Study On The Relationship Between The Level Of ST2 And Atrial Remodeling In Patients With Atrial Fibrillation

Atrial fibrillation(AF)is an ancient arrhythmia.Since it was recognized by human beings in 1909,we have made a great breakthrough in the occurrence,development,etiology,pathology,clinical characteristics and treatment of AF.Recent studies support that inflammation and atrial remodeling play an important role in the occurrence and maintenance of atrial fibrillation,and soluble growth stimulated expression gene 2(sst2),a new marker of myocardial fibrosis,may be involved in this process,and there is evidence that the serum sst2 concentration in patients with atrial fibrillation with significantly increased left atrial diameter(LAD)is higher than that in patients with normal LAD.Objective:to detect the changes of the serum level of ST2 in patients with atrial fibrillation,and to analyze the correlation with NT proBNP and LAD collected at the same time,to explore the correlation with the central atrial remodeling of atrial fibrillation,and to explore the mechanism of the role of ST2 in the occurrence and development of atrial fibrillation,so as to provide a new auxiliary index for the diagnosis of atrial fibrillation,and for the sustainable development and treatment of atrial fibrillation The evaluation of therapeutic effect provides reference index.Methods:85 patients were enrolled in the Department of Cardiology,Jingzhou Central Hospital,Hubei Province from December 2018 to July 2019.In the atrial fibrillation group,60 patients were diagnosed as AF according to the criteria set by the electrophysiology and pacing branch of the Chinese Medical Association.In the control group,25 normal ECG patients were examined as sinus rhythm by ECG and/or ambulatory ECG.At the time of admission,blood routine examination and liver examination were performed The function,renal function and blood lipid were all in the normal range,and the exercise treadmill ECG was negative.There was no significant difference in age,gender,drinking,smoking,hypertension,diabetes and coronary heart disease among all the selected subjects(P>0.05).The N-terminal B-type natriuretic peptide(NT proBNP)levels and biochemical indexes of all patients were collected.All the patients in the group were examined by ECG and color Doppler echocardiography.The serum level of ST2 was detected by enzyme-linked immunosorbent assay(ELISA),and the indexes related to atrial remodeling in echocardiography,left atrial diameter(LAD),were collected,compared and analyzed.Results:(1)the levels of NT proBNP in paroxysmal AF group and persistent AF group were higher than those in control group([465.0(200.0900.0)]and[1120.0(715.51693.5)]vs[50.0(36.5,68.0)]),the difference was statistically significant(P<0.05),and the serum NT proBNP value of the persistent AF group was higher than that of the paroxysmal AF group;the lad value of the paroxysmal AF group and the persistent AF group was significantly higher than that of the control group([3.9(3.7,4.6)]and[4.5(4.0,5.7)]vs[3.3(3.2,3.6),the difference was statistically significant(P<0.05);the serum ST2 value of persistent atrial fibrillation group was higher than that of paroxysmal atrial fibrillation group and control group([39.9(37.2,49.3)]vs[17.7(11.2,24.4)]and[14.3(10.3,19.5)),the difference was statistically significant(P<0.05).(2)In the correlation analysis of serum sst2,NT proBNP and lad,NT proBNP was positively correlated with serum sst2(r=0.314,P<0.05);lad was positively correlated with serum sst2(r=0.523,P<0.05).(3)In logistic regression analysis,serum sst2 was correlated with persistent atrial fibrillation(or=1.447,95%CI:1.087～1.926,P=0.011<0.05);there was no significant correlation between serum sst2 and paroxysmal atrial fibrillation(or=0.95,95%CI:0.835～1.080,P=0.432>0.05);NT proBNP and LAD were correlated with persistent atrial fibrillation(P<0.05).Conclusion:1.The serum levels of ST2 and NT proBNP in patients with AF were significantly higher than those in healthy controls.The serum levels of ST2 and NT proBNP in patients with persistent AF were higher than those in patients with paroxysmal AF,suggesting that the increase of the serum levels of ST2 may play an important role in the development of AF,indicating that the serum levels of ST2 can be used as a biomarker of the activity of AF.2.ST2 was positively correlated with NT proBNP and LAD in patients with AF,suggesting that high concentration of serum ST2 was related to the development of AF and atrial remodeling.The level of serum ST2 can be used as a biomarker of the disease activity of atrial fibrillation.High concentration of serum ST2 is related to the progress of atrial fibrillation and atrial remodeling.