用CHA2DS2-VASc评分评估半凝集素-3作为非瓣膜性房颤患者血栓栓塞风险的预测因子

F. Moustafa, M. Abdel-Fadeil, Salah Atta, Azza S Abdelhaffez
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摘要

背景:循环重构标志物如半凝集素-3 (Gal-3)在房颤(AF)患者中明显升高。然而,关于房颤患者Gal-3水平与卒中风险的已发表文献仍然很少。本研究的目的是根据现行标准评分系统(CHA2DS2-VASc)以及其他超声心动图和实验室参数,评价阵发性或持续性非瓣膜性房颤患者血清Gal-3水平与预测血栓栓塞危险因素的相关性。方法:采用横断研究方法,根据CHA2DS2-VASc评分分为低危(70例)、中度(50例)和高危(40例)三组。采用酶联免疫吸附试验(ELISA)检测血清Gal-3浓度。此外,估计所有患者的活化部分凝血活素时间(aPTT)。超声心动图评价两组患者的瓣膜功能、左室射血分数和左房容积指数。结果:高危患者Gal-3水平明显高于中、低危患者,aPTT持续时间明显低于中、低危患者,LAVI值明显高于中、低危患者。CHA2DS2-VASc评分与血清Gal-3水平、LAVI呈显著正相关。同样,CHA2DS2-VASc评分与aPTT呈显著负相关。所有年龄组女性患者的Gal-3水平均明显高于男性患者。结论:血清Gal-3水平可能是房颤患者血栓栓塞并发症的一个预测指标,具有潜在的临床效益。
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Galectin-3 as a predictor for thromboembolic risk in patients with non-valvular atrial fibrillation assessed by CHA2DS2-VASc scoring
Background: Circulating remodeling markers such as Galectin-3 (Gal-3) are significantly higher in atrial fibrillation (AF) patients. Nevertheless, there is still scarcity in the published literature regarding Gal-3 levels and risk of stroke in AF patients. The aim of this study was to evaluate the correlation of Gal-3 blood levels with the predicted thromboembolic risk factors according to the current standard scoring system (CHA2DS2-VASc) as well as some other echocardiographic and laboratory parameters, among patients with paroxysmal or persistent non-valvular AF. Methods: Three groups were enrolled in this cross-sectional study: low (70 patients), moderate (50 patients) and high risk (40 patients) categorized according to CHA2DS2-VASc score. Serum concentrations of Gal-3 were detected by an enzyme-linked immunosorbent assay (ELISA). In addition, activated partial thromboplastin time (aPTT) was estimated in all patients. Echocardiography was carried out to evaluate valvular functions and left ventricular ejection fraction and left atrial volume index (LAVI). Results: Patients with high risk had significantly higher Gal-3 level, lower aPTT duration and higher LAVI values than moderate and low risk. There were statistically significant positive correlations between CHA2DS2-VASc score and serum Gal-3 level and LAVI. Similarly, there was statistically significant negative correlation between CHA2DS2-VASc score and aPTT. Female patients at all age groups had significantly higher Gal-3 levels than male patients. Conclusion: Serum Gal-3 level might be a predictor for thromboembolic complication in AF patients with potential clinical benefit.
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