The Correlation Between Fibrosis Markers With Single Nucleotide Polymorphism Of TGF-β1 Gene And Atrial Fibrillation And The Predictive Value Of Atrial Fibrillation After Radiofrequency Ablation

Objective: By detecting the fibrosis markers serological levels of radiofrequency ablation before and after in atrial fibrillation,and then discuss the diagnostic index of morbidity and recurrence in atrial fibrillation.Testing major fibrotic markers of transforming growth factor beta 1 gene rs1800468 and rs1800469,and then explore the correlation between the gene and atrial fibrillation.The HATCH score of atrial fibrillation is taken as the dependent variable to establish HATCH score rating parameter model based on the serum level of fibrosis markers,then to evaluate the predictive value of it in the recurrence of atrial fibrillation,so as to find a new HATCH score that could predict the recurrence of atrial fibrillation after radiofrequency ablation more easily.Methods: Specimens were collected by using case control studies,there were 100 cases in the control group and 108 cases in the case group.Collecting general clinical informations of the subjects,patients were divided into two groups according to whether there was a recurrence of atrial fibrillation within three months after surgery,and detecting the serological levels of transforming growth factor beta 1,type I collagen peptide,carboxyl end type III collagen peptide amino end before,Hyaluronic Acid,Laminin,applying statistics software SPSS22.0 to draw ROC curve,through the area under the ROC curve(AUC),95%CI,P values to evaluate the diagnostic values for atrial fibrillation of TGF-beta 1,ⅠCTP,P IIIP N-P,HA and LN.To assess HATCH integral with the level of serum of each marker correlation regression analysis,HATCH after radiofrequency ablation of atrial fibrillation recurrence score parameter model was established and tested.Using polymerase chain reaction and the first-generation of sequencing technology to detect TGF-beta 1 gene rs1800468 and rs1800469 loci polymorphism,unconditional Logstic regression analysis is used to compare to rs1800468,rs1800469 loci gene polymorphism and the susceptibility of atrial fibrillation,its genotype and risk of atrial fibrillation,TGF-beta 1 serum level and HATCH score.Results: Compared with control group,preoperative TGF-beta 1 and ⅠCTP level of the group of atrial fibrillation was statistically difference between the two groups(P<0.05);The TGF-beta1,ⅠCTP level between radiofrequency ablation of atrial fibrillation group before and after operation has statistically increased and has statistical difference(P<0.05),and postoperative TGF-beta 1 is higher than the average preoperative and postoperative ⅠCTP preoperative below the average level.Recurrent atrial fibrillation group and non-recurrent group in age,total operation time,the dosage of contrast agent,LAD,LVEDD,BNP,cTn I,CRP and preoperative TGF-beta 1,ⅠCTP,HA,LN,PIIIP N-P,HATCH score level statistically significant(P<0.05);TGF-beta 1 level in preoperative and postoperative recurrence of atrial fibrillation group has increased statisticaltly and has statistical significance(p<0.05).In genotype combination analysis,atrial fibrillation group and the control group in double heterozygous mutation genotype GA/CT proportion is the largest.Compared carrying double wild GG/CC individual comparison,double the homozygous mutations combination of AA/TT distribution between individual in atrial fibrillation group and control group has statistical difference(P<0.05).Atrial fibrillation in the binary Logistic regression analysis,finding that age,TGF-beta1,ⅠCTP are risk factors for atrial fibrillation sick,HA,LN,PIIIP N-P are the protective factors of the atrial fibrillation.The two loci polymorphisms of TGF-beta1 gene rs1800468 and rs1800469 are the risk factors of atrial fibrillation.The expression of TGF-beta1 levels in rs1800468(F=4.596,P =0.008)and rs1800469(F=5.756,P=0.002)of TGF-beta1 gene loci are statistically significant among different genotypes,and the levels of serum from heterozygous mutations to homozygous mutations gradually increased.The area of TGF-beta1 under the ROC curve is the largest,indicating that it has the greatest diagnostic value for atrial fibrillation.Eventually establish regression equation:the HATCH scores = 0.026TGF-beta1+0.033ⅠCTP-0.054HA-0.028LN-0.032 PIIIPN-P-0.674,and then to verify the established scoring model.Conclusion: 1.TGF-beta 1,ⅠCTP serological levels could be used as assistant diagnostic indicators of atrial fibrillation,and TGF-beta 1 has the greatest assistant diagnostic value,TGF-beta1,ⅠCTP,HA,LN and PIIIP N-P serum levels could be used as predictive indicators of recurrence after radiofrequency ablation of atrial fibrillation.2.The polymorphisms of rs1800468,rs1800469 are associated with the susceptibility of atrial fibrillation,and-800A/-509 T is related to the occurrence of atrial fibrillation and the serous expression levels of TGF-beta 1.3.The HATCH scoring paramenter model is constructed based on the serum levels of TGF-beta1,ⅠCTP,HA,LN and PIIIP N-P:The HATCH scores = 0.026TGF-beta1+0.033ⅠCTP-0.054HA-0.028LN-0.032PIIIPN-P 0.674.The parameter model could be used as an assistant index to evaluate the recurrence of atrial fibrillation after radiofrequency ablation.