RELATIONSHIP OF HOMOCYSTEINE, PROLINE AND GLYCINE LEVELS WITH CLINICAL COURSE OF PAROXYSMAL AND PERSISTENT ATRIAL FIBRILLATION

The aim of this study was to evaluate the relationship of homocysteine (Hcy), proline (Pro) and glycine (Gly) levels with the clinical course of paroxysmal and persistent atrial fibrillation (AF). The study included 75 patients with AF secondary to ischemic heart disease (IHD) and / or hypertension without significant myocardial structural damage. Among them, the first group included 48 patients with paroxysmal AF, the second ? 27 patients with persistent AF. For comparison, there was formed the third ? control ? group which consisted of 19 patients with IHD and / or hypertension without AF episodes in history. Two-dimensional transthoracic echocardiography was performed to assess left atrium (LA) size and function. There were also determined blood levels of Hcy, Pro, hydroxyproline (Hpro) and Gly. AF recurrence was evaluated in a year’s time. The Hcy level >11,2 mcmol / l was correlated with the increased LA size (>40 mm). Its value >11 mcmol / l was associated with higher AF frequency and AF recurrence. The level of Pro >97 mcmol / L was associated with higher AF incidence. The Gly level >349 mcmol / L was associated both with longer AF duration, and increased AF frequency, given that the Hcy level was > 11 mcmol / l. Conclusions: In patients with AF the increased Hcy level > 11 mcmol / L allows us to consider it as a prognostic factor of LA enlargement as well as increasing AF recurrence. The relationship of Hcy, Gly, Pro with the LA size, AF frequency and duration shows their effects on atrial remodeling, and their levels may have prognostic significance.