| Objective:To study concenteation the changes and clinical signifycance of the level of serum matrix metalloproteinase-2 (MMP-2) and high sensitivity C-reactive protein (hs-CRP) in patients with atrial fibrillation (AF).Methods:51 cases (male 27 cases, female 24 cases) of chronic AF aged of 68.12±11.21 years were selected as the AF group. The patients were divided into the following groups according to the basic cardiovascular disease:17 cases of coronary atherosclerotic heart disease (CAD).10 cases of rheumatic valvular heart disease (RHD),15 cases of dilated cardiomyopathy (DCM),9 cases of essential hypertension (EH); in accordance with New York Heart Association (NYHA) grading standards the patients were divided into the four groups:I level in 9 cases.Ⅱlevel in 11 cases.Ⅲlevel in 15 cases, IV level in 16 cases; according to the continuing situation of AF. the patients were divided into the three groups:paroxysmal AF (15 cases), persistent AF (15 cases) and permanent AF (21 cases).22 cases of sinus rhythm (SR) (12 males,10 females) who were denied the history of AF and aged 62.05±6.72 years were selected as SR group. There are 6 cases of CAD,5 cases of RHD,5 cases of DCM,6 cases of EH; the NYHA cardiac function classification were as follows:4 cases of I level,5 cases of II level,7 cases of III level,6 cases of IV level. All the patients of the two groups were checked color doppler echocardiography to measure the left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF); and early morning fasting blood sample were sent to measure the serum MMP-2 and hs-CRP levels.Results:(1) There are no significant differences between AF group and SR group in gender composition, NYHA heart function classification, LVEF and LVEDD (all P>0.05). AF group's smoking rate 41.2%is significantly higher than that's of SR group 13.6%(P<0.05); AF group's age 68.12±11.21 years is significantly higher than that's of SR group 62.05±6.72 years (P<0.05). (2) AF group's serum MMP-2 level 30.09±9.31 ng/ml is significantly higher than SR group's 15.99±5.63 ng/ml (P<0.05). AF group's serum hs-CRP level 20.39±6.05 mg/1 is significantly higher than SR group's 12.77±4.34 mg/l (P<0.05). AF group's LAD 46.82±6.40 mm is signifycantly higher than SR group's 35.72±3.17 mm (P<0.05). (3) In AF group, the serum MMP-2 and hs-CRP levels showed no significantly difference (P>0.05) among EH group. CAD group. RHD group and DCM group (P>0.05). But RHD group's LAD is signifycantly larger than the other three groups (P<0.05). (4) The paroxysmal AF group's, persistent AF group's and permanent AF group's serum MMP-2 levels are 20.92±4.30 ng/ml,29.67±5.88 ng/ml and 36.94±8.18 ng/ml, signifycantly different in each group (P<0.05). The serum hs-CRP levels of paroxysmal AF group, persistent AF group and permanent AF group are 15.93±4.43 mg/1,20.12±5.33 mg/1 and 23.78±5.56 mg/l, signifycantly different in each group (P<0.05). The paroxysm-mal AF group's, persistent AF group's and permanent AF group's LAD are 40.73±3.58 mm,45.60±3.66 mm and 52.05±5.14 mm. signifycantly different in each group (P<0.05). (5) The AF group's levels of serum MMP-2 and hs-CRP were positively correlated (r= 0.729, F=80.36. P<0.001), linear regression equation was Y = 4.438+1.181 X; the AF group's serum MMP-2 level and LAD were positively correlated (r= 0.741, F= 86.527, P<0.001), linear regression equation was Y= 1.038X-19.344; The AF group's serum hs-CRP level and LAD were positively correlated (r= 0.669, F= 57.665,P<0.001), linear regression equation was Y 0.578X-7.059.Conclusions:1. Atrial fibrosis and inflammatory mechanisms participate in the occurrence and maintenance of AF.2. The high levels of serum MMP-2, hs-CRP and LAD increasing could be used to predict paroxysmal AF, persistent AF and permanent AF. |
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