The Clinical Value of Serum Gal-2 and PGC-1α Levels in Predicting Atrial Fibrillation Recurrence after Radiofrequency Ablation in Patients with Persistent Atrial Fibrillation

ZHAO Rongcheng; HAN Jia; GUO Jing; HU Jing; FU Jinling; ZHAO Jinghua

doi:10.12102/j.issn.1672-1349.2025.18.014

Abstract：Objective: To analyze the clinical value of serum galectin-2 (Gal-2) and peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) levels in predicting recurrence of persistent atrial fibrillation after radiofrequency ablation. Methods: A total of 109 patients with atrial fibrillation admitted to our hospital from January 2020 to January 2023 were selected and divided into paroxysmal atrial fibrillation group (58 cases) and persistent atrial fibrillation group (51 cases). Another 109 individuals with sinus rhythm who underwent physical examination during the same period were selected as the control group. Patients in the persistent atrial fibrillation group received radiofrequency ablation treatment and were followed up for 6 months, and were further divided into recurrence group (13 cases) and non-recurrence group (38 cases) based on follow-up results. Data including total cholesterol (TC), triglycerides (TG), left ventricular ejection fraction (LVEF), and left atrial diameter (LAD) were collected. Serum Gal-2 and PGC-1α levels were determined using enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to evaluate the correlation between serum Gal-2 and PGC-1α levels in the recurrence group. Multivariate logistic regression analysis was performed to identify factors influencing recurrence of atrial fibrillation after radiofrequency ablation. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive efficacy of serum Gal-2 and PGC-1α levels for recurrence of atrial fibrillation after radiofrequency ablation. Results: Serum Gal-2 levels were higher in both paroxysmal and persistent atrial fibrillation groups compared to the control group, while PGC-1α levels were lower. Compared with the paroxysmal atrial fibrillation group, the persistent atrial fibrillation group showed significantly increased serum Gal-2 levels and decreased PGC-1α levels (P < 0.05). Serum Gal-2 levels were negatively correlated with PGC-1α levels in patients with persistent atrial fibrillation (r = -0.411, P < 0.001). Compared with the non-recurrence group, the recurrence group had lower LVEF and higher LAD (P < 0.05). Compared with the non-recurrence group, the recurrence group showed higher serum Gal-2 levels and lower PGC-1α levels (P < 0.05). LVEF, LAD, Gal-2, and PGC-1α were all independent risk factors for recurrence after radiofrequency ablation in patients with persistent atrial fibrillation (P < 0.05). The areas under the ROC curve (AUC) for Gal-2 and PGC-1α were 0.773 and 0.768, with sensitivities of 76.92% and 61.54%, respectively. When combined, their AUC increased to 0.941, and sensitivity increased to 92.31% (Z values of 2.128 and 1.970, P values of 0.033 and 0.049, respectively). Conclusion: In patients with persistent atrial fibrillation who experience recurrence after radiofrequency ablation, serum Gal-2 is upregulated and PGC-1α is downregulated. Detection of serum Gal-2 and PGC-1α can effectively predict the risk of recurrence after radiofrequency ablation.