The Relationship Between TLR2、HIF-1α、MMP-9with The Occurrence And Maintenance Of Atrial Fibrillation

ObjectiveAtrial fibrillation (AF) is one of the clinically frequent occurred tachyarrhythmia, it can do greatest harm to the patientsm. Its happening mechanism is relatively complex. In recent years, more and more researches found that between inflammation and atrial fibrillation occurrence and maintainance has a certain relevance. This study through the determination in patients with atrial fibrillation in the serum Toll sample receptor2(TLR2), matrix metalloproteinases9(MMP-9), HIF-1alpha (HIF-lα). To discuss the relation between TLR2、HIF-1α、MMP-9as immunological and inflammatory factor in the occurrence and maintenance of atrial fibrillation..Method:Patients in outpatient service, emergency treatment and hospitalization from Cardio department of the Second Hospital of Tianjin Medical University were enrolled. The cases we collected contained complete history from Mar2011to Oct2011.Basci clinical features, patient history, treatment, a part of clinical biochemical indicators of laboratory examinations and UCG results.125cases of atrial fibrillation were chosen,34cases were paroxysmal atrial fibrillation and49cases were persistent atrial fibrillation and42cases were permanent atrial fibrillation,38sinus rhythm cases were also selected into the control group. TLR2、HIF-1α、MMP-9levels of each group were compared and left atrial diameter and LVEF were measured, respectively. We use SPSS17.0statistical software to do statistical analysis, single factor analysis of variance and Chi-square test were applied to analyze the association between the level of TLR2, MMP-9, HIF-laand the occurrence and maintenance of atrial fibrillation in the four groups.Results:1. compare the basic clinical features of the four groups1.1compare the results of UCGLeft atrial diameter:Compared with left atrial diameter of persistent atrial fibrillation group (44.65±6.67) mm vs (41.15±5.53) mm,paroxysmal atrial fibrillation (44.65±6.67) mm vs (38.62±4.63) and control group (44.65±6.67) mm vs (38.03±3.80) mm,that of the permanent atrial fibrillation group increased significantly(P<0.05).The level of persistent atrial fibrillation group increased significantly than paroxysmal atrial fibrillation group (41.15±5.53) mm vs (38.62±4.63) mm, control group (41.15±5.53) mm vs (38.03±3.80) mm(P<0.05).But the level between persistent atrial fibrillation group and permanent atrial fibrillation group has no difference (P>0.05), the level between paroxysmal atrial fibrillation and control group has no difference (P>0.05)left ventricular ejection fraction(LVEF):compared with LVEF of persistent atrial fibrillation group (44.48±6.18)%vs (49.12±6.63)%, paroxysmal atrial fibrillation (44.48±6.18)%vs (56.18±7.11)%and control group (44.48±6.18)%vs (58.82±5.16)%,that of the permanent atrial fibrillation group decreased significantly (P＜0.05). Compared with paroxysmal atrial fibrillation (49.12±6.63)%vs (56.18±7.11)%and control group (49.12±6.63)%vs (58.82±5.16)%, that of the persistent atrial fibrillation group decreased significantly (P<0.05). But the level between persistent atrial fibrillation group and permanent atrial fibrillation group has no difference (P>0.05), the level between paroxysmal atrial fibrillation and control group has no difference (P>0.05).1.2compare the other basic clinical features of the four groupsThe age, gender and basic diseases have no difference in the four groups(P>0.05).2.the level of TLR2、MMP-9、HIF-1α in the four groups2.1the level of TLR2in the four groupsTLR2level of permanent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation group and the control group (846.59±341.51) ng/L vs (522.14±292.08) ng/L、557.70±366.81ng/L (P＜0.05),the level of persistent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation group and the control group (807.49±417.99) ng/L vs (522.14±292.08) ng/L、557.70±366.81ng/L (P＜0.05),the level of permanent atrial fibrillation group between persistent and paroxysmal atrial fibrillation have no differences, the level between paroxysmal atrial fibrillation and control group has no difference(P>0.05). 2.2. the level of MMP-9in the four groupsThe MMP-9level of permanent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation and control group (798.99±254.43) ng/L vs (501.94±288.31) ng/L、(497.95±329.37) ng/L (P＜0.05), the level of persistent atrial fibrillation group was significantly higher than that of paroxysmal atrial fibrillation and control group (745.74±301.84) ng/L vs (501.94±288.31) ng/L、(497.95±329.37) ng/L (P＜0.05) the level between permanent atrial fibrillation group and persistent atrial fibrillation group has no difference (P>0.05),the level between paroxysmal atrial fibrillation and control group has no difference (P>0.05)2.3. the level of HIF-1α in the four groupsThe HIF-1α level of permanent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation and control group (83.12±26.39) ng/L vs (67.15±31.91) ng/L、(55.97±18.01) ng/L (P＜0.05); the level of persistent atrial fibrillation group was significantly higher than that of control group (75.02±34.89) ng/L vs (55.97±18.01) ng/L (P＜0.05), the level between permanent atrial fibrillation group and persistent atrial fibrillation group has no difference (P>0.05),the level between paroxysmal atrial fibrillation and control group has no difference (P>0.05) Conclusions:The increase of TLR2、HIF-1α、MMP-9level probably participates in occurrence of atrial fibrillation, thus it indicates that the inflammatory reaction may promote the occurrence and maintenance of atrial fibrillation.