Correlation Study Of Inflammatory Factors And Atrial Fibrillation

BackgroundAtrial fibrillation is one of clinical common arrhythmia.Several studies have shown that inflammation is involved in the atrial electrical remodeling and structural remodeling which are the basis of occurrence,development and maintain process of atrial fibrillation.Systemic inflammation score is a tool based on variety of inflammatory factors,usually used to predict the prognosis of malignant tumor,the association between it with atrial fibrillation remains to be evaluated.Recently,Interleukin-17(IL-17)as a specific effect factor of helper T cells 17(Th17)also is a major concern.It has been reported that Th17/IL-17 are associated with a variety of cardiovascular diseases.But there are any evidences of the associations between Th17/IL-17 with AF,and the role of Th17/IL-17 in atrial fibrillation also needs to be studied.ObjectiveFor further understanding the role of inflammation in atrial fibrillation,we conduct a case-control study based on the established database and sample library of atrial fibrillation in southwest of China to explore the associations of clinical commonly used circulating inflammatory factors and systemic inflammation scores with atrial fibrillation,and to discovery wether inflammation invoved in atrial structure remolding of atrial fibrillation;detect plasma levels of Th17/IL-17 related cytokine in patients with and without atrial fibrillation to explore the associations between Th17/IL-17 related cytokine with atrial fibrillation and atrial structure indexes.Our results will provide evidence for clinical commonly used circulating inflammatory factors and Th17/IL-17 related cytokines as biomarkers of atrial fibrillation in early diagnosis and monitoring of disease progression,also,will help further understanding the mechanism of atrial fibrillation,which provides the theoretical basis for new therapeutic targets.Method1.Collecting 10 years’ medical records of a first-class hospital in Chongqing,using case-control study design,retrospectively analyze the associations of clinical commonly used circulating inflammatory factors,including c-reactive protein(CRP),fibrinogen(Fib),albumin(ALB),hemoglobin(HGB),white blood cell(WBC),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR),with atrial fibrillation,and the correlations of above inflammatory factors with cardiac structure indexes,including left ventricular diameter(LVD),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),right ventricular diameter(RVD)and right atrial diameter(RAD).The systemic inflammation score is constructed to evaluate the associations of body inflammation levels with atrial fibrillation and atrial structure indexes.2.Through 1:1 propensity score matching case-control study,the plasma levels of Th17/IL-17 related cytokines,including IL-17 A,IL-17 F,IL-21 and IL-22,in 336 patients with and without atrial fibrillation are detected.Multiple logistic regression is used to analysis the associations of Th17/IL-17 related cytokines with atrial fibrillation and cardiac structure indexes.ResultsPart Ⅰ1.Circulating levels of CRP and NLR are significantly associated with atrial fibrillation,and the risk of atrial fibrillation is increased along with elevating levels of CRP and NLR.High levels of CRP and NLR are significantly associated with AF,and the risk of atrial fibrillation is 2.25 times(P = 0.020)and 1.41 times(P = 0.020)compared with the lowest levels,respectively.2.ALB,HGB,PLR and LMR significantly associated with atrial fibrillation,and the higher levels of ALB and LMR is the smaller risk of atrial fibrillation is.Compared with the lowest levels,OR value of ALB is 0.40(P < 0.001),OR value of PLR is 0.66(P = 0.003),OR value of LMR is 0.48(P < 0.001).When compared with the lowest group(< 115.00 g/L),HGB significantly associated with atrial fibrillation only in 115.00 to 125.99 g/L levels,the OR value is 0.63(P = 0.001).3.Compared to the systemic inflammation score of 0,there is 2.27 times risk of atrial fibrillation when the score equal to or higher than 3(95% CI: 1.58,3.26,P < 0.001),and the higher the score is,the greater the risk of atrial fibrillation is(P < 0.001).4.Results of Spearman correlation analysis shows that CRP significantly negative correlation with RAD,ALB significantly negative correlation with LAD,RVD and RAD,HGB significantly negative correlation with RVD and RAD,PLR significantly positive correlation with RVD.In addition,systemic inflammation score significantly positively related to RVD and RAD.Part Ⅱ1.IL-17 A,IL-17 F,IL-21 and IL-22 are significantly associated with the risk of atrial fibrillation,and the risk become greater with the increasing level of those factors.The OR values are 2.58(P = 0.001),1.82(P = 0.034),2.08(P = 0.013),2.18(P = 0.006)when the highest levels of IL-17 A,IL-17 F,IL-21 and IL-22 compared to the lowest levels,respectively.2.Levels of IL-17 A,IL-17 F,IL-21 and IL-22 had no statistical significant differences between the paroxysmal atrial fibrillation and chronic atrial fibrillation.3.Results of Spearman correlation analysis shows that plasma levels of IL-17 A and IL-21 are significant positive correlated to LAD(r = 0.118,P = 0.038;r = 0.126,P = 0.027,respectively).IL-17 F is significantly positively correlated to LVD,and significantly negative correlated to LVEF(r = 0.128,P = 0.025;r =-0.130,P = 0.023,respectively).ConclusionCRP,NLR,ALB,HGB,PLR and LMR as clinical commonly used circulating inflammatory factors associated with atrial fibrillation to varying degrees.In addition,the higher of the body’s inflammatory state may the greater risk of atrial fibrillation is.Th17/IL-17 related cytokines may be independent risk factors of atrial fibrillation and affected occurrence of atrial fibrillation by involving in the atrial structure remolding.