Correlation Between Tricuspid Regurgitation And Pulmonary Hypertension Gene In Patients With Non-valvular Atrial Fibrillation

Objective:The purpose of this study was to investigate the relationship between the degree of tricuspid regurgitation and the gene expression of pulmonary hypertension in patients with non-valvular atrial fibrillation,it is more likely to trigger the formation mechanism of pulmonary hypertension,thus causing more severe tricuspid regurgitation,which provides a theoretical basis for studying the mechanism of tricuspid regurgitation caused by atrial fibrillation,it is expected to predict the risk of patients with functional tricuspid regurgitation by detecting pulmonary hypertension-related genes in patients with atrial fibrillation,and to carry out individualized intervention as soon as possible,it has important clinical significance for high risk patients to convert sinus rhythm as soon as possible and to use targeted drugs for pulmonary hypertension.Methods:25 patients with non-valvular atrial fibrillation at the Cardiovasology department and the Geriatric department of the Yijishan Hospital of Wannan Medical College were enrolled consecutively from September 2018 to March 2020,and it was approved and signed by the Ethics Committee of Wannan Medical College.Including the patient's basic disease,atrial fibrillation course and ECG,echocardiography,blood routine,blood biochemical,b-type natriuretic peptide(BNP)and other routine examination,and patients with New York Heart Association(NYHA)classification of cardiac function,two patients with rheumatic valvular disease were excluded and 23 patients were included in the study.The patients were divided into 4 groups according to the results of different degrees of tricuspid regurgitation: 11 patients without tricuspid regurgitation in control group,3 patients with mild tricuspid regurgitation,and 5patients with moderate tricuspid regurgitation in echocardiography group,four cases of severe tricuspid regurgitation.Three known exons of the pulmonary hypertension gene were sequenced in these patients,bone morphogenetic protein 2(BMPR2)gene,activin receptor-like kinase-1(ACVRL1)gene,activin receptor-like kinase-1(ACVRL1)gene and caveolae-1(CAV-1)gene,respectively,were used to design primers for PCR amplification,sequencing and electrophoresis.Results:1.There was no significant difference between tricuspid regurgitation and age,left atrial size,EF(p > 0.05).2.There were significant differences in the degree of Tricuspid regurgitation and the course of AF,BNP level and NYHA cardiac function(p < 0.05).3.There was a positive correlation between the degree of Tricuspid regurgitation and the number of gene mutations(p < 0.05,?=0.95).4.There was significant difference between the mutation expression of ACVRL1 and BMPR2 in tricuspid regurgitation(p < 0.05),the mutation expression of ACVRL1 and CAV-1 was significantly higher than that of the latter(p > 0.05).5.There was significant difference in the number of mutations between CAV-1 and BMPR2 in tricuspid regurgitation(p < 0.05),and the number of mutations was significantly higher than that of the latter.Conclusion:The more severe the tricuspid regurgitation,the higher the mutation rate of pulmonary hypertension gene,and the higher the mutation detection rate of ACVRL1 gene and CAV-1 gene.