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Updated: Mar 17, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
[Relationship between serum level of CD40 ligand and persistent lone atrial fibrillation]
Evin Bozçalı1, Veli Polat2, Gönül Kutlu3
1Department of Cardiology, Koç University Faculty of Medicine, İstanbul, Turkey. epolat@kuh.ku.edu.tr.
Insights
This study found elevated CD40 ligand (CD40L) levels in patients with lone atrial fibrillation, suggesting its role in the condition. Higher CD40L levels may indicate increased cardiovascular disease risk in these patients.
Area of Science:
- Cardiology
- Immunology
- Biochemistry
Background:
- Inflammation is implicated in atrial fibrillation pathogenesis.
- CD40 ligand (CD40L) is a prothrombotic and proinflammatory molecule.
- The specific role of CD40L in lone atrial fibrillation requires elucidation.
Purpose of the Study:
- To investigate the relationship between CD40L and lone atrial fibrillation.
- To assess serum CD40L levels for distinguishing lone atrial fibrillation patients from healthy individuals.
- To explore correlations between CD40L, inflammatory markers, and cardiac dimensions.
Main Methods:
- Study included 35 patients with lone persistent atrial fibrillation and 30 healthy controls.
- Serum CD40L and high-sensitive C-reactive protein (hs-CRP) levels were measured.
- Transthoracic echocardiography was performed to assess cardiac dimensions.
Main Results:
- Patients with lone atrial fibrillation exhibited significantly higher serum CD40L, hs-CRP, and left atrial diameter compared to controls.
- Serum CD40L levels positively correlated with left atrial diameter and hs-CRP.
- Serum CD40L levels effectively discriminated patients with lone atrial fibrillation from controls (AUC: 0.847, p<0.0001).
Conclusions:
- Elevated CD40L levels are crucial in the development of lone atrial fibrillation.
- Increased CD40L suggests a higher cardiovascular disease risk in these patients.
- Regular clinical follow-up is recommended for patients with lone atrial fibrillation due to elevated CD40L.
Objective:
Inflammation is thought to play a role in the pathogenesis of atrial fibrillation. The relationship between CD40 ligand (CD40L), a prothrombotic and proinflammatory molecule, and lone atrial fibrillation was presently investigated for the first time. Levels of serum CD40L were also tested, regarding potential to distinguish patients with lone atrial fibrillation from healthy individuals.
Methods:
Presently included were 35 patients with lone persistent atrial fibrillation and a control group of 30 healthy individuals. Serum levels of CD40L and high-sensitive C-reactive protein (hs-CRP) were measured, and transthoracic echocardiography was performed.
Results:
Mean serum CD40L, hs-CRP, left ventricular end-diastolic diameter, and left atrial diameter values were significantly higher in the group with lone persistent atrial fibrillation than in the control group (7.4±3.5 ng/mL vs 4.3±1.2 ng/mL, p<0.0001; 3.7±1.6 mg/L vs 1.7±0.8 mg/L, p<0.0001; 53.0±4.2 mm vs 46.0±3.8, p<0.0001; 43.5±3.5 mm vs 33.7±3.5, p<0.0001, respectively). Serum CD40L levels were positively correlated with left atrial diameter (r=0.81, p<0.0001) and hs-CRP (r=0.72, p<0.0001). Receiver operating characteristic curve analysis revealed that serum CD40L at the optimal cut-off level of >4.5 ng/mL successfully discriminated patients with lone atrial fibrillation from controls (area under the curve: 0.847; 95% confidence interval: 0.759-0.934; p<0.0001).
Conclusion:
The present findings suggest that CD40L levels play a crucial role in the development of lone atrial fibrillation. In addition, results support that regular clinical follow-up of these patients is necessary, due to increased cardiovascular disease risk, determined by elevated CD40L levels.
