Risk Factors Of Leukodystrophy In Patients With Nvaf And The Relationship Between B-type Diuretic Natriuretic Peptide,Cystatin C And Leukodystrophy

Objective:In recent years,the research about the relationship between atrial fibrillation and cerebral white matter lesions(white matter lesions,WMLs)has received the attention.There are many common risk factors between them.But the study of atrial fibrillation in patients with cerebral white matter lesions is relatively less.In this study the patients with nonvalvular atrial fibrillation as the object,we want to investigate the relationship between the atrial fibrillation and cerebral white matter lesions,and we want to investigate the B-type natriuretic peptide(Brain natriuretic peptide,BNP),cystatin C(CysC)and the relationship between the cerebral white matter lesions of concomitant atrial fibrillation.The aim is to improve people’s new understanding about the danger of atrial fibrillationMethods:The patients with nvaf admitted to the cerebrovascular disease treatment center of liaoning provincial people’s hospital from January,2008 to June,2019 were collected.The general conditions of the patients were collected and analyzed at baseline.These clinical data included basic baseline data,BNP,CysC,and cranial MRI.According to head MRI and use Fazekas score to assess the severity of leukoencephalopathy of these patients,WMLs was divided into 4 grades,with no score of:0.Mild WMLs:Fazekas(1-2 points);Moderate WMLs:Fazekas(3-4 points);Severe WMLs:Fazekas(5-6 points).The levels of B-type diuretic natriuretic peptide and cystatin C were detected by electrochemical luminescence and latex immunoturbidimetry,respectively.SPSS 21.0 software was used for data analysis Factors with statistical differences in univariate analysis were used as independent variables.White matter lesions were used as dependent variables for multivariate binary logistic regression analysis and multivariate binary logistic regression analysis after correction factors were included.The correlation of BNP,CysC and WMLs were analyzed by Spearson correlationResults:152 patients with nvaf were included in the study.The patients ranged in age from 51 to 91 years old,with an average of 74.85±9.50 years old,including 88 males(88/152,57.89%)and 64 females(64/152,42.11%),109 with hypertension(109/152,71.71%),44 with diabetes(44/152,28.95%),44 with hyperlipidemia(44/152,28.95%),and 110 with homocysteine(110/152,72.37%).The 152 patients with nvaf were classified by MRI according to Fazekas,including 1 with no WMLs,50 with mild WMLs(50/152,32.9%),68 with moderate WMLs(68/152,44.7%),and 33 with severe WMLs(33/152,21.7%),Univariate analysis showed(P<0.2)that,the age,male,smoking,BNP and CysC levels affected the severity of leuboencephalopathy,then multivariate binary logistic regression analysis suggested that the age and CysC were independent risk factors for WMLs in patients with nvaf.Spearman rank correlation analysis results showed that:age,hypertension,stroke history,smoking history,HCY and CysC were correlated with WMLs in patients with nvaf.Conclusions:The degree of WMLs in patients with nvaf was related to age,hypertension,history of stroke,smoking history,and CysC level.The age and CysC level were independent risk factors for WMLs in patients with nvaf.Patients with nvaf have higher proportion and more severe leukoencephalopathy(mainly moderate and severe).The age and CysC were independent risk factors for leukodystrophy in patients with nonvalvular atrial fibrillation,and leukodystrophy in patients with atrial fibrillation also worsened with age.Gender,hypertension,stroke history,smoking history,homocysteine and BNP levels affect the severity of leukodystrophy in patients with atrial fibrillation,but they are not independent risk factors for leukodystrophy in patients with nvaf.