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Serum YKL‐40 as a Marker of Left Atrial Fibrosis Assessed by Delayed Enhancement MRI in Lone Atrial Fibrillation
Author(s) -
CANPOLAT UĞUR,
AYTEMİR KUDRET,
HAZIROLAN TUNCAY,
ÖZER NECLA,
OTO ALI
Publication year - 2015
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12729
Subject(s) - medicine , fibrosis , atrial fibrillation , cardiology , magnetic resonance imaging , odds ratio , myocardial fibrosis , ejection fraction , inflammation , gastroenterology , heart failure , radiology
Background Assessment of the left atrial (LA) fibrosis by using delayed‐enhanced magnetic resonance imaging (DE‐MRI) in atrial fibrillation (AF) patients is a pioneering noninvasive method. Serum YKL‐40 is a novel marker for inflammation and known to play a role in ongoing tissue fibrosis. However, its role in LA fibrosis is unclear. We aimed to investigate the association of serum YKL‐40 with the presence and extent of LA fibrosis. Methods A total of 50 patients with lone paroxysmal AF (62% male; age: 47.2 ± 7.0 years) underwent cardiac DE‐MRI according to study protocol. Cardiac DE‐MRI at 1.5 Tesla scanner was used to quantify LA fibrosis. Serum YKL‐40 levels and clinical and echocardiographic data were recorded in all participants. Results DE‐MRI revealed any degree of LA fibrosis in 31 (62%) patients. Median serum YKL‐40 was significantly higher (P = 0.008) and left venticular ejection fraction was lower (P = 0.047) in patients with LA fibrosis as compared to patients without LA fibrosis. Extent of LA fibrosis was significantly correlated with age, duration of AF history, serum C‐reactive protein, and serum YKL‐40 levels. Only log (YKL‐40) level was found as independent predictor for the presence of LA fibrosis (odds ratio: 1.626, P = 0.022). Multivariate linear regression analysis pointed out that duration of AF history (β = 0.330, P = 0.003) and serum log (YKL‐40) levels (β = 0.546, P < 0.001) were significantly and independently associated with the extent of LA fibrosis. Conclusion Higher levels of serum YKL‐40 are associated with the presence and more extensive LA fibrosis in patients with lone AF. As a marker of inflammation, serum YKL‐40 may also be used as an indicator for the degree of LA fibrosis.