血清TGF-β1和CTGF水平对长程持续性房颤术后复发的预测价值
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摘要
目的探讨长程持续性房颤患者血清TGF-β1和CTGF的水平对长程持续性房颤术后复发的预测价值。方法入选92例行房颤射频消融术的长程持续性房颤患者,根据入选患者的年龄、性别比例采集健康人群血清作为对照组(n=30)。采用ELISA法分别检测入选患者和对照组血清TGF-β1和CTGF水平。结果根据随访结果将患者分为房颤未复发组(n=48)与房颤复发组(n=44)。与正常对照组相比,房颤未复发组与房颤复发组血清TGF-β1与CTGF水平均显著升高;房颤复发组血清TGF-β1水平较房颤未复发组明显增加;房颤复发组中血清TGF-β1与CTGF水平呈负相关;Logistic回归分析发现血清TGF-β1水平与房颤持续时间是长程持续性房颤术后复发的独立危险因素。结论长程持续性房颤患者血清TGF-β1与CTGF水平明显升高;房颤复发组血清TGF-β1水平升高更显著,且其与CTGF水平呈负相关;血清TGF-β1水平和房颤持续时间对长程持续性房颤术后复发有预测价值。
Objective To investigate the serum levels of TGF-β1 and CTGF in patients with long-standing atrial fibrillation(AF)undergoing catheter ablation and their values for predicting rhythm outcomes. Methods 92 patients with long-standing AF undergoing catheter ablation were enrolled. Meanwhile 30 age-and gender-matched healthy individuals from the population were chosen as controls. Serum levels of TGF-β1 and CTGF were measured using commercial ELISA assays. Results During follow-up, 44 patients in the AF group experienced AF recurrence(AF recurrence group) and 48 patients were free from atrial tachyarrhythmias(non-AF recurrence group).Compared with controls,the serum levels of TGF-βl and CTGF were significantly elevated in both the AF recurrence group and non-AF recurrence group. Serum levels of TGF-β1 were significantly higher in the AF recurrence group than that in the non-AF recurrence group. A significant negative correlation was found between the serum levels of CTGF and TGF-β1 in the AF recurrence group. In the Logistic regression analysis, longer AF duration and increased serum levels of TGF-β1 were found to be independent risk factors for AF recurrence. Conclusion The serum levels of TGF-β1 and CTGF are significantly elevated in patients with long-standing persistent AF undergoing catheter ablation compared with healthy controls. In patients with long-standing AF undergoing catheter ablation, the serum levels of TGF-β1 are higher in those who will suffer from recurrences, and in those patients the serum TGF-β1 levels are negatively correlated with CTGF levels. Longer AF duration and higher serum levels of TGF-β1 in procedure are independent risk factors for AF recurrences after catheter ablation.
Objective To investigate the serum levels of TGF-β1 and CTGF in patients with long-standing atrial fibrillation(AF)undergoing catheter ablation and their values for predicting rhythm outcomes. Methods 92 patients with long-standing AF undergoing catheter ablation were enrolled. Meanwhile 30 age-and gender-matched healthy individuals from the population were chosen as controls. Serum levels of TGF-β1 and CTGF were measured using commercial ELISA assays. Results During follow-up, 44 patients in the AF group experienced AF recurrence(AF recurrence group) and 48 patients were free from atrial tachyarrhythmias(non-AF recurrence group).Compared with controls,the serum levels of TGF-βl and CTGF were significantly elevated in both the AF recurrence group and non-AF recurrence group. Serum levels of TGF-β1 were significantly higher in the AF recurrence group than that in the non-AF recurrence group. A significant negative correlation was found between the serum levels of CTGF and TGF-β1 in the AF recurrence group. In the Logistic regression analysis, longer AF duration and increased serum levels of TGF-β1 were found to be independent risk factors for AF recurrence. Conclusion The serum levels of TGF-β1 and CTGF are significantly elevated in patients with long-standing persistent AF undergoing catheter ablation compared with healthy controls. In patients with long-standing AF undergoing catheter ablation, the serum levels of TGF-β1 are higher in those who will suffer from recurrences, and in those patients the serum TGF-β1 levels are negatively correlated with CTGF levels. Longer AF duration and higher serum levels of TGF-β1 in procedure are independent risk factors for AF recurrences after catheter ablation.
引文
[1]Iwasaki YK, Nishida K, Kato T, et al. Atrial fibrillation pathophysiology:implications for management. Circulation, 2011,124(20):2264-2274.
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[3]Ko WC, Hong CY, Hou SM, et al. Elevated expression of connective tissue growth factor in human atrial fibrillation and angiotensin IItreated cardiomyocytes. Circ J, 2011,75(7):1592-1600.
[4]Liu B, Yu J, Taylor L, et al. Microarray and phosphokinase screenings leading to studies on ERK and JNK regulation of connective tissue growth factor expression by angiotensin II la and bradykinin B2receptors in Ratl fibroblasts. J Cell Biochem, 2006,97(5):1104-1120.
[5]Jiang H, Wang W, Wang C, et al. Association of pre-ablation level of potential blood markers with atrial fibrillation recurrence after catheter ablation:a meta-analysis. Europace,2017,19(3):392-400.
[6]He X, Gao X, Peng L, et al. Atrial fibrillation induces myocardial fibrosis through angiotensinⅡtype 1 receptor-specific Arkadiamediated downregulation of Smad7. Circ Res, 2011,108(2):164-175.
[7]Li J, Yang Y, Ng CY, et al. Association of Plasma Transforming Growth Factor-betal Levels and the Risk of Atrial Fibrillation:A Meta-Analysis. PloS One, 2016, 11(5):e0155275.
[8]Kishima H, Mine T, Takahashi S, et al. The Impact of Transforming Growth Factor-betal Level on Outcome After Catheter Ablation in Patients With Atrial Fibrillation. J Cardiovasc Electrophysiol, 2017,28(4):402-409.
[9]Kornej J, Ueberham L, Schmidl J, et al. Addition of TGF-betal to existing clinical risk scores does not improve prediction for arrhythmia recurrences after catheter ablation of atrial fibrillation. Int J Cardiol, 2016,221:52-54.
[10]Sasaki N, Okumura Y, Watanabe I, et al. Increased levels of inflammatory and extracellular matrix turnover biomarkers persist despite reverse atrial structural remodeling during the first year after atrial fibrillation ablation. J Interv Card Electrophysiol, 2014,39(3):241-249.
[11]Wu CH, Hu YF, Chou CY, et al. Transforming growth factor-betal level and outcome after catheter ablation for nonparoxysmal atrial fibrillation. Heart Rhythm, 2013,10(1):10-15.
[2]Levy S, Sbragia P,[Remodelling in atrial fibrillation]. Archives Mal Coeur Vaiss, 2005,98(4):308-312.
[3]Ko WC, Hong CY, Hou SM, et al. Elevated expression of connective tissue growth factor in human atrial fibrillation and angiotensin IItreated cardiomyocytes. Circ J, 2011,75(7):1592-1600.
[4]Liu B, Yu J, Taylor L, et al. Microarray and phosphokinase screenings leading to studies on ERK and JNK regulation of connective tissue growth factor expression by angiotensin II la and bradykinin B2receptors in Ratl fibroblasts. J Cell Biochem, 2006,97(5):1104-1120.
[5]Jiang H, Wang W, Wang C, et al. Association of pre-ablation level of potential blood markers with atrial fibrillation recurrence after catheter ablation:a meta-analysis. Europace,2017,19(3):392-400.
[6]He X, Gao X, Peng L, et al. Atrial fibrillation induces myocardial fibrosis through angiotensinⅡtype 1 receptor-specific Arkadiamediated downregulation of Smad7. Circ Res, 2011,108(2):164-175.
[7]Li J, Yang Y, Ng CY, et al. Association of Plasma Transforming Growth Factor-betal Levels and the Risk of Atrial Fibrillation:A Meta-Analysis. PloS One, 2016, 11(5):e0155275.
[8]Kishima H, Mine T, Takahashi S, et al. The Impact of Transforming Growth Factor-betal Level on Outcome After Catheter Ablation in Patients With Atrial Fibrillation. J Cardiovasc Electrophysiol, 2017,28(4):402-409.
[9]Kornej J, Ueberham L, Schmidl J, et al. Addition of TGF-betal to existing clinical risk scores does not improve prediction for arrhythmia recurrences after catheter ablation of atrial fibrillation. Int J Cardiol, 2016,221:52-54.
[10]Sasaki N, Okumura Y, Watanabe I, et al. Increased levels of inflammatory and extracellular matrix turnover biomarkers persist despite reverse atrial structural remodeling during the first year after atrial fibrillation ablation. J Interv Card Electrophysiol, 2014,39(3):241-249.
[11]Wu CH, Hu YF, Chou CY, et al. Transforming growth factor-betal level and outcome after catheter ablation for nonparoxysmal atrial fibrillation. Heart Rhythm, 2013,10(1):10-15.