medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-167medsovet-8282Research ArticleАРИТМИИARRHUTHMIASСвязь между биомаркерами фиброза и эхокардиографическими параметрами у пациентов с различными формами фибрилляции предсердийConnection between сardiac fibrosis biomarkers and echocardiography parameters in patients with various forms of atrial fibrillationhttps://orcid.org/0000-0001-5801-3742КочетковА. И.KochetkovA. I.

Кочетков Алексей Иванович, к.м.н., доцент, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Aleksey I. Kochetkov, Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

ak_info@list.ruhttps://orcid.org/0000-0002-7745-3628ОрловаИ. Ю.OrlovaI. Yu.

Орлова Ирина Юрьевна, старший лаборант кафедры терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; врач-кардиолог первого кардиологического отделения, Городская клиническая больница имени Е.О. Мухина

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

111399, Москва, Федеративный проспект, д. 17

Irina Yu. Orlova, Senior Laboratory Assistant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Cardiologist at the 1st ardiological Department, Mukhin Municipal Clinical Hospital

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

17, Federativny Ave., Moscow, 111399

irina-orlova88@list.ruhttps://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна, д.м.н., профессор, заведующий кафедрой терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University)

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ostroumova.olga@mail.ruhttps://orcid.org/0000-0002-0229-5055ЛопухинаМ. В.LopukhinaM. V.

Лопухина Мария Вадимовна, к.м.н., заведующий отделением функциональной диагностики

111399, Москва, Федеративный проспект, д. 17

Mariya V. Lopukhina, Cand. Sci. (Med.), Head at the Department of Functional Diagnostics

17, Federativny Ave., Moscow, 111399

ofd70@mail.ruhttps://orcid.org/0000-0001-9262-9233СтародубоваА. В.StarodubovaA. V.

Стародубова Антонина Владимировна, д.м.н., заведующий отделением сердечно-сосудистой патологии, заместитель директора по научной и лечебной работе, Федеральный исследовательский центр питания и биотехнологии; заведующий кафедрой факультетской терапии лечебного факультета, Российский национальный исследовательский медицинский университет имени Н.И. Пирогова

115446, Москва, Каширское шоссе, д. 21,

117997, Москва, ул. Островитянова, д. 1

Antonina V. Starodubova, Dr. Sci. (Med.), Deputy Director for Scientific and Medical Work, Federal Research Centre of Nutrition and Biotechnology; Professor, Pirogov Russian National Research Medical University

21, Kashirskoye Shosse, Moscow, 115446,

1, Ostrovityanov St., Moscow, 117997

lechebnoedelo@yandex.ruhttps://orcid.org/0000-0002-3684-9992КоротковаТ. Н.KorotkovaT. N.

Короткова Татьяна Николаевна, к.м.н., заведующий лабораторией биохимии, иммунологии и аллергологии

115446, Москва, Каширское шоссе, д. 21

Tatiana N. Korotkova, Cand. Sci. (Med.), Head of the Laboratory

21, Kashirskoye Shosse, Moscow, 115446

korotkova.gkb64@mai.ruhttps://orcid.org/0000-0003-2529-9152ВорожкоИ. В.VorozhkoI. V.

Ворожко Илья Викторович, к.м.н., старший научный сотрудник лаборатории биохимии, иммунологии и аллергологии

115446, Москва, Каширское шоссе, д. 21

Ilya V. Vorozhko, Cand. Sci. (Med.), Senior Research fellow of the Laboratory

21, Kashirskoye Shosse, Moscow, 115446

bio455@inbox.ruhttps://orcid.org/0009-0008-4854-5858ЛандаА. В.LandaA. V.

Ланда Анатолий Владимирович, ординатор первого года обучения кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Anatoly V. Landa, Resident of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

a_landa@mail.ruhttps://orcid.org/0009-0005-4463-8844АндриановА. И.AndrianovA. I.

Андрианов Александр Игоревич, ординатор 2-го года обучения кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Aleksandr I. Andrianov, Resident of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

Российская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationРоссийская медицинская академия непрерывного профессионального образования; Городская клиническая больница имени Е.О. МухинаРоссияRussian Medical Academy of Continuous Professional Education; Mukhin Municipal Clinical HospitalRussian FederationРоссийская медицинская академия непрерывного профессионального образования; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияRussian Medical Academy of Continuous Professional Education; Sechenov First Moscow State Medical University (Sechenov University)Russian FederationГородская клиническая больница имени Е.О. МухинаРоссияMukhin Municipal Clinical HospitalRussian FederationФедеральный исследовательский центр питания и биотехнологии; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияFederal Research Centre of Nutrition and Biotechnology; Pirogov Russian National Research Medical UniversityRussian FederationФедеральный исследовательский центр питания и биотехнологииРоссияFederal Research Centre of Nutrition and BiotechnologyRussian Federation20241905202406170179Copyright © Кочетков А.И., Орлова И.Ю., Остроумова О.Д., Лопухина М.В., Стародубова А.В., Короткова Т.Н., Ворожко И.В., Ланда А.В., Андрианов А.И., 20242024Кочетков А.И., Орлова И.Ю., Остроумова О.Д., Лопухина М.В., Стародубова А.В., Короткова Т.Н., Ворожко И.В., Ланда А.В., Андрианов А.И.Kochetkov A.I., Orlova I.Y., Ostroumova O.D., Lopukhina M.V., Starodubova A.V., Korotkova T.N., Vorozhko I.V., Landa A.V., Andrianov A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8282Введение

Введение. Фиброз миокарда часто встречается при фибрилляции предсердий (ФП), однако отсутствуют данные о его взаимосвязи со структурно-функциональным поражением сердца при различных формах последней.

Цель

Цель. Определить возможную связь между эхокардиографическими параметрами и уровнем в крови маркеров фиброза сердца (С-терминальный пропептид проколлагена 1-го типа, PICP; N-терминальный пропептид проколлагена 1-го типа, P3NP; галектин-3; трансформирующий фактор роста бета-1, TGF-β1) у пациентов с различными формами ФП.

Материалы и методы

Материалы и методы. Включены 50 пациентов с пароксизмальной формой ФП (медиана возраста 73 [65,8; 76] года) и 34 больных с персистирующей / постоянной формами ФП (медиана возраста 77,5 [67,5; 81,3] года). Всем участникам выполнена трансторакальная рутинная и спекл-трекинг эхокардиография (ЭхоКГ) и определены сывороточные уровни PICP, P3NP, галектина-3 и TGF-β1.

Результаты

Результаты. В группе персистирующей / постоянной ФП уровень P3NP коррелирует с E/е’ сред. (p = 0,048, R2 = 0,117), уровень PICP – со стрейном левого предсердия (ЛП) (p = 0,01, R2 = 0,189). Уровень галектина-3 ассоциировался в общей когорте пациентов с ФП и у больных с персистирующей / постоянной ФП с E/е’ сред. (р = 0,005, R2 = 0,095 и р = 0,027, R2 = 0,144 соответственно), а у пациентов с пароксизмальной ФП – с глобальным продольным стрейном левого желудочка (ГПС ЛЖ) (р = 0,044, R2 = 0,084). Уровень TGF-β1 коррелировал с E/е’ сред. (р = 0,013, R2 = 0,074) в общей когорте пациентов с ФП и ГПС ЛЖ (р = 0,027, R2 = 0,099) в группе пароксизмальной ФП.

Выводы

Выводы. Сывороточные уровни PICP, P3NP, галектина-3 и TGF-β1 коррелируют со значениями E/е’ сред., ГПС ЛЖ и стрейна ЛП. Комплексный подход, включающий стандартную ЭхоКГ, спекл-трекинг ЭхоКГ, определение уровня биомаркеров фиброза в крови, может помочь точнее оценить степень фиброза сердца неинвазивным способом при различных формах ФП.

Introduction

Introduction. Myocardial fibrosis is often found in atrial fibrillation (AF), but there are no data on its relationship with structural and functional heart damage in various forms of the latter.

Aim

Aim. To determine the possible relationship between echocardiographic parameters and blood levels of cardiac fibrosis markers (C-terminal propeptide of procollagen type 1, PICP; N-terminal propeptide of procollagen type 1, P3NP; galectin 3; transforming growth factor beta 1, TGF-β1) in patients with different forms of AF.

Materials and methods

Materials and methods. The study included 50 patients with paroxysmal AF (median age 73 [65.8;76] years, 34 (68%) women) and 34 patients with persistent/permanent forms of AF (median age 77.5 [67.5;81.3] years, 21 (62%) women). Transthoracic echocardiography was performed in all patients using the speckle tracking technique and serum levels of PICP, P3NP, galectin 3 and TGF-β1 were determined.

Results

Results. Serum P3NP correlate with E/e’ media (p=0.048, R2 = 0.117) in patients with persistent/permanent forms of AF. PICP level correlated with the average strain of the left atrium (LA) in patients with persistent/permanent forms of AF (p = 0.01, R2 = 0.189). The blood level of galectin 3 correlated with E/e’ media in the general cohort of patients with AF and in the group of patients with persistent/permanent forms of AF (p = 0.005, R2 = 0.095 and p = 0.027, R2 = 0.144, respectively), and with global longitudinal strain of the left ventricle (LV) – in the group of patients with paroxysmal AF (p = 0.044, R2 = 0.084). The serum TGF-β1 correlated with E/e’ media (p = 0.013, R2 = 0.074) in the general cohort of patients with AF and with values of the global longitudinal LV strain (p = 0.027, R2 = 0.099) in the group of patients with paroxysmal AF.

Conclusions

Conclusions. Serum levels of PICP, P3NP, galectin-3 and TGF-β1 correlate with the values of E/e’ media, global longitudinal LV strain and average LA strain. An integrated approach, including standard echocardiography, Speckle Tracking echocardiography, and determination of the level of fibrosis biomarkers in the blood can help to more accurately assess the degree of cardiac fibrosis in a noninvasive way in patients with various forms of AF.

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The authors declare that there are no conflicts of interest present.