Atrial Fibrillation And Cardiac Autonomic Nerve Regulation Function And Correlative Analysis

Objective: We apply the case-control study to analyze the heart rate variability(HRV)and blood biochemical indexes of patients with paroxysmal and persistent atrial fibrillation(AF),and explore the relationship between AF and cardiac autonomic nervous regulation activities and circadian rhythm changes,it lays a certain theoretical foundation for the research and treatment of the mechanism of AF.Methods:We selected the subjects who underwent 24-hour Holter and blood biochemical tests in the outpatient and cardiovascular inpatient areas of the Affiliated Hospital of Inner Mongolia Medical University from 2019-01-01 to 2020-10-31.There are 78 cases in the control group as the group 1,44 cases in the paroxysmal AF group as the group 2 and 53 cases in the persistent AF group as the group 3;We collected the past or current medical records and/or outpatient visits and medical records of all study subjects that meet the inclusion and exclusion criteria;Analysis using SPSS 24.0 statistical software,in order to explore the relationship between paroxysmal and persistent AF of HRV and blood biochemical indicators.Results:1.The age and gender of all researchers did not change obviously(P>0.05).2.Blood biochemical indicators:(1)Between group 2 and group 1:C reactive protein(CRP),uric acid(UA),homocysteine(Hcy),N-terminal pro-brain natriuretic peptide(NT-pro BNP)was higher than that of group 1(P<0.05);(2)Between group 3 and group 1:group 3 of CRP,UA,Hcy and NT-pro BNP were higher than group 1,total cholesterol(TC)and low-density lipoprotein(LDL)were lower than group 1.(3)Between group 3 and group2:CRP and NT-proBNP in group 3were higher than those in group 2.3.Holter indicators:(1)Between group 2 and group 1:the pNN50,rMSSD,SDNN Index,LF,HF,day and night pNN50,day and night SDNN,day and night rMSSD,fastest heart rate,total heart rate,24-hour average heart rate of group 2 increased;NNs,maximum LF/HF,and night NNs were lower than group 1;Among them,p NN50:group 1day<night,group 2 day>night,that is,circadian rhythm imbalance.(2)Between group 3 and group 1:the pNN50,rMSSD,SDNN,SDNN Index,Triangle Index(TRIIDX),LF,HF,full LF/HF,day and night SDNN,day and night SDANN,fastest heart rate,24-hour average heart rate of group 2 increased.(3)Between group 3 and group 2:the pNN50,rMSSD,SDNN,SDNN Index,TRIIDX,LF,HF,full LF/HF,day and night rMSSD,day and night SDANN of group 3 is higher.(4)Poincare scatter plots were analyzed by chi-square test.Baseball rod shape was more common in group 1,irregular shape was more common in group 2,and oval shape was more common in group 3.Conclusions:(1)The increase of CRP,UA,Hcy,NT-proBNP and the decrease of TC and LDL can promote AF;This indicates that the presence of AF is closely related to the presence of inflammatory factors,oxidative stress,and lipid metabolism disorders.(2)The autonomic nerve function of AF patients has been destroyed as a whole,so some areas have been reconstructed,and the tension of the parasympathetic nerves has increased significantly;the sympathetic tension at night also shows a tendency to increase,and the tension of the parasympathetic nerves is higher than that in the day,indicating that the autonomic nerve imbalance at night is serious and the circadian rhythm is disordered;and paroxysmal AF In contrast,HRV changes more obviously in persistent AF,and the autonomic nerves are affected more deeply.(3)By comparing Poincare scatter plots,it is possible to distinguish AF from healthy subjects intuitively and simply based on the shape of the scatter plot.