Latent Transforming Growth Factor Beta Binding Protein 4 as a Biomarker of Arrhythmia-Induced Cardiomyopathy in Atrial Fibrillation: Insights from a High-Throughput Proteomic Analysis

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  Figure 1. Proteomic identification and validation of biomarkers distinguishing AIC from non-AIC. (A) Baseline characteristics of the discovery and validation cohorts. (B, C) Plasma levels of LTBP4 and CHST15 in the discovery CHF cohort. Both proteins were significantly elevated in AF patients with reduced LVEF compared with those with preserved LVEF. (D, E) Validation in the RFCA cohort. Plasma LTBP4 levels were significantly higher in patients diagnosed with AIC (n = 10) than in those with non-AIC (n = 6), whereas CHST15 showed a non-significant trend towards elevation. (F) ROC curve for LTBP4 discriminating AIC from non-AIC in the validation cohort. The area under the curve (AUC) was 0.767 (95% CI 0.470–1.000). Protein levels are expressed as log10-transformed relative fluorescence units (RFU). P values were calculated using logistic regression in the discovery cohort and the Wilcoxon rank-sum test in the validation cohort. Abbreviations: AF, atrial fibrillation; AIC, arrhythmia-induced cardiomyopathy; CHST15, carbohydrate sulfotransferase 15; LTBP4, latent transforming growth factor-β binding protein 4; LVEF, left ventricular ejection fraction; ROC, receiver operating characteristic.