Determination Of Apelin-13 And TGF-?1 Levels In Patients With Atrial Fibrillation And Their Correlation With Atrial Fibrillation Structural Remodeling

Objective: observe the changes of Apelin-13 and TGF-? 1 in peripheral blood of patients with atrial fibrillation,to analyze the relationship between them and known NT-Pro-BNP and LAD,to explore the correlation between Apelin-13 and TGF-? 1 in the development of atrial fibrillation,and to explore the mechanism of Apelin-13 and TGF-? 1 in atrial fibrillation.It provides a new auxiliary index for judging the development of atrial fibrillation and provides a faster and more effective method and basis for evaluating the prognosis of atrial fibrillation and providing a new treatment method.Methods:From November 2016 to September 2017,60 patients with atrial fibrillation were enrolled in Department of Cardiovascular Medicine,Jingzhou Central Hospital,and 20 normal sinus rhythm patients were selected as healthy control group,49 males and 31 females,aged 54-81 years,were selected as healthy control group.The average age was 65.00 ±8.12 years old.Patients with atrial fibrillation were divided into three groups according to the relevant diagnostic guidelines: paroxysmal AF)20 in paroxysmal atrial fibrillation,persistent persistent AF)20 in persistent atrial fibrillation and permanent AF)20 in permanent atrial fibrillation.Admission physical examination: blood routine,liver,kidney function,blood sugar,blood lipid were in normal range,exercise load electrocardiogram results were negative.All subjects were enrolled in age,sex,smoking,drinking,high.There was no significant difference in blood pressure,body mass index,history of diabetes mellitus and dyslipidemia(P > 0.05).All subjects were excluded such as congenital heart disease,cor pulmonale,rheumatic heart disease and other serious heart valvular disease,complicated with various cardiomyopathy,malignant tumor,severe heart failure,liver and kidney insufficiency,infection,trauma,Peripheral vascular diseases,autoimmune system diseases,and cardiac surgery or referral surgery were performed within 3 months.Blood sampling time: paroxysmal atrial fibrillation group within 24 hours after onset;persistent atrial fibrillation group,continuous atrial fibrillation group,The permanent atrial fibrillation group and the healthy control group were collected in the morning on an empty stomach.All the specimens were centrifuged within 30 minutes with 3000 r / min for 10 min,and sealed after separating the serum.The expression levels of Apelin-13 and TGF-? 1 in peripheral blood of each group were measured by enzyme linked immunosorbent assay(Elisa),and the correlation with NT-Pro-BNP and LAD were analyzed.Results: The concentration of Apelin-13 in paroxysmal atrial fibrillation group was lower than that in control group,but there was no significant difference(P > 0.05).The concentration of Apelin-13 in persistent atrial fibrillation group and permanent atrial fibrillation group was significantly lower than that in persistent atrial fibrillation group.(respectively:5.01(4.73 5.60)and 3.26(2.69,3.40),P<0.05;5.01(4.73 5.60)and1.47(1.28,1.76),P<0.05);Compared with the paroxysmal atrial fibrillation group,the concentration of Apelin-13 in the persistent atrial fibrillation group and the permanent atrial fibrillation group was significantly lower than that in the paroxysmal atrial fibrillation group(respectively:4.43(3.87 5.10)and 3.26(2.69,3.40),P<0.05;4.43(3.87 5.10)and 1.47(1.28,1.76),P<0.05);Compared with persistent atrial fibrillation group,Apelin-13 concentration in permanent atrial fibrillation group was significantly lower than that in persistent atrial fibrillation group.(3.26(2.69,3.40)1.47(1.28,1.76),P<0.05)?The levels of TGF-? 1 in paroxysmal atrial fibrillation group,persistent atrial fibrillation group and permanent atrial fibrillation group were significantly higher than those in control group(P < 0.05).(respectively:63.50(50.00,71.50)and 116.50(98.25,129.75),P<0.05;63.50(50.00,71.50)and 195.50(171.25,224.00),P<0.05;63.50(50.00,71.50)and 271.50(254.00,294.25),P<0.05);Compared with paroxysmal atrial fibrillation group,TGF-?1concentration in persistent atrial fibrillation group and permanent atrial fibrillation group was significantly higher than that in paroxysmal atrial fibrillation group.(195.50(171.25,224.00)and 271.50(254.00,294.25),P<0.05).The correlation analysis between Apelin-13 TGF-? 1 and NT-Pro-BNP LAD showed that there was a significant negative correlation between Apelin-13 and TGF-? 1 NT-pro-BNP concentration and LAD in all experimental groups.? is respectively-0.964,-0.945,-0.963,P<0.01.Correlation analysis showed that TGF-?1 was negatively correlated with NT-pro-BNP concentration and LAD in all experimental groups? is respectively 0.984,0.992,P>0.01.Correlation analysis showed that there was a significant positive correlation between LAD size and NT-pro-BNP concentration in all experimental groups.(r = 0.978(P < 0.01))Conclusion:(1)Apelin-13 and TGF-?1are closely related to the development of atrial fibrillation,which can be considered as a new index to predict the prognosis of atrial fibrillation and provide new ideas and references for the treatment of atrial fibrillation.(2)Apelin-13 and TGF-?1 were correlated with the development of atrial fibrillation.Low level of Apelin-13 and high level of TGF-?1may indicate poor prognosis and therapeutic effect in patients with atrial fibrillation.