Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,
Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
Cardiology. 2023;148(6):517-527. doi: 10.1159/000533405. Epub 2023 Aug 4.
Sympathetic nervous system disorder promotes atrial fibrillation (AF), and neuropeptide Y (NPY) is an important neurotransmitter. This study aimed to explore the predictive value of plasma NPY in patients with AF.
Five hundred seventy-six patients were divided into AF (including paroxysmal and long-standing persistent AF; 360) and sinus rhythm (SR) groups (216). NPY level was detected using enzyme-linked immunosorbent assay, and NPY mRNA expression level was detected using quantitative polymerase chain reaction. Logistic regression was used to analyse the risk factors for AF; the correlations between blood NPY level and age, body mass index (BMI), left ventricular ejection fraction, left atrial diameter (LAD), and European Heart rate Association (EHRA) score in patients with AF were determined. The receiver operating characteristic (ROC) curve was utilised to predict AF.
Plasma NPY levels were found to be higher in patients with AF than in patients with SR and in patients with long-standing persistent AF than in patients with paroxysmal AF; blood NPY mRNA levels were higher in the paroxysmal and long-standing persistent AF groups compared to the SR group (p < 0.05). Increased age {odds ratio (OR) = 1.201 (95% confidence interval [CI]: 1.01, 1.427)} and high NPY [OR = 1.239 (95% CI: 1.022, 1.501)] were factors found to affect AF detrimentally. NPY was associated with BMI (r = 0.5856, p < 0.05), LAD (r = 0.4023, p < 0.05), and EHRA score (r = 0.898, p < 0.05). The ROC curve for the predictive value of plasma NPY levels for AF showed an area under the curve (AUC) value of 0.919 (p < 0.05), while that for long-standing persistent AF showed an AUC of 0.784 (p < 0.05).
Circulating NPY may be a promising molecular biomarker of AF.
交感神经系统紊乱可促进心房颤动（AF）发生，而神经肽 Y（NPY）是一种重要的神经递质。本研究旨在探讨血浆 NPY 对 AF 患者的预测价值。
将 576 例患者分为 AF（包括阵发性和持续性持久性 AF；360 例）和窦性节律（SR）组（216 例）。采用酶联免疫吸附试验检测 NPY 水平，采用定量聚合酶链反应检测 NPY mRNA 表达水平。采用 Logistic 回归分析 AF 的危险因素；分析 AF 患者血液 NPY 水平与年龄、体重指数（BMI）、左心室射血分数、左心房直径（LAD）和欧洲心律协会（EHRA）评分的相关性。利用受试者工作特征（ROC）曲线预测 AF。
与 SR 组相比，AF 患者的血浆 NPY 水平较高，持续性持久性 AF 患者的血浆 NPY 水平高于阵发性 AF 患者；与 SR 组相比，阵发性和持续性持久性 AF 组的血液 NPY mRNA 水平较高（p < 0.05）。年龄增加（优势比[OR] = 1.201（95%置信区间[CI]：1.01，1.427））和 NPY 升高[OR = 1.239（95% CI：1.022，1.501）]是影响 AF 的不利因素。NPY 与 BMI（r = 0.5856，p < 0.05）、LAD（r = 0.4023，p < 0.05）和 EHRA 评分（r = 0.898，p < 0.05）相关。血浆 NPY 水平对 AF 的预测价值的 ROC 曲线下面积（AUC）值为 0.919（p < 0.05），而对持续性持久性 AF 的 AUC 值为 0.784（p < 0.05）。
循环 NPY 可能是 AF 的一种有前途的分子生物标志物。
