血浆半乳糖凝集素-3与房颤左心耳重塑和血栓形成的关系

Relationship between plasma galectin⁃3 and left atrial appendage remodeling and thrombosis in patients with atrial fibrillation

目的 探讨血浆半乳糖凝集素-3水平(Gal-3)与房颤(AF)患者左心耳(LAA)重塑和血栓形成的关系。方法 本研究入选了2015年1月—2017年2月期间住院的153名非瓣膜性房颤患者,其中阵发性房颤58例,持续性房颤55例,永久性房颤40例。通过食道超声评估LAA的形态和收缩功能,同时应用酶联免疫吸附法测定患者血浆Gal-3水平。结果 经食道超声检查共发现22例LAA血栓形成,其中阵发性房颤组2例、持续性房颤组11例、永久性房颤组9例。不同类型房颤患者之间,LAA形态和收缩功能存在显著性差异。血浆Gal-3水平在不同类型房颤中也存在明显的差异,持续性或永久性房颤患者的Gal-3水平显著高于阵发性房颤(P<0.01)。Gal-3水平升高与LAA容积增加、 LA射血分数降低、 LAA峰值血流速度降低、 LAA血栓形成密切相关。多变量Logistic回归分析提示Gal-3是房颤患者LAA血栓形成的独立预测因素之一。结论 房颤患者血浆Gal-3水平升高与LAA重塑密切相关,Gal-3水平升高可能是LAA血栓形成的独立预测因子之一。

Objective To explore the relationship between plasma galectin⁃3(Gal⁃3)and left atrial appendage(LAA)remodeling and thrombosis in patients with atrial fibrillation(AF).Methods 153 patients with nonvalvular AF who were hos⁃pitalized from January 2015 to February 2017 were enrolled,including 58 ones with paroxysmal AF,55 ones with persistent AF,and 40 ones with permanent AF.Morphology and systolic function of LAA were evaluated by transesophageal echocardio⁃graphy and plasma Gal⁃3 level was measured by enzyme⁃linked immunosorbent assay.Results A total of 22 cases with LAA thrombosis were found by transesophageal echocardiography,including 2 ones in the paroxysmal AF group,11 ones in the per⁃sistent AF group,and 9 ones in the permanent AF group.There were significant differences in the morphology and systolic function of LAA among patients with different types of AF.There were also significant differences in plasma Gal⁃3 level among patients with different types of AF.The plasma Gal⁃3 level in patients with persistent or permanent AF was significantly higher than that in patients with paroxysmal AF(P<0.01).The increase of plasma Gal⁃3 level was closely related to the increase of LAA volume,decrease of LAA ejection fraction,decrease of LAA peak flow velocity,and LAA thrombosis.Multivariate Lo⁃gistic regression analysis suggested that plasma Gal⁃3 was an independent predictor of LAA thrombosis in patients with AF.Conclusion Elevated plasma Gal⁃3 level in patients with AF is closely related to LAA remodeling,and it may be an independ⁃ent predictor of LAA thrombosis.