| Atrial fibrillation(AF),especially Non-valvular Atrial fibrillation(NVAF),is one of the most common arrhythmias in clinical practice.It is often associated with ischemic stroke and heart failure,causing severe disability and mortality.Atrial fibrillation increased the risk of stroke and was an independent predictor of cognitive decline.Our study explored the correlation and interaction between cognitive impairment and cerebral perfusions,inflammatory factors and cognitive decline,and the correlations between cognitive function and inflammatory markers in patients with AF.Part Ⅰ Cerebral Blood Perfusion Related to Cognitive Impairment in Patients with Atrial FibrillationObjective To study the correlations between cognitive impairment and cerebral blood perfusions in patients with atrial fibrillation.Methods From July 2018 to August 2020,167 inpatients in the First Affiliated Hospital of Guangxi Medical University were selected,aged(65.4±9.83),118 males and 49 females.All patients with non-valvular atrial fibrillation and no history of stroke or TIA were selected.Patients with atrial fibrillation included 63 cases of paroxysmal atrial fibrillation,57 cases of persistent atrial fibrillation,and 47 cases of permanent atrial fibrillation.Exclude patients with secondary atrial fibrillation and patients with acute disease in the past 4 weeks.MRI plain scan distinguishes different patients with atrial fibrillation according to SNCIs,LNCCIs,WML,and microbleeds.Mo CA score,CT perfusion scan to obtain cerebral volumetric cerebral blood flow r CBV value,regional cerebral blood flow r CBF value,average blood transit time MTT value,peak blood flow TTP value,and perfusion parameter maps.Results 1.There were no significant differences in sex,BMI,smoking and educational levels.The LNCCI group had higher incidence in the olds,hypertension and diabetes,while there were no similar changes in SNCI and microbleeds.The incidence of cerebral lesions detected by MRI was 22% in LNCCI,26% in SNCI,29% in microbleeds and 90% in white matter lesionss.2.The Mo CA score of patients with or without cerebral lesions.In the comparison of Mo CA scores for cognitive function evaluation,patients with SNCI,LNCCI and WML were significantly lower than those without,except for patients with microbleeds.The correlation between Mo CA and different types of cerebral lesions: In patients with SNCI and microbleeds,there is no correlation between cerebral lesions and Mo CA.In LNCCI patients,cerebral lesions is significantly correlated with Mo CA,r=-0.83,P<0.0001.In patients with WML,there is a significant correlation between cerebral lesions and Mo CA,r=-0.74,P<0.0001.The estimated parameters of the multivariate linear regression model of Mo CA and cerebral lesions in LNCCI patients were β=-0.25,P=0.0001.3.There were no significant differences in different types of atrial fibrillation of cerebral lesions in gender,BMI,smoking and education.In LNCCI,compared with non-accompanied persons,persistent atrial fibrillation and permanent atrial fibrillation,who were older(70.7±5.80: 64.3±5.36,P=0.037;75.3±8.62: 65.1±8.36,P=0.025),hypertension(8:6,P=0.032;7:5,P=0.043),diabetic patients(7:5,P=0.04,2:7,P=0.031)have a high incidence of cerebral lesions.However,there was no increase in the incidence of age,blood pressure and diabetes in SNCI,microbleeds.4.Mo CA and cerebral perfusion results of different types of atrial fibrillation with and without SNCI.(1)Comparison of Mo CA,CBF(ml/100g/min),CBV(ml/100g),MTT(s),TTP(s)with and without SNCI of different types of atrial fibrillation showed no significant difference in CBV.Compared with patients with different types of atrial fibrillation with SNCI,paroxysmal atrial fibrillation Mo CA(24.88±0.34: 26.85±0.72,P=0.001),CBF(50.937±4.0: 53.98±3.35,P=0.013),Both decreased significantly;MTT and TTP increased significantly(4.79±0.17: 4.25±0.15,P=0.001;12.38±1.59: 10.83±1.45,P=0.014).Mo CA for persistent atrial fibrillation and permanent atrial fibrillation was significantly reduced(24.27±0.59:26.09±0.297,P<0.001;23.67±0.49:26.03±0.17,P<0.001),and CBF was significantly reduced(46.13±4.34:49.28±3.69,P=0.012;45.58±1.83: 48.95±3.61,P=0.011),MTT and TTP increased significantly(5.32±0.57: 4.71±0.63,P=0.0014;13.8±1.13: 11.56±1.13,P=0.011;5.65±0.45 : 5.11±0.53,P=0.0013;14.58±0.99: 12.36±1.2,P=0.001).In the CT perfusion map of cerebral blood flow,the CBF of permanent atrial fibrillation with SNCI was significantly less than that of the patients without SNCI,and the TTP of atrial fibrillation with SNCI was significantly longer than that of the patients without SNCI.(2)Comparison of Mo CA,CBF,MTT,TTP with different types of atrial fibrillation with SNCI,in different types of atrial fibrillation with SNCI,the reduction of Mo CA is manifested as permanent atrial fibrillation>persistent atrial fibrillation>paroxysmal atrial fibrillation,CBF reduction manifested as permanent atrial fibrillation/persistent atrial fibrillation> paroxysmal atrial fibrillation,there was a significant difference.There was no significant difference between persistent and permanent atrial fibrillation.The increase of TTP and MTT manifested as permanent atrial fibrillation/persistent atrial fibrillation> paroxysmal atrial fibrillation,with significant differences.There was no significant difference between persistent atrial fibrillation and permanent atrial fibrillation.5.Mo CA and cerebral perfusion results of different types of atrial fibrillation with and without LNCCI.1).There was no significant difference in CBV between Mo CA,CBF,CBV,MTT,TTP groups of different types of atrial fibrillation with LNCCI and without LNCCI.Compared with Mo CA and CBF of different types of atrial fibrillation with LNCCI than those without LNCCI,paroxysmal atrial fibrillation: 24.47±0.52: 26.37±0.53,P<0.001;48.93±3.79: 52.48±5.34,P=0.031;continuous Atrial fibrillation 23.83±0.58: 26.04±0.21,P<0.001;45.42±3.85: 49.56±4.58,P=0.021;Permanent atrial fibrillation 22.8±0.79: 26.02±0.16,P<0.001;42.1±2.33:46.87±3.28,P=0.015,both were significantly reduced.Comparing MTT and TTP,paroxysmal atrial fibrillation 4.84±0.18: 4.15±0.23,P=0.001;13.07±1.33: 11.47±1.24,P=0.01;persistent atrial fibrillation 5.41±0.38 : 4.76±0.18,P=0.001;14.58±1.44: 12.78±1.56,P=0.014,permanent atrial fibrillation 5.98±0.70: 5.21±0.64,P=0.001;16.1±1.37: 14.62±1.41,P=0.01,both obviously increase.In the cerebral blood flow CT perfusion map,different types of atrial fibrillation with LNCCI,including paroxysmal atrial fibrillation,persistent atrial fibrillation,and permanent atrial fibrillation,had significantly less CBF than those without counterparts.Different types of atrial fibrillation with LNCCI TTP was significantly longer than that of unaccompanied patients.2).Comparison of Mo CA,CBF,MTT,TTP with different types of atrial fibrillation with LNCCI showed that the Mo CA and CBF of patients with LNCCI were significantly reduced,and the reduction range was permanent atrial fibrillation>persistent atrial fibrillation>paroxysmal atrial fibrillation,which were significant differences.MTT and TTP increased,and the increase range was permanent atrial fibrillation>persistent atrial fibrillation>paroxysmal atrial fibrillation,showed a significant difference.6.There was no significant difference between the groups of MOCA,CBF,CBV,MTT,TTP with and without microbleeds.7.Correlation between different types of atrial fibrillation perfusion indexes with different brain injuries and Mo CA.Among the different types of atrial fibrillation perfusion indexes with SNCI cerebral lesions,paroxysmal atrial fibrillation,persistent atrial fibrillation CBF,CBV,MTT,TTP had no significant correlation with Mo CA,and CBF of permanent atrial fibrillation had a significant positive correlation with Mo CA: =0.638,P=0.025.The correlations between MTT,TTP and Mo CA were: r=-0.646,P=0.023;r=-0.624,P=0.031,a significant negative correlation.Among different types of atrial fibrillation with LNCCI,the correlation between CBF and Mo CA in paroxysmal atrial fibrillation,persistent atrial fibrillation,and permanent atrial fibrillation were: r=0.674,P=0.0058;r=0.607,P=0.036;r=0.798,P=0.0057,both were significantly positively correlated.CBV had no obvious correlation.The correlation between MTT and Mo CA in paroxysmal atrial fibrillation,persistent atrial fibrillation,and permanent atrial fibrillation were: r=-0.633,P=0.0113;r=-0.648,P=0.0228;r=-0.721,P= 0.0186 had a significant negative correlation.The correlation between TTP and Mo CA in paroxysmal atrial fibrillation,persistent atrial fibrillation,and permanent atrial fibrillation were: r=-0.774,P=0.0007;r=-0.813,P=0.0013;r=-0.821,P= 0.0036.Among different types of atrial fibrillation with microbleeds,CBF,CBV,MTT,TTP and Mo CA were not related.8.Different types of atrial fibrillation perfusion indexes with different brain injuries and parameter estimation of Mo CA regression model.In permanent atrial fibrillation with SNCI cerebral lesions,the β parameters fitted by the perfusion index CBF,MTT,TTP and Mo CA regression model were: β=0.17,P=0.015;β=-0.37,P=0.034;β=-0.42,P=0.02,there was significant difference,CBV was not significant.Paroxysmal atrial fibrillation,persistent atrial fibrillation related perfusion indicators and Mo CA model β parameter estimates hadno significant difference.In different types of atrial fibrillation with LNCCI,the paroxysmal atrial fibrillation perfusion index CBF,MTT,TTP and the β parameters fitted by the Mo CA regression model were: β=0.08,P=0.001;β=-1.86,P=0.01,β=-0.29,P=0.001,there were significant differences.The β parameters of CBF,MTT,TTP and Mo CA regression model fitted by persistent atrial fibrillation perfusion indexes were: β=0.09,P=0.016;β=-0.98,P=0.02;β=-0.3,P=0.0013;significant difference.The β parameters of permanent atrial fibrillation perfusion indexes CBF,MTT,TTP and Mo CA regression model fitting were β=0.26,P=0.005;β=-0.8,P=0.018;β=-0.43,P=0.003,which is significant difference.There was no significant difference in CBV.In different types of atrial fibrillation with microbleeds,the perfusion indexes CBF,CBV,MTT,TTP and the β parameters fitted by the Mo CA regression model had no significant differences.Conclusions Among patients with atrial fibrillation who do not have a stroke clinically,the patients may have different degrees of cerebral lesions and insufficient cerebral perfusion,which can cause cognitive decline.Cognitive impairment caused by atrial fibrillation is related to cerebral lesion,which may be related to changes in cerebral blood flow.Patients with LNCCI,CBF,MTT,TTP,changes in cognitive function have obvious changes;permanent atrial fibrillation or persistent atrial fibrillation had a higher degree of cerebral lesions and cerebral perfusion changes than paroxysmal atrial fibrillation,and a higher degree of cognitive decline.With SNCI,perfusion changes affect cognitive function only in permanent atrial fibrillation.There are few changes in cerebral perfusion in patients with microbleeds,and no cognitive dysfunction occurs.Part Ⅱ Inflammatory Markers Related to Cognitive Impairment in Patients with Atrial FibrillationObjective To study the correlation between cognitive dysfunction and inflammatory factors in patients with atrial fibrillationMethods The experimental blood samples were derived from the selected cases in the first part,and the exclusion criteria were the same.Choose human Creactive protein,human interleukin 6,human tumor necrosis factor alpha ELISA kit,fibrinogen Clauss kit.ELISA and Clauss methods were used to detect the concentration of the respective observation samples.Results 1.Detection of Mo CA and inflammation indicators CRP,FIB,IL-6 and TNF-α of different types of atrial fibrillation with and without SNCI.In comparison within the group,compared with those without SNCI,patients with different types of atrial fibrillation with SNCI had lower Mo CA(same as part one).CRP in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 2.50± 0.47: 1.06 ± 0.39,P <0.0001;2.99 ± 0.44: 1.15 ± 0.38,P <0.0001;3.85 ± 0.48: 1.12 ± 0.44,P <0.0001;FIB in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation The tremors were: 2.69±0.26:2.51±0.25,P=0.017;2.95±0.31:2.54±0.25,P<0.0001;3.19±0.39:2.60±0.26,P<0.0001.IL-6 in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 1.99±0.25:1.65±0.41,P=0.008;2.33±0.23:1.66±0.39,P<0.0001;2.40±0.22: 1.69±0.48,P<0.0001;TNF-α in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were 4.02±0.54:2.08±0.33,P<0.0001;4.72±0.69:2.14±0.30,P <0.0001;5.14±0.80: 2.16±0.36,P<0.0001,both were significantly higher.In comparison between groups,in different types of atrial fibrillation with SNCI,Mo CA decreased(same as the first part),CRP,FIB,IL-6 and TNF-α increased,and CRP showed an increase of permanent atrial fibrillation> persistent atrial fibrillation Fibrillation> paroxysmal atrial fibrillation,there was a significant difference.The increase of FIB,IL-6 and TNFα manifested as permanent atrial fibrillation/persistent atrial fibrillation> paroxysmal atrial fibrillation,with significant differences.There was no significant difference between persistent atrial fibrillation and permanent atrial fibrillation.2.Detection of Mo CA and inflammation indexes CRP,FIB,IL-6 and TNF-α of different types of atrial fibrillation with and without LNCCI.Compared within the group,different types of atrial fibrillation with LNCCI had lower Mo CA than those without LNCCI(same as part one).CRP in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were 2.52±0.53vs1.11,respectively ±0.31,P<0.0001;3.02±0.47: 1.19±0.40,P<0.0001;3.91±0.37: 1.22±0.33,P<0.0001;FIB in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were respectively :2.92±0.18: 2.64±0.26,P=0.0002;3.41±0.78: 2.72±0.34,P<0.0001;4.44±1.28: 2.73±0.22,P<0.0001;IL-6 in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 3.00±0.25: 1.72±0.41,P<0.0001;3.27±0.19: 1.72±0.43,P<0.0001;3.59±0.23: 1.74±0.36,P<0.0001;TNF-α was in the array Primary atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 5.25±0.87: 2.16±0.31,P<0.0001;6.28±0.81: 2.17±0.31,P<0.0001;7.28±0.79: 2.18±0.33,P<0.0001;Both were significantly increased.In comparison between groups,the Mo CA of patients with LNCCI decreased,and CRP,FIB,IL-6 and TNFα were significantly increased.The range of increase was permanent atrial fibrillation>persistent atrial fibrillation>paroxysmal atrial fibrillation,with significant differences.3.The Mo CA and inflammatory levels of CRP,FIB,IL-6 and TNF-α of different types of atrial fibrillation with and without microbleeds were not significantly reduced in comparison within and between groups and groups.4.The correlation between different types of atrial fibrillation inflammation indicators with different cerebral lesions and Mo CA.Among the inflammatory indicators of different types of atrial fibrillation with SNCI cerebral lesions,paroxysmal atrial fibrillation,persistent atrial fibrillation CRP,FIB,IL-6 and TNFα had no significant correlation with Mo CA,and the correlation between CRP,FIB,IL-6,TNFα and Mo CA in permanent atrial fibrillation were: r=-0.756,P=0.004;r=-0.765,P=0.0038;r=-0.782,P=0.0026,r=-0.729,P=0.007,there was a significant negative correlation.Among different types of atrial fibrillation with LNCCI,the correlations between CRP,FIB,IL-6 and TNFα and Mo CA in paroxysmal atrial fibrillation were: r=-0.729,P=0.002;r=-0.775,P=0.0007,r=-0.736,P=0.0018,r=-0.722,P=0.0024;the correlations between CRP,FIB,IL-6 and TNFα and Mo CA in persistent atrial fibrillation were: r=-0.786,P=0.0025;r=-0.77,P=0.0033;r=-0.818,P=0.0011;r=-0.804,P=0.0016;the correlations between CRP,FIB,IL-6 and TNFα and Mo CA in permanent atrial fibrillation were: r=-0.843,P=0.0022;r=-0.814,P=0.0041;r=-0.807,P=0.0047;r=-0.842,P=0.0022;all had significant negative correlation.In different types of atrial fibrillation with microbleeds,CRP,FIB,IL-6 and TNFα were not significantly correlated with Mo CA.5.Different types of atrial fibrillation inflammation indexes with different cerebral lesions and parameter estimation of Mo CA regression model.In permanent atrial fibrillation with SNCI cerebral lesions,the inflammatory indexes CRP,FIB,IL-6 and TNFα and the β parameters fitted by the Mo CA regression model were β=-0.64,P=0.003;β=-0.87,P=0.001,respectively;β=-1.52,P=0.002;β=-0.34,P=0.001,with significant differences.There was no significant difference between the inflammatory indexes of paroxysmal atrial fibrillation and persistent atrial fibrillation and the β parameter estimation of the Mo CA models.In different types of atrial fibrillation with LNCCI,the inflammatory indexes CRP,FIB,IL-6 and TNFα of paroxysmal atrial fibrillation and the β parameters fitted by the Mo CA regression model were β=-0.51,P=0.163;β=-1.18,respectively.P=0.21;β=-0.85,P=0.22;β=-0.33,P=0.16,there was no significant difference.Persistent atrial fibrillation inflammation indicators CRP,FIB,IL-6 and TNFα and the β parameters fitted by the Mo CA regression model were: β=-0.68,P=0.001;β=-0.47,P=0.001;β=-1.72,P=0.001;β=-0.48,P=0.002,with significant difference.The β parameters fitted by the permanent atrial fibrillation indicators CRP,FIB,IL-6 and TNFα and Mo CA regression model were: β=-1.31,P=0.001;β=-0.36,P=0.001;β=-1.95,P=0.002,β=-0.63,P=0.001,there were significant differences.There were no significant differences in the parameters of CRP,FIB,IL-6 and TNF fitting MOCA regression model in different types of AF with microbleeds.Conclusions In patients with atrial fibrillation without clinical stroke,dementia or cognitive decline was accompanied by an increase in inflammation indicators: CRP,FIB,IL-6 and TNFα.Inflammatory factors and inflammatory reactions may cause cerebral lesion through decreased cerebral blood flow.Among the patients with atrial fibrillation with LNCCI or SNCI,the cognitive function decline of permanent atrial fibrillation or persistent atrial fibrillation was more obvious than that of paroxysmal atrial fibrillation.Part Ⅲ Blood Markers Related to Cognitive Impairment in Patients with Atrial FibrillationObjective To study the correlation between amyloid precursor protein,glycogen synthase kinase 3 and cognitive impairment and inflammatory factors in atrial fibrillation.Methods The experimental blood samples were derived from the selected cases in the first part,and the exclusion criteria and grouping were the same.Use human amyloid precursor protein(APP)enzyme-linked immunosorbent assay kit,human amyloid precursor protein(APP-α,APP-β)enzyme-linked immunosorbent assay kit,human glycogen synthase kinase 3α(GSK3α),3β(GSK3β)enzyme-linked immunoassay kit.Enzyme-linked immunosorbent assay ELISA was used to detect the concentration of the respective observation samples.Use rabbit anti-GSK3 antibody,anti-GSK3(alpha + beta)antibody,and internal reference antibody to detect GSK3β and GSK3αβ by Western blot.Results 1.Mo CA and APP,GSK3 with and without SNCI in different types of atrial fibrillation.Intra-group comparison of Mo CA,APPα,APPβ,APP,GSK3α,GSK3β with different types of AF with and without SNCI.Compared with those without SNCI,patients with different types of AF with SNCI had lower Mo CA(same as above).The APPβ groups in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were 1.92±0.59:1.15±0.47,P < 0.0001;2.78±0.80vs1.21±0.46,P<0.0001;2.92±0.70: 1.26±0.55,P<0.0001;GSK3β groups in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 3.97±0.69:3.19±0.66,P=0.0001;4.94±0.79:3.22±0.75,P<0.0001;5.32±0.70: 3.27±0.69,P<0.0001;APPβ and GSK3β were significantly increased,APPα,APP,GSK3α were not significantly increased.In comparison between groups,in different types of atrial fibrillation with SNCI,Mo CA decreased(same as above),APPβ,GSK3β increased,and the manifestations were permanent atrial fibrillation/persistent atrial fibrillation>paroxysmal atrial fibrillation.There was no significant difference between persistent atrial fibrillation and permanent atrial fibrillation.2.Mo CA and APP,GSK3 of different types of atrial fibrillation with and without LNCCI.Mo CA with and without LNCCI of different types of atrial fibrillation,APPα,APPβ,APP,GSK3α,GSK3β group comparison,different types of atrial fibrillation with LNCCI lower than those without LNCCI Mo CA(same as above),APPβ in the two groups Primary atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 1.95±0.67:1.21±0.50,P < 0.001;2.83±0.71:1.26±0.43,P<0.0001;3.83±0.45:1.31±0.41,P <0.0001;GSK3β groups in paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation were: 5.23±0.69: 3.26±0.67,P<0.0001;6.10±0.82: 3.24±0.70,P < 0.0001;7.16 ±0.77: 3.26±0.71,P<0.0001;APPβ,GSK3β all increased significantly,APPα,APP,GSK3α did not increase significantly(P>0.05).In comparison between groups,the Mo CA of patients with LNCCI decreased,APPβ and GSK3β were significantly increased,and the increase range was permanent atrial fibrillation>persistent atrial fibrillation>paroxysmal atrial fibrillation,with significant differences.3.Mo CA and APP,GSK3 indicators of different types of atrial fibrillation with and without microbleeds.There were no significant differences between groups of Mo CA,APPα,APPβ,APP,GSK3α,GSK3β with and without microbleeds in different types of atrial fibrillation.4.Correlation between different types of atrial fibrillation APP with different cerebral lesions,GSK3 and Mo CA.Among the inflammatory indicators of different types of atrial fibrillation with SNCI brain injury,paroxysmal atrial fibrillation,persistent atrial fibrillation APPα,APPβ,APP,GSK3α,GSK3β had no significant correlation with Mo CA,and permanent atrial fibrillation had no significant correlation between APPα,GSK3α and Mo CA.Significant correlation.The correlations between APPβ,GSK3β and Mo CA were: r=-0.782,P=0.0027;r=-0.747,P=0.0053;both were significant negative correlations.Among different types of atrial fibrillation with LNCCI,APPα,GSK3α had no significant correlation with Mo CA,and the correlations between APPβ,GSK3β and Mo CA in paroxysmal atrial fibrillation were: r=-0.749,P=0.0013;r=-0.773,P =0.0007;the correlations between APPβ,GSK3β and Mo CA in persistent atrial fibrillation were: r=-0.726,P=0.0076;r=-0.781,P=0.0027;the correlations between APPβ,GSK3β and Mo CA in permanent atrial fibrillation are respectively : R=-0.788,P=0.0068;r=-0.775,P=0.0086 were all significant negative correlations.Among different types of atrial fibrillation with microbleeds,APPα,APPβ,GSK3α,GSK3β have no significant correlation with Mo CA.5.Different types of atrial fibrillation APP with different cerebral lesions,GSK3 and Mo CA regression model parameter estimation.For paroxysmal atrial fibrillation with SNCI brain injury and APP for persistent atrial fibrillation,there was no significant difference between GSK3 :and Mo CA model β parameter estimation.In permanent atrial fibrillation,APP,GSK3 indicators APPβ,GSK3β and the β parameters fitted by the Mo CA regression model were respectively:-0.158,P=0.01;-0.248,P=0.001,with significant differences,while the β of APPα and GSK3α were no significant difference in parameters.Among different types of atrial fibrillation with LNCCI,paroxysmal atrial fibrillation APP,GSK3:APPα,APPβ,GSK3α,GSK3β and the β parameters fitted by the Mo CA regression model had no significant differences.Persistent atrial fibrillation inflammation indicators APPβ,GSK3β and the β parameters fitted by the Mo CA regression model are respectively:-0.293,P=0.001;-0.256,P=0.001,with significant differences,while the β parameters of APPα and GSK3α were not significant.For permanent atrial fibrillation APP,GSK3 indicators APPβ,GSK3β and the β parameters fitted by the Mo CA regression model are respectively:-0.361,P=0.001;-0.397,P=0.001,which have significant differences.The β parameters of APPα and GSK3α were not significant.In different types of atrial fibrillation with microbleeds,APP,GSK3,APPα,APPβ,GSK3α,GSK3β and the β parameters fitted by the Mo CA regression model had no significant differences.6.Correlation between inflammatory indicators of different types of atrial fibrillation with different cerebral lesions and APPβ.Among the inflammatory indicators of different types of atrial fibrillation with SNCI brain injury,CRP,FIB,IL-6 and TNFα in paroxysmal atrial fibrillation,persistent atrial fibrillation had no significant correlation with APPβ,and the correlation between CRP,FIB,IL-6,TNFα and APPβ in permanent atrial fibrillation were: r=0.824,P=0.001;r=0.782,P=0.0027;r=0.728,P=0.0073;r=0.741,P=0.0058;both showed significant positive correlation.Among different types of atrial fibrillation with LNCCI,the correlations between CRP,FIB,IL-6 and TNFα and APPβ were: paroxysmal atrial fibrillation was r=0.737,P=0.0017;r=0.741,P=0.0016;r= 0.731,P=0.0019;r=0.713,P=0.0029;persistent atrial fibrillation is r=0.831,P=0.0008;r=0.784,P=0.0026;r=0.782,P=0.0027;r=0.776,P=0.0030;Permanent atrial fibrillation was r=0.857,P=0.0016;r=0.823,P=0.0035;r=0.815,P=0.0041;r=0.816,P=0.0040;both showed a significant positive correlation.In different types of atrial fibrillation with microbleeds,CRP,FIB,IL-6 and TNFα were not significantly correlated with APPβ.7.Correlation between different types of atrial fibrillation inflammation indicators with different cerebral lesions and GSK3β.There was no significant correlation between GSK3 and levels of CRP,FIB,IL-6 and TNF in patients with paroxysmal atrial fibrillation,persistent atrial fibrillation,and CRP,FIB,IL-6 and TNF in patients with SNCI brain lesion.The levels of CRP,FIB,IL-6 and TNF in patients with permanent AF were r = 0.773,p = 0.0032 respectively R = 0.808,p = 0.0015;r = 0.768,p = 0.0035;r = 0.817,p = 0.0013;all of them showed significant positive correlation.The correlation between CRP,FIB,IL-6 and TNF and GSK3 in different types of AF with LNCCI was r = 0.739,p = 0.0016;r = 0.737,p = 0.0017;r = 0.759,p = 0.001;r = 0.752,p = 0.0012;r = 0.809,p = 0.014 in patients with persistent AF;R = 0.829,p = 0.0008;r = 0.745,p = 0.0055;r = 0.783,p = 0.0026;r = 0.833,p = 0.0027;r = 0.841,p = 0.0023;r = 0.832,p = 0.0028;r = 0.825,p = 0.0033;all showed significant positive correlation.There was no significant correlation between CRP,FIB,IL-6 and TNF and GSK3 in different types of AF with microbleeds.8.Expression of GSK3β and GSK3αβ GSK3β and GSK3αβ were detected by Western blot in patients with atrial fibrillation with normal cognition and cognitive impairment.The results showed that the expression of GSK3β and GSK3αβ was enhanced in the cognitive impairment group(p<0.001).The enhancement of GSK3β expression was significantly higher than that of GSK3αβ(p<0.001).Conclusion In patients with atrial fibrillation without clinical stroke,dementia or cognitive decline is accompanied by APPβ and GSK3β increase,which is also associated with a significant increase in inflammation indicators CRP,FIB,IL-6 and TNFα. |
PDF Full Text Request