| Objective:To investigate the changes of inflammatory factor:interleukin-6(IL-6), hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-a(TNF-a) in patients with atrial fibrillation(AF) after radiofrequency catheter ablation(RFCA).We observed the relevance between inflammatory and atrial fibrillation. We accessed the predictive value of other cardiac factors in AF recurrence.Methods:A cohort of60consecutive patients from March2011to September2012in Tianjin Chest Hospital undergoing circumferential pulmonary vein isolation(CPVI) procedure for atrial fibrillation refractory to antiarrhythmic drugs was include in this study. The serum concentrations of hs-CRP,TNF-a and IL-6were measured at baseline,48hours,6months after CPVI respectively. Meanwhile60healthy volunteers were enrolled into this study as control.The concentrations of the baseline inflammatory factors were compared between the experiment groups and controls.We randomly divided the patients with AF into2subgroups:paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PsAF).Left ventricular end-diastolic volume (LVEDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and pulmonary arterial pressure(PAP) were estimated by ultrasonic cardiogram.Looking the differences of above indicators by comparing PAF and PsAF and analyzing correlations of LAD and the inflammation factor. We again compare inflammation factors of preoperation and postoperation to the further understanding the relationship between the atrial fibrillation and inflammation. Following-up were completed by all the cases after3months of surgery. Holter and12lead electrocardiogram(ECG) were monthly producted to make a definite diagnosis of atrial fibrillation. We explored the risk factors of the recurrence with AF by the single factor and regression analysis.Results:1. The baseline hs-CRP and IL-6levels are higher in the AF group than in the control group(P<0.05). There was no difference between the two groups inTNF-a(P>0.05). 2.The serum concentrations of hs-CRP were increased at48h after RFCA (P<0.05). TNF-α and IL-6in three periods were not obvious difference(P>0.05).3. There was positively correlation of hs-CRP and LAD (P<0.05).4. Comparing the clinical factors of PsAF with PAF:the size of LAD in PsAF is greater, the higher hs-CRP than that of PAF group (P<0.05).Persistent atrial fibrillation had a bigger possibility of drug or electrical conversion (P<0.05).But we did not found the statistical difference in age,sex,duration of atrial fibrillation, disease composition, LVEDD, LVEF,PAP and the inflammatory factors levels(P>0.05).5.There was significant different in LAD size, type of atrial fibrillation,coronary heart disease (CHD) and the hs-CRP levels of at baseline and6months after operation between recurrence group and sinus group after RFCA(P<0.05), but it was similar in the age, sex, duration of atrial fibrillation, hypertension history, PAP,LVEDD,the level of IL-6and TNF-α(P>0.05).6. We analyzed risk factors of atrial fibrillation recurrence by binary Logistic regression,it shows that only the duration of atrial fibrillation and the size of LAD is a risk factor for recurrence of atrial fibrillation.Conclusions:1. The patients with atrial fibrillation had higher baseline levels of hs-CRP,CPVA may cause focal the elevated hs-CRP levels in the short term. We prompted it is possible that the hs-CRP and IL-6participated in the occurrence of atrial fibrillation. There seems not be very close among TNF-α with atrial fibrillation.2. The level of hs-CRP was positively related to LAD,so that it may be involved in the maintenance of atrial fibrillation through influence the atrial remodeling.3. The size of LAD,the level of hs-CRP, persistent atrial fibrillation and history of coronary heart disease may be have some predict value.4. By binary logistic regression analysis, the LAD size and duration of atrial fibrillation is a risk factor for recurrence. |
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