Department of Cardiology, Ningbo First Hospital.
Int Heart J. 2023;64(4):632-640. doi: 10.1536/ihj.22-560.
Atrial fibrillation (AF) is the most common arrhythmia that is harmful to human health. This study aims to explore the relationship between myosin light chain 4 (MYL4) and AF recurrence after radiofrequency ablation (RFA). Patients with AF (n = 85) were enrolled, and healthy subjects (n = 90) with normal sinus rhythm and no previous history of AF were selected as controls. The serum levels of MYL4, transforming growth factor (TGF) -β1, and procollagen type-I C-terminal propeptide (PICP) were determined. The correlation between MYL4 and atrial fibrosis remodeling indicators (TGF-β1/PICP) and left atrial diameter (LAD) was analyzed. The influence of MYL4 on AF recurrence after RFA was evaluated, and the independent correlation between them was assessed. Patients with AF and the controls showed no significant differences in age, gender, body mass index, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, white blood cell count, neutrophil/lymphocyte ratio, brain natriuretic peptide, and history of smoking, drinking, hypertension, and diabetes (P > 0.05), but with increased LAD in patients with AF (P < 0.01). Serum MYL4 level was reduced in patients with AF (0.6 ± 0.2) compared with that of controls (0.1 ± 0.6) (P < 0.01), and it was negatively correlated with TGF-β1, PICP, and LAD (r = -0.2389, P < 0.05; r = -0.5174, P < 0.01; r = -0.3191; P < 0.01). Low levels of MYL4 increased the risk of AF recurrence after RFA (χ = 16.64; P < 0.0001). A low MYL4 level in patients with AF showed a poorer prognosis. Serum MYL4 level and AF type were independent risk factors affecting AF recurrence after RFA.
心房颤动(AF)是对人类健康危害最大的最常见的心律失常。本研究旨在探讨肌球蛋白轻链 4(MYL4)与射频消融(RFA)后 AF 复发的关系。纳入 85 例 AF 患者,选择窦性节律正常且无 AF 既往史的 90 例健康受试者作为对照。测定 MYL4、转化生长因子(TGF)-β1 和前胶原 I 型 C 端前肽(PICP)的血清水平。分析 MYL4 与心房纤维化重塑指标(TGF-β1/PICP)和左心房直径(LAD)的相关性。评估 MYL4 对 RFA 后 AF 复发的影响,并评估它们之间的独立相关性。AF 患者和对照组在年龄、性别、体重指数、收缩压、舒张压、左心室射血分数、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、白细胞计数、中性粒细胞/淋巴细胞比值、脑钠肽、吸烟史、饮酒史、高血压史和糖尿病史方面无统计学差异(P>0.05),但 AF 患者的 LAD 增加(P<0.01)。AF 患者的血清 MYL4 水平(0.6±0.2)低于对照组(0.1±0.6)(P<0.01),且与 TGF-β1、PICP 和 LAD 呈负相关(r=-0.2389,P<0.05;r=-0.5174,P<0.01;r=-0.3191,P<0.01)。低水平的 MYL4 增加了 RFA 后 AF 复发的风险(χ=16.64;P<0.0001)。AF 患者中低 MYL4 水平预示着预后较差。血清 MYL4 水平和 AF 类型是影响 RFA 后 AF 复发的独立危险因素。