Correlation Between Serum Uric Acid Level And Left Atrial Fibrosis In Patients With Atrial Fibrillation

Objective: To study the correlation between serum uric acid(SUA)level and the degree of left atrial fibrosis in patients with atrial fibrillation.Methods: Retrospective analysis of patients undergoing catheter radiofrequency ablation for atrial fibrillation(including paroxysmal and persistent atrial fibrillation),after bilateral pulmonary vein electrical isolation,the left atrial voltage map during sinus rhythm,if local bipolar signal <0.5m V,it is defined as low-voltage areas(LVAS).According to the range of the area of the low-voltage area in the total area of the left atrium,it is divided into two groups: <10%(N=57),≥10%(N =51),the larger the proportion of the area of the low-voltage zone,the more severe the degree of atrial fibrosis.Compare the age,gender,body mass index(BMI),glycosylated hemoglobin,white blood cell count(WBC),red blood cell count(RBC),platelet count(PLT),triglyceride(TG),total cholesterol(TC),SUA,Whether there is a difference between left atrium diameter(LAD)and other related indicators,multivariate logistic regression analysis was used to analyze the independent risk factors affecting the severity of atrial fibrosis,and the receiver operating characteristic(ROC)curve was drawn.Observe the value of SUA and other related indicators to predict the degree of left atrial fibrosis.Results: There were 108 cases in the study population,and there was no significant difference in baseline characteristics(sex,age,BMI,past medical history)between the two groups(P>0.05).The proportion of persistent atrial fibrillation,SUA,LAD,TG,smoking history,and alcohol history in the group with low voltage area ≥10% of the total area of the left atrium were higher than those in the group <10%,and the difference was statistically significant(P<0.05).Linear correlation analysis showed that the severity correlation index of SUA and left atrial fibrosis was 0.327(P=0.001),and there was a certain correlation between the two.Multivariate logistic regression analysis of the above indicators showed that SUA increased(OR 1.01,95%CI1.003-1.016,P=0.004),persistent atrial fibrillation(OR 11.041,95%CI2.479-49.166,P=0.002),Increased LAD(OR 1.146,95% CI 1.016-1.293,P=0.026)is an independent risk factor for the severity of atrial fibrosis.The ROC curve showed that the cut-off value of SUA level was 396.5 umol/l,the diagnostic efficiency was the highest,the sensitivity for predicting the level of left atrial fibrosis was 0.392,and the specificity was 0.965(Youden index0.357,AUC 0.702,95% CI 0.602-0.803,P<0.001),LAD cut-off value of37.5mm has the highest diagnostic efficiency,the sensitivity to predict the level of left atrial fibrosis is 0.706,the specificity is 0.754(Youden index0.460,AUC 0.779,95% CI 0.69-0.869,P<0.001),type of atrial fibrillation(AUC 0.72,95%CI 0.62-0.819,P<0.001).Conclusion: Serum uric acid level in patients with atrial fibrillation is an independent risk factor for the degree of left atrial fibrosis,and has certain reference value for predicting the degree of atrial fibrosis.