| Objective:To investigate the changes of serum high-senstive C-reactive protein (hs-CRP), Brain natriuretic peptide (BNP), endothelin-1 (ET-1) concentrations in patients with nonvalvular atrial fibrillation (AF) and their contribution to the occurrence and the maintenance of AF, the risk of ischemic stroke.Methods:A total of 162 patients were selected in cohort, who were in the Department of Cardiology, the Second Hospital of Tianjin Medicial University between November 2009 to October 2010. All patients were divided into three groups:the chronic nonvalvular AF group, the paroxysmal nonvalvular AF group and the sinus rhythm group(SR)(the three groups were comparable in sex, ages and pathogenetic condition). Patients with any situation below were excluded in our study:(1)valvar AF. (2)Acute coronary syndrome (ACS) with 3 months. (3) infectioous disease. (4) malignant tumor. (5) immunological disease. (6) histroy of wound and operation recently. (7) cerebrovascular disease within 6 months. (8) hepatic inadequency and renal inadequency. (9) thyroicl disease. (10) electrolyte disturbance nulli-retrieve. We comprhand the history of disease, physical examination and laboratory examination in detail. Blood samples were obtained after admission at about 6am on the second morning. ELISA was used to measure the concentration of BNP and ET-1. Hs-CRP concentration was measured by immunoturbidimetry. Then, we analysis the results by SPSS 11.5 statistic software.Results:(1) A total of 162 hospitalized patients were enrolled in the study. The SR group, the chronic AF (CAF) group, the paroxysmal AF (PAF) group had no statistical difference on sex, age, level of blood lipid, creatinine, urea nitrogen (p>0.05). Besides, the three groups had no statistical difference on prevalence of coronary heart disease (CHD), hypertension, diabetes, ischemic stroke (p>0.05). There were no statistical difference (p>0.05) of left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) among three groups, except for the comparison of left atrial diameter (LAD) reached statistical significance P<0.05). (2) Serum hs-CRP in SR group, CAF group and PAF group were respectively 1.52±0.95mg/L,2.34±1.40mg/L,3.39±2.39mg/L. ANOVA showed that there were statistical significance among the three groups (p<0.05). Then, LSD test was used to compare every two groups and there were statistical significance in any two group (p<0.05). The CAF group had the highest serum hs-CRP, the second was PAF group and the last was SR group. Serum BNP in the three groups were respectively 225.41±70.62pg/ml,345.52±137.01 pg/ml,407.10±131.91 pg/ml. ANOVA showed that there were statistical significance in the three groups (p<0.05). Then, LSD test was used to compare every two groups and there were statistical significance in any two group (p<0.05). The CAF group had the highest serum hs-CRP, the second was PAF group and the last was SR group. Serum ET-1 in the three groups were respectively 1.41±0.69 ng/ml,1.92±0.84 ng/ml,2.24±1.19ng/ml. ANOVA showed that there were statistical significance among three groups (p<0.05). Then, LSD test was used to compare every two groups. It showed that there were statistical significance between CAF group and SR group (p<0.05), PAF group and SR group (p<0.05). (3) According to the cause of AF, there were no statistical significance of serum hs-CRP, BNP, ET-1 in subset CHD group, subset hypertension group and CHD combined hypertension group in each AF groups(p>0.05). (4) There were no statistical significance in serum hs-CRP, BNP, ET-1 between male and female in each groups(p>0.05). (5) With the growth of age (50-60 years old,61-70 years old,71-80 years old,>80 years old), the prevalence of NVAF stepped up. (6) Pearson correlation test showed that the level of BNP was positively and statistically correlated with the level of ET-1 in AF group(r=o.35, p=0.000). The level of hs-CRP and ET-1, hs-CRP and BNP had no relationship(p>0.05). (7) Binary Logistic regression analysis showed serum BNP and LAD were good prediction index for the occurrence of AF (p<0.05). Serum hs-CRP had predictive value but no statistical significance (p>0.05). Serum ET-1 can't predict AF.Conclusion:(1) Inflammatory reaction participates in the occurrence and maintence of NVAF.(2) Cardiac atrium secretion of BNP is higher in AF patients, the longer AF maintenance the higher BNP. BNP is an anticipation index on AF occurrence.(3) Damaged endothelial function in AF increases the release of ET-1, increases the risk of ischemic stroke.(4) Larger LAD can predict AF occurrence, the longer AF maintenance the larger LAD. They are causation each other.(5) There is no relationship between serum hs-CRP, BNP, ET-1 and the cause of NVAF.(6) With the growth of age, the prevalence of AF steps up. |
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