Significance And Change Of Peripheral Blood Monocytic Nicotinamide Adenosine Dinucleotide Phosphate Oxidase Activity And Malondialdehyde Concentration In Patients With Atrial Fibrillation

Objective: To investigate the significance and change of nicotinamide adenosinedinucleotide phosphate (NADPH) oxidase of peripheral blood mononuclear cells,malondialdehyde (MDA) and high-sensitivity C-reactive protein (hs-CRP) concentrationin patients with atrial fibrillation.Methods: Thirty-four hospitalized patients with atrial fibrillation from September2013to March2014were selected, and divided into persistent atrial fibrillationgroup(n=16) and paroxysmal atrial fibrillation group(n=18). Twenty-four hospitalizedpatients with paroxysmal supraventricular tachycardia were selected as control group. Onthe second day after admission, fasting blood was drawn to measure the level ofbiochemical markers. The concentration of MDA was measured by Enzyme-LinkedImmunosorbent Assay(ELISA) method, and the concentration of O2-and the NADPHoxidase activity were measured by the WST-1method. All patients received dopplerechocardiography to measure the left atrial diameter(LAD) and left ventricular ejectionfraction(LVEF). The concentrations of hs-CRP、malondialdehyde (MDA)、superoxide (O2-)and the activity of monocytic NADPH oxidase of each group were compared respectively,and the relationships between LAD and the above indexes were analyzed in patients withatrial fibrillation.Results:1. There were no significance of the general material among persistent atrialfibrillation group, paroxysmal atrial fibrillation group and control group（P>0.05）. 2. The concentration of hs-CRP[(4.88±2.40) mg/L] of persistent atrial fibrillationgroup was significantly higher than that of paroxysmal atrial fibrillation group [(2.33±1.03)mg/L] and control group [(1.14±0.86) mg/L](P <0.01), while there was no significantdifference of the concentration of hs-CRP between paroxysmal atrial fibrillation group andcontrol group(P>0.05). Neutrophil to lymphocyte ratio(NLR) of persistent atrial fibrillationgroup(2.87±1.46) was significantly higher than that of paroxysmal atrial fibrillationgroup(1.68±0.41) and control group(1.66±0.39)(P <0.01), while there was no significantdifference of NLR between paroxysmal atrial fibrillation group and control group(P>0.05).3. LAD of persistent atrial fibrillation group[(50.00±5.37) mm] was significantlygreater than that of paroxysmal atrial fibrillation group [(39.81±5.72) mm] and controlgroup [(38.21±7.70) mm](P <0.01), and LAD of paroxysmal atrial fibrillation group wassignificantly higher than that of control group(P <0.01).4. LVEF of persistent atrial fibrillation group(0.61±0.07) was significantly lower thanthat of paroxysmal atrial fibrillation group(0.68±0.06) and control group(0.69±0.06)(P<0.05), while there was no significant difference of LVEF between paroxysmal atrialfibrillation group and control group(P>0.05).5. The concentration of MDA of persistent atrial fibrillation group[(4.31±1.45)μmol/ml] was significantly higher than that of paroxysmal atrial fibrillation group[(3.00±0.87) μmol/ml] and control group [(2.31±0.81) μmol/ml](P<0.01), there was no significantdifference of the concentration of MDA between paroxysmal atrial fibrillation group andcontrol group(P>0.05). The concentration of O2-of persistent atrial fibrillationgroup[（964.4±441.7）RLU/mg protein] was significantly higher than that of paroxysmalatrial fibrillation group [(610.6±271.1) RLU/mg protein] and control group[（571.4±314.4）RLU/mg protein](P<0.05), there was no significant difference of the concentration of O2-between paroxysmal atrial fibrillation group and control group(P>0.05). The activity ofNADPH oxidase of persistent atrial fibrillation group[(5.31±1.02) RLU/mg protein] washigher than that of paroxysmal atrial fibrillation group[(3.86±0.90) RLU/mg protein] andcontrol group [(3.20±1.03) RLU/mg protein](P<0.05), there was no significant difference of the activity of NADPH oxidase between paroxysmal atrial fibrillation group and controlgroup(P>0.05).6. LAD had a positive correlation with the concentration of hs-CRP in patients withatrial fibrillation(r=0.74, P <0.01); LAD also had a positive correlation with theconcentration of MDA in patients with atrial fibrillation(r=0.57, P <0.01); while LAD hadno significant correlation with the concentration of O2-and the activity of NADPH oxidasein patients with atrial fibrillation(P>0.05).Conclusions:1. The concentration of hs-CRP and NLR of persistent atrial fibrillation group wassignificantly higher than that of paroxysmal atrial fibrillation group and control group,while there was no significant difference between paroxysmal atrial fibrillation group andcontrol group. This suggests that inflammation is involved in the occurrence andmaintaining of atrial fibrillation.2. The concentration of MDA and O2-, and the activity of monocytic NADPH oxidaseof persistent atrial fibrillation group were significantly higher than those of paroxysmalatrial fibrillation group and control group, while there was no significant differencebetween paroxysmal atrial fibrillation group and control group. This indicates that theoxidative stress is also involved in the occurrence and maintaining of atrial fibrillation.3. LVEF of persistent atrial fibrillation group was significantly lower than that ofparoxysmal atrial fibrillation group and control group, while there was no significantdifference between paroxysmal atrial fibrillation group and control group. This suggeststhat the heart function will be affected with the extended duration of atrial fibrillation.4. LAD of persistent atrial fibrillation group was significantly bigger than that ofparoxysmal atrial fibrillation group and control group, and LAD of paroxysmal atrialfibrillation group was significantly bigger than that of control group. LAD had significantpositive correlation with the concentrations of hs-CRP and MDA in patients with atrialfibrillation. This suggests that inflammation and oxidative stress are involved in theprocess of left atrial structural remodeling.