0.02) views. Conclusion: Middle-aged patients with the first episode of AF and normal LA sizes had reduced LA reservoir and active atrial functions. Although beginning signs of LA functional remodeling were shown on S and SR imaging, these were not completely reflected by serum galectin-3 levels.