The relationship between oxidative stress and autophagy and apoptosis in patients with paroxysmal atrial fibrillation.

Although the pathophysiology of paroxysmal atrial fibrillation (PAF) is not fully known, oxidative stress (OS) and atrial remodeling seem to be important triggers. Autophagy and apoptosis which are the types of cell death are fundamental processes in the human body. Although they investigated in many diseases, no study evaluated these parameters in PAF patients. We aimed to investigate autophagy and apoptosis which may be associated with atrial remodeling, and to show whether these factors are associated with OS in PAF patients. In this study, 44 PAF patients admitted to our clinic and 44 healthy volunteers were included. Serum total oxidative stress (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and ATG5 for autophagy and serum M30 for apoptosis were studied. Serum TOS, OSI, ATG5, M30 and left atrium (LA) diameter were higher, while TAS was lower in PAF group than the control group (p < 0.001, for all). ATG5 was positively correlated with TOS, OSI and LA, whereas negatively correlated with TAS. Also, M30 was positively correlated with TOS and OSI, whereas negatively correlated with TAS. Logistic regression analysis showed that TOS (P = 0.002), ATG5 (p = 0.013) and M30 (p = 0.006) were independent predictors of the PAF. It also found that ATG5 was the only independent predictor of LA enlargement in linear regression analysis. Our study showed that ATG5 and M30 were increased, and they were correlated with OS in patients with PAF. Therefore, we suggest that autophagy and apoptosis may play an important role in the PAF process.