| Objective:Soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,soluble suppression of tumorigenicity,To explore the efficacy of catheter ablation in patients with atrial fibrillation and the prediction value of sST2 combined with LAD for postoperative recurrence of atrial fibrillation.Methods: A total of 160 patients with nonvalvular atrial fibrillation admitted to the Department of Cardiology,the First Affiliated Hospital of Hebei North University from January 2021 to December 2021 were retrospectively collected.In the experimental group,80 patients underwent catheter ablation for the first time(56 patients with persistent AF and 24 patients with paroxysmal AF).The control group included 80 patients(58patients with persistent AF and 22 patients with paroxysmal AF)who were only treated with drugs during the same period.General clinical data(including age,gender,body mass index,medical history,etc.)of all patients were collected,relevant laboratory tests(including routine blood routine,blood glucose,lipid,liver function,kidney function,electrolyte,preoperative four items,thyroid function,etc.),serum sST2 level was measured,and echocardiography was improved.Follow-up was conducted at the 3rd,6th and 12 th months.Serum sST2 detection and echocardiography were performed in the enrolled patients,and postoperative recurrence was investigated.By comparing the changes of sST2 and echocardiography,we analyzed the efficacy of catheter ablation in patients with nonvalvular atrial fibrillation and their value in predicting postoperative recurrence.The correlation between serum sST2 and LAD was calculated by Pearson correlation analysis.Univariate and multivariate Cox regression analysis were used to investigate the related factors affecting the recurrence of atrial fibrillation.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of serum sST2 level and LAD for postoperative recurrence of atrial fibrillation.Outcome:1.There was no statistical significance in the basic data between the experimental group and the control group(P>0.05),indicating comparability.2.Changes of serum sST2 level and left heart function and structural indexes before and after treatment2.1 Comparison of sST2 and echocardiographic indexes between the experimental group and the control groupAt 3 months after treatment,sST2 level and LAD in the experimental group were decreased compared with the control group,and the difference was statistically significant(P < 0.05).There were no significant differences in Left ventricular end diastolic diameter(LVEDD)and Left ventricular ejection fraction(LVEF)between the experimental group and the control group(P>0.05).At 6 and 12 months after treatment,sST2 level,LAD and LVEDD in the experimental group were decreased compared with the control group,and the differences were statistically significant(P < 0.05).LVEF of the experimental group was higher than that of the control group,and the difference was statistically significant(P < 0.05).At 6 and 12 months after treatment,sST2 level,LAD and LVEDD of the experimental group were decreased compared with the control group,the difference was statistically significant(P>0.05).LVEF of the experimental group was higher than that of the control group,the difference was statistically significant(P>0.05).2.2 Changes of sST2 and echocardiographic indexes in the experimental group before and after treatmentAt 3 months after catheter ablation,sST2 level and LAD in the experimental group were decreased compared with those before surgery,and the difference was statistically significant(P < 0.05).LVEDD and LVEF were not significantly different from those before operation(P>0.05).At 6 and 12 months after catheter ablation,sST2 level,LAD and LVEDD in the experimental group were decreased compared with those before operation,and the differences were statistically significant(P < 0.05).LVEF was higher than that before operation,and the difference was statistically significant(P < 0.05).3.Pearson correlation analysis showed a positive correlation between serum sST2 level and LAD(r=0.593,P<0.05).4.Univariate Cox risk model showed that age,course of disease,persistent atrial fibrillation,LAD,sST2,and N-terminal pro-brain B-type natretic peptide(NT-pro BNP)were risk factors for recurrent atrial fibrillation after catheter ablation.Age,course of disease,LAD,sST2 and NT-pro BNP were included as possible independent risk factors that may affect the recurrence after AF catheter ablation,and Cox multivariate regression model was established.sST2(HR=1.025,95%CI 0.976-1.028,P=0.036)and LAD(HR=1.092,95%CI 0.952-1.289,P=0.041)were independent risk factors for postoperative recurrence of atrial fibrillation.5.The area under ROC curve of serum sST2 for predicting recurrence after catheter ablation in patients with atrial fibrillation was 0.805(95%CI0.704～0.961,P<0.05),the cutoff value was 32.67ng/ml,the sensitivity was70.2%,and the specificity was 87.5%.The area under ROC curve of LAD for predicting recurrence after catheter ablation in atrial fibrillation patients was 0.897(95%CI 0.836～0.954,P<0.05),the cut-off value was 36.9mm,the sensitivity was 81.5%,and the specificity was 80.8%.The area under ROC curve of sST2 combined with serum LAD for predicting postoperative recurrence was 0.903(95%CI 0.896～0.973,P<0.05),the sensitivity was 93.8%,and the specificity was 95.6%.Conclusion:1.Catheter ablation can cause reversible changes in left atrial structure and function in patients with atrial fibrillation.LAD and serum sST2 levels are significantly reduced compared with those before surgery.2.There is a positive correlation between serum sST2 and LAD,and sST2 level can evaluate the degree of left atrial myocardial fibrosis to a certain extent.3.Serum sST2 combined with LAD can provide predictive value for the recurrence of atrial fibrillation after catheter ablation. |
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