Relation Of Homo Cysteine And Cardiotrophin-1Levels With Recurrence Of Atrial Fibrillation After Catheter Ablation Of Atrial Fibrillation

Objective:It’s found that oxidative stress and inflammation factors play important roles inthe occurrence and maintenance of atrial fibrillation (Af). Homocystine (HCY) as anew oxidative stress factor causing blood vessel damage, has attracting more andmore attention in recent years, as well as the relationship between cytokine,cardiotrophin-1(CT-1) and Af. In this study, we explored the relationship betweenHCY and CT-1levels and Af, and the relationship with the Af recurrence Aftercatheter ablation.Method:In this study, we selected157cases (99male cases and58female cases)undergoing Af catheter ablation in the vasculocardiology department of our hospitalduring the period of June2011to April2013, including paroxysmal Af (100cases)and persistent Af (57cases).20cases of matched gender and age (basic data similarto theAf group, but without Af) were selected as control (control group). Preoperativeexamination included CT-1, HCY, B-type brain natriuretic peptide (BNP), Highsensitive C-reactive Protein (hs-CRP), hepatorenal function, myocardial enzymology,thyroid function, cardiac color ultrasound and dynamic electrocardiogram (DCG), etc.Performed DCG for24h at postoperative3,6and12months, respectively, when anydiscomfort was present, visited the local or our hospital at any time. If patients havesymptom of palpitation, but ECG and Holter uncaught atrial fibrillation, we couldperform remote ECG monitoring. Divided the patients into recurrence group andnon-recurrence group according to the Af recurrence After one-year follow-up, andcarried out retrospective analysis. In statistics, variance analysis was used for thecomparison within group, and t-test for the comparison between groups, P<0.05indicated a statistically difference. Multivariable logistic regression analysis andPearson correlation analysis were carried out on the Af occurrence and risk factors fortheAf recurrenceAfter catheter ablation. Results:1. The one-year recurrence rate After Af ablation was29.9%(47/157), of whichthe recurrence of paroxysmal Af was24.0%(24/100), and persistent Af was40.4%(23/57).2. Compared the157Af cases with control group, the results showed that theplasma CT-1, BNP and HCY in Af group were all higher than those in control group(P<0.05). Multivariable logistic regression analysis showed that the plasma HCY andCT-1levels were independently associated with the Af occurrence [OR=1.26,95%CI(1.01~1.57), P=0.045];[OR=1.01,95%CI (1.00~1.02), P=0.049].3. Both the plasma HCY and CT-1levels in47patients with recurrence weresignificantly increased, compared with the110patients without recurrence (P<0.05),regardless of whether it’s paroxysmal or persistent Af, both the plasma HCY andCT-1levels in recurrence group were higher than those in non-recurrence group(P<0.05).4. Multiariable logistic regression analysis showed that the plasma HCY andCT-1levels were independently associated with the recurrence After Af ablation[OR=1.39,95%CI (1.01~1.90),P=0.042];[OR=1.04,95%CI (1.02~1.06),P<0.001].5. The plasma CT-1level was positively correlated with left atrial diameter(r=0.36,P<0.01); and plasma BNP (r=0.40,P<0.01). The plasma HCY was positivelycorrelated with hs-CRP (r=0.60,P<0.01).6. Divided the patients into normal (HCY5~14umol/L) and increased groups(HCY≥14umol/L), according to the HCY levels. After one-year follow-up, both thehalf-and one-year recurrence rates in increased group were higher than those innormal group for paroxysmal Af (P<0.05); while the half-and one-year recurrencerates in increased group were significantly higher than those in normal group forpersistentAf (P<0.01).Conclusions:1. High plasma HCY and CT-1may be related with the development ofAf.2. High plasma HCY and CT-1can perform a forewarning function forrecurrence ofAfAfter radiofrequency catheter ablation.3. High plasma HCY and CT-1may be independent risk factors for recurrence of AfAfter radiofrequency catheter ablation.