Key result
Baseline levels of CA-125, Caspase-3, Cathepsin L, and Galectin-3 were not associated with atrial fibrillation recurrence after pulmonary vein isolation in patients with a structurally normal heart.
Why the study?
AF is accompanied by variable inflammation and fibrosis, but the associations of fibrosis biomarker concentrations with long-term PVI success in patients with a structurally normal heart remained to be assessed.
Are baseline and 3-year post-ablation levels of fibrosis biomarkers (CA-125, Caspase-3, Galectin-3, Cathepsin L) associated with atrial fibrillation recurrence after pulmonary vein isolation in patients with a structurally normal heart?
Cohort (n=63)
No
Are baseline and 3-year post-ablation levels of fibrosis biomarkers (CA-125, Caspase-3, Galectin-3, Cathepsin L) associated with atrial fibrillation recurrence after pulmonary vein isolation in patients with a structurally normal heart?
Fibrosis biomarkers (CA-125, Caspase-3, Cathepsin L, and Galectin-3) do not predict atrial fibrillation recurrence after pulmonary vein isolation in patients with structurally normal hearts, although most decrease significantly over a 3-year follow-up.
Baseline fibrosis biomarkers do not aid AF recurrence prediction after PVI in structurally normal hearts; leaves open their role in broader populations or serial monitoring.
Background: Atrial fibrillation (AF) is accompanied by inflammation and fibrosis to variable extent. The biomarkers of fibrosis were measured in patients with different forms of AF and cardiac status. Herein, we assessed the associations of the baseline concentrations of different biomarkers with the long-term success of pulmonary vein isolation (PVI) in patients with a structurally normal heart. Furthermore, we compared biomarker levels before and 3 years after ablation to gain further insights into the AF mechanism. Methods: Patients, undergoing PVI for paroxysmal/persistent AF were enrolled prospectively. Blood samples were obtained 24 hours before and 3 years after ablation. Serum cancer antigen 125 (CA-125), plasma Caspase-3, Galectin-3 and Cathepsin L concentrations were measured. Follow-up visits every 6 months included 12-lead electrocardiogram, 24-hour Holter, trans-telephonic monitoring as well as transthoracic echocardiography after ablation. Biomarker levels, left ventricular ejection fraction and left atrial (LA) diameters at baseline and at the 3-year follow-up were compared in patients with versus without AF recurrence. Results: A total of 63 patients were enrolled (23 women; age 61.4 (± 8.8) years). The acute isolation of all pulmonary veins was achieved in all patients. During a mean follow-up of 36.3 ± 6.3 months, AF recurrence was demonstrated in 26 (41.3%) patients. No significant differences were demonstrated in the levels of CA-125, Galectin-3, Caspase-3 and Cathepsin L pre- and post-ablation in patients with versus without AF recurrence. A significant decrease was detected in the concentrations of Caspase-3, Galectin-3 and Cathepsin L during follow-up with no difference in patients with versus without AF recurrence. A positive correlation was found between Caspase-3 levels and LA diameters in the AF recurrence group both before (r = 0.477; p = 0.018) and after the procedure (r = 0.533; p = 0.019). Conclusions: Our results demonstrated that the levels of CA-125, Caspase-3, Cathepsin L and Galectin-3 are not associated with AF recurrence after PVI in patients with a structurally normal heart and mainly paroxysmal AF. Except for CA-125, all the other biomarkers demonstrated a significant decrease during a 3-year follow-up post-ablation. Furthermore, Caspase-3 levels demonstrated a positive correlation with LA dimensions in patients with AF recurrence.
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Szuromi et al. (2023) conducted a cohort in Paroxysmal and Persistent Atrial Fibrillation (n=63). Pulmonary vein isolation was evaluated on Association of baseline biomarker levels (CA-125, Galectin-3, Caspase-3, Cathepsin L) with AF recurrence. Baseline levels of CA-125, Caspase-3, Cathepsin L, and Galectin-3 were not associated with atrial fibrillation recurrence after pulmonary vein isolation in patients with a structurally normal heart.
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