Comparative evaluation of markers of inflammation and fibrosis in patients with various clinical forms of atrial fibrillation

Aim. To identify and assess the significance of clinical and functional data characterizing cardiac remodeling, as well as inflammatory and fibrosis markers in patients with various clinical forms that promote the progression of atrial fibrillation (AF).

Material and methods. We observed 213 patients with arterial hypertension or in combination with coronary artery disease, who were diagnosed with AF. For the clinical and functional assessment of various clinical forms of AF, the significance of certain clinical, hemodynamic, structural, functional, and immunological risk factors for AF was studied. We used the method of binary logistic regression and calculated the significance of the risk factors odds ratio (OR).

Results. We made a database consisting of 33 indicators characterizing the clinical, hemodynamic and structural-functional heart condition, inflammatory and fibrosis markers, the significance of which was ambiguous in various clinical groups of AF patients. We identified enough informativeness of the OR significance for indicators of atrial electrical remodeling, which significantly increases from the paroxysmal AF to the persistent form. It confirms a significant role for the heterogeneity of pulses in the atria during the progression of AF. The degree of structural remodeling of both the atria and ventricles also significantly increases with the progression of AF. We also noted that inflammatory markers have statistically significant role with paroxysmal AF. With persistent AF, the significance of OR for inflammatory markers increases, and with permanent AF, their significance decreases. The significance of the OR in fibrosis marker is significantly high with AF and in the further AF progression, and it significantly increases with the persistent AF form.

Conclusion. We determined different degrees of electrical and structural remodeling of the atria and ventricles in patients with various clinical forms of AF. At the same time, there is an increase in the reliability of OR in inflammatory and fibrosis markers. However, in patients with persistent AF, the duration of AF and increase in the significance of the OR in fibrosis marker come to the fore.

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