Gao Q, Geng J, Ding Y, Yao Z, Meng J, Wang C, Zhang H, Kang P, Tang B
Department of Cardiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China.
School of Mental Health, Bengbu Medical College, Bengbu 233030, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2022 Nov 20;42(11):1689-1696. doi: 10.12122/j.issn.1673-4254.2022.11.13.
To investigate the changes in serum levels of endothelin-1 (ET-1) and connective tissue growth factor (CTGF) in patients with atrial fibrillation (AF) and their value for predicting recurrence of AF after radiofrequency ablation (RFCA).
Sixty-six patients with paroxysmal AF (PaAF) and 72 with persistent AF (PaAF) admitted in our hospital were recruited as AF group and 80 patients with sinus rhythm as the control group, and in all the participants, serum levels of ET-1 and CTGF were measured using ELISA and Western blotting. From 6 patients with AF and 6 with sinus rhythm undergoing cardiac surgery in our hospital, tissue samples of the right atrial appendage were taken intraoperatively for observation of structural changes of the cardiomyocytes, myocardial fibrosis and expression of ET-1 and CTGF protein. In AF group, the patients receiving RFCA were followed up for 6 months following the procedure for assessment of the outcomes.
Compared with the control patients, the patients with AF showed obvious damages of the cardiomyocyte structure and myocardial fibrosis. Serum levels of ET-1 and CTGF levels were significantly higher in PaAF and PeAF groups than in the control group, and were higher in PeAF group than in PaAF group. In the patients with AF, serum ET-1 and CTGF levels were positively correlated with left atrial diameter (LAD) ( < 0.05), and ET-1 was positively correlated with CTGF levels ( < 0.05). In patients with postoperative AF recurrence, the serum levels of ET-1 and CTGF were significantly higher than those in patients without recurrence; serum ET-1 and CTGF levels before and after the operation were positively correlated with the recurrence of PeAF, and elevated serum levels of ET- 1 and CTGF were identified by logistic regression analysis as independent risk factors for postoperative recurrence of PeAF.
Serum levels of ET-1 and CTGF are significantly elevated in AF patients in positive correlation with AF duration. ET-1 and CTGF levels are higher in AF patients with postoperative recurrence, and they both have predictive value for recurrence of PeAF following RFCA.
探讨心房颤动（AF）患者血清内皮素-1（ET-1）和结缔组织生长因子（CTGF）水平的变化及其对预测射频消融（RFCA）术后AF复发的价值。
选取我院收治的66例阵发性AF（PaAF）患者和72例持续性AF（PeAF）患者作为AF组，80例窦性心律患者作为对照组，采用酶联免疫吸附测定（ELISA）法和蛋白质免疫印迹法检测所有研究对象血清ET-1和CTGF水平。选取我院6例接受心脏手术的AF患者及6例窦性心律患者，术中取右心耳组织样本，观察心肌细胞结构改变、心肌纤维化及ET-1和CTGF蛋白表达情况。AF组中接受RFCA的患者术后随访6个月，评估手术效果。
与对照组患者相比，AF患者心肌细胞结构和心肌纤维化损伤明显。PaAF组和PeAF组血清ET-1和CTGF水平显著高于对照组，且PeAF组高于PaAF组。AF患者血清ET-1和CTGF水平与左心房内径（LAD）呈正相关（<0.05），ET-1与CTGF水平呈正相关（<0.05）。术后AF复发患者血清ET-1和CTGF水平显著高于未复发患者；手术前后血清ET-1和CTGF水平与PeAF复发呈正相关，logistic回归分析显示血清ET-1和CTGF水平升高是PeAF术后复发的独立危险因素。
AF患者血清ET-1和CTGF水平显著升高，与AF病程呈正相关。AF术后复发患者ET-1和CTGF水平更高，二者对RFCA术后PeAF复发均有预测价值。
