The Relationship Between Serum Copeptin Levels And Atrial Fibrillation In Patients With Chronic Heart Failure

Objective: To investigate the relationship between serum copeptin level and atrial fibrillation in patients with chronic heart failure,so as to provide clinical diagnosis and treatment basis for identification of patients with chronic heart failure associated with high risk atrial fibrillation.Methods: We enrolled the method of case-control study to select 149 cases which were admitted to the department of cardiology or outpatient department of Loudi city central hospital from February 2019 to November 2019.The patients were divided into 51 cases of chronic heart failure with atrial fibrillation group(A group),52 cases of chronic heart failure with sinus rhythm group(B group)and 20 cases of atrial fibrillation without chronic heart failure group(C group),and these patients are regarded as experimental research object.26 sinus rhythm cases without heart failure group(D group)are selected as the object of control study.According to the NYHA classification,all cases were divided into NYHA class I,NYHA class II,NYHA class III and NYHA class IV,and each class were divided into the atrial fibrillation group and the sinus rhythm group.Collect general data,routine blood biochemical indexes and echocardiographic parameters from all cases.Serum copeptin concentration was determined by Enzyme Linked Immunosorbent Assay(ELISA).SPSS19.0 statistical software was used to analyze the data.Compare the differences between groups,plot the Receiver Operating Charecteristic Curve(ROC Curve),and evaluate the diagnostic value of serum copeptin in patients with chronic heart failure complicated with atrial fibrillation.Results: 1.The serum copeptide levels are the highest in the chronic heart failure group with atrial fibrillation(18.63±4.83)pmol/l,followed by the chronic heart failure group with sinus rhythm(13.42±3.14)pmol/l,and then the non-heart failure group with atrial fibrillation(10.40±2.60)pmol/l.The level of control group is the lowest(sinus rhythm group without heart failure)(5.88±1.55)pmol/l.The differences among the groups were statistically significant(All p<0.05).2.In patients with chronic heart failure in NYHA class I,NYHA class II group,NYHA class III group,and NYHA class IV group,the serum copeptin level of the atrial fibrillation group was higher than that of the sinus rhythm group [(10.40±2.60)pmol/l vs(5.88±1.55)pmol/l;(13.43±1.49)pmol/l vs(10.18±0.96)pmol/l;(18.27±2.67)pmol/l vs(14.43±2.23)pmol/l;(24.26±2.08)pmol/l vs(15.38±3.09)pmol/l],and the differences among the groups was statistically significant(All p<0.05).3.The serum copeptin levels were positively correlated with Left atrial diameter and serum NT-proBNP levels(r=0.863,0.778,p<0.05).4.In the multivariate logistic regression analysis of factors affecting atrial fibrillation,the influence coefficient of copeptin on atrial fibrillation was 0.297(OR: 1.345,95%CI: 1.005-1.801,p<0.05).5.The areas under the ROC curve of copeptin levels was 0.852(p<0.05).When its cut-off point was 15.16 pmol/l,the sensitivity and specificity of predicting chronic heart failure complicated with atrial fibrillation were 72.5% and 80.8%,respectively.Conclusions: 1.Increased serum copeptin expression in patients with chronic heart failure complicated with atrial fibrillation.2.Serum copeptin levels are risk factors for chronic heart failure with atrial fibrillation.