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A polymorphism associated with increased levels of YKL-40 and the risk of early onset of lone atrial fibrillation.

ABSTRACT: Plasma levels of YKL-40 are elevated in patients with atrial fibrillation (AF). We hypothesized that a single nucleotide polymorphism (SNP) that affects YKL-40 plasma levels is associated to the risk of lone AF.We included 178 young patients with lone AF and the first episode before the age of 40 years, and a control group of 875 healthy individuals. We analyzed a promoter SNP (-131CG) (rs4950928) in the Chitinase 3-like 1 (CHI3L1) gene encoding YKL-40, which had previously been associated with elevated levels of YKL-40.The (-131CG) genotype was not associated with increased risk of AF. Genetically increased YKL-40 levels were not associated to AF.

SUBMITTER: Henningsen KM

PROVIDER: S-EPMC3554423 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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A polymorphism associated with increased levels of YKL-40 and the risk of early onset of lone atrial fibrillation.

Henningsen Kristoffer M A KM Olesen Morten S MS Sajadieh Golnaz G Haunsoe Stig S Svendsen Jesper H JH

Journal of negative results in biomedicine 20130102

<h4>Background</h4>Plasma levels of YKL-40 are elevated in patients with atrial fibrillation (AF). We hypothesized that a single nucleotide polymorphism (SNP) that affects YKL-40 plasma levels is associated to the risk of lone AF.<h4>Findings</h4>We included 178 young patients with lone AF and the first episode before the age of 40 years, and a control group of 875 healthy individuals. We analyzed a promoter SNP (-131CG) (rs4950928) in the Chitinase 3-like 1 (CHI3L1) gene encoding YKL-40, which ...[more]

PMID: 23279705

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Project description:RationaleAtrial fibrillation (AF) is encountered rarely in pregnancy. Management of maternal AF is challenging as it poses a threat to both maternal and fetal well-being.Patient concernsWe report a case of a 35 weeks pregnant woman who presented in emergency with sudden-onset palpitations and mild shortness of breath with no personal/family history of cardiac diseases.DiagnosesPatient's pulse was irregularly irregular with an average rate of 179 beats per minute. The obstetric examination was normal.DiagnosisHigh-sensitive cardiac troponin T (hs-cTnT) was elevated. The 12 lead electrocardiogram (ECG) confirmed AF. The obstetric ultrasound, electronic fetal heart rate (EFHR) trace, and maternal echocardiography were normal.InterventionsThe patient was admitted under joint cardiology and obstetric care and monitored with continuous telemetry. She was commenced on a therapeutic dose of low-molecular weight heparin (LMWH) and intravenous fluid. She received a single 200 Joule synchronized direct current (DC) shock under general anesthesia in operation theater, which reverted the rhythm back to normal. EFHR monitoring was normal pre- and post-DC cardioversion. We acknowledge the unwise use of therapeutic dose of LMWH before DC cardioversion (DCCV) because of a potential need for emergency cesarean delivery for maternal and/or fetal compromise.OutcomeThe patient remained well and in sinus rhythm after cardioversion. She was discharged home the following day on Flecainide (anti-arrhythmic) and therapeutic dose of low molecular weight heparin (LMWH) and followed up in outpatient clinics frequently. She had a baby at term and received prophylactic LMWH for 10 days post-cesarean. She was discharged from cardiology clinic when she was 10 weeks postnatal, and Flecainide was discontinued.LessonsWe are reporting this case because of the rarity of the condition and successful use of DCCV for treating maternal AF. High-sensitive cardiac troponin T (hs-cTnT) level is a useful laboratory indicator to gauge the severity of AF in pregnancy. We emphasize to make the arrangements for EFHR monitoring and potential cesarean delivery and advocate cautious use of thromboprophylaxis while planning for electrical cardioversion (ECV) for maternal AF.

Dataset Information

A polymorphism associated with increased levels of YKL-40 and the risk of early onset of lone atrial fibrillation.

Publications

A polymorphism associated with increased levels of YKL-40 and the risk of early onset of lone atrial fibrillation.

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