Zhong Yuan, Zhang Jingying, Tang Kai, Kou Wenxin, Xu Shaojie, Yang Haotian, Liu Lu, Luan Peipei, Mohammed Abdul-Quddus, Abdu Fuad A, Zhao Dongdong, Li Hailing, Peng Wenhui, Xu Yawei
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Ann Transl Med. 2021 Feb;9(3):203. doi: 10.21037/atm-20-3259.
Musclin is involved in the regulation of natriuretic peptide (NP) clearance and may affect the concentration of atrial natriuretic peptide (ANP). It has also been found to play an important role in several diseases, such as diabetes mellitus and hypertension. Both abnormalities in ANP and associated medical history are involved in the pathogenesis of atrial fibrillation (AF). However, plasma concentration of musclin as a biomarker for risk stratification in patients with AF has not been fully investigated.
Plasma musclin levels were measured in 290 patients with AF (including 199 paroxysmal AF patients and 91 persistent AF patients) and 120 control subjects. The association between plasma musclin levels and AF onset, as well as its predictive effects on clinical outcomes after cryoballoon ablation were analyzed.
AF patients were found to have a lower concentration of plasma musclin than healthy controls. Moreover, in the non-diabetic group and normal N-terminal pro-brain natriuretic peptide (NT-proBNP) level group, the association between lower plasma concentration of musclin and AF remained significant. According to receiver operating characteristic (ROC) curve analysis, the optimal cut-off point of musclin for predicting AF onset was 54.94 ng/mL, which had a sensitivity of 81.67% and a specificity of 31.47% [area under the ROC curve (AUC) =60.71%]. In follow-up studies, both diabetes and left atrial size were independent predictors of AF recurrence after ablation, while musclin showed only a modest relationship with the outcome of cryoballoon ablation.
Our data indicated that decreased musclin was associated with the onset of AF. Moreover, lower plasma levels of musclin were an independent risk factor of AF in non-diabetic patients. Our studies suggest that musclin could be a predictive factor for the onset of AF.
肌肉素参与利钠肽（NP）清除的调节，可能影响心房利钠肽（ANP）的浓度。还发现它在几种疾病中起重要作用，如糖尿病和高血压。ANP异常和相关病史均参与心房颤动（AF）的发病机制。然而，肌肉素作为AF患者风险分层生物标志物的血浆浓度尚未得到充分研究。
测定了290例AF患者（包括199例阵发性AF患者和91例持续性AF患者）和120例对照者的血浆肌肉素水平。分析了血浆肌肉素水平与AF发作之间的关联及其对冷冻球囊消融术后临床结局的预测作用。
发现AF患者的血浆肌肉素浓度低于健康对照者。此外，在非糖尿病组和正常N末端脑钠肽前体（NT-proBNP）水平组中，较低的血浆肌肉素浓度与AF之间的关联仍然显著。根据受试者工作特征（ROC）曲线分析，预测AF发作的肌肉素最佳截断点为54.94 ng/mL，其灵敏度为81.67%，特异性为31.47% [ROC曲线下面积（AUC）=60.71%]。在随访研究中，糖尿病和左心房大小都是消融术后AF复发的独立预测因素，而肌肉素与冷冻球囊消融的结局仅呈适度关系。
我们的数据表明，肌肉素降低与AF发作有关。此外，较低的血浆肌肉素水平是非糖尿病患者AF的独立危险因素。我们的研究表明，肌肉素可能是AF发作的预测因素。
