Expression And Clinical Significance Of Serum ROCK1 In Patients With Atrial Fibrillation

Objective:To realize the expression level of serum ROCK1 in patients with atrial fibrillation;To investigate the value of preoperative serum ROCK1 expression level in predicting late recurrence after radiofrequency ablation in patients with atrial fibrillation.Methods:A total of 131 patients diagnosed with atrial fibrillation(af)in the Department of Cardiovascular,the First Affiliated Hospital of Wannan Medical College from March2018 to April 2019 were selected as the experimental group,including 80 patients with paroxytic af and 51 patients with persistent af.Forty patients with sinus rhythm who were hospitalized at the same time and matched in gender and age were used as the control group.Basic clinical data of all patients were collected,and serum ROCK1 protein levels were determined by enzyme-linked immunosorbent assay(elisa),differences in clinical data and serum ROCK1 expression between different groups were compared,pearson method was used to analyze the correlation between serum ROCK1 and other clinical data.105 patients with af(65 patients with paroxysmal af and 40 patients with persistent af)who received radiofrequency ablation in the experimental group were followed up for9 months,According to the follow-up results,the patients were divided into the recurrent group and the non-recurrent group,and the basic clinical data and serum ROCK1 protein levels were compared between the recurrent group and the non-recurrent group,multivariate logistic regression analysis was performed on the different indicators to investigate the value of preoperative serum ROCK1 expression level in predicting af recurrence after radiofrequency ablation.Results:Body mass index(BMI)[(23.77±3.63)kg/m2 vs(21.74±2.89)kg/m2,P=0.001],left atrial diameter(LAD)[(37.70±3.58)mm vs(34.95±3.43)mm,P<0.05],C-reactive protein(CRP)[(6.45±2.83)mg/L vs(5.33±2.19)mg/L,P=0.023]and serum ROCK1 protein levels[30.15(23.09,36.34)ng/ml vs 22.96(14.29,25.48)ng/ml,P<0.05]in the atrial fibrillation group were significantly higher than those in the sinus rhythm group.Correlation analysis revealed a significant positive correlation between serum ROCK1 protein level and LAD(correlation coefficient=0.237,P=0.002).Multivariate logistic regression analysis showed that BMI(OR=1.201,P=0.010),LAD(0R=1.269,P=0.001),CRP(OR=1.329,P=0.006)and ROCK1(OR=1.175,P<0.05)were independent risk factors for af.Subgroup analysis showed that the level of serum ROCK1in paroxysmal fibrillation group was higher than that in sinus rhythm group[29.21(19.29,33.15)ng/ml vs 22.96(14.29,25.48)ng/ml,P<0.05];sustained af group was higher than paroxysmal af group[33.16(25.06,43.86)ng/ml vs 29.21(19.29,33.15)ng/ml,P<0.05].In patients with paroxysmal af who received radiofrequency ablation,the recurrence group was higher than the non-recurrence group in the duration of atrial fibrillation(month)[(15.83±8.36)vs(10.75±7.05),P=0.033]、BMI[(25.74±4.64)kg/m~2 vs(23.23±3.22)kg/m~2,P=0.028]、LAD[(38.75±3.25)mm vs(36.36±3.40)mm,P=0.030]and serum ROCK1 levels[34.65(24.67,39.40)ng/ml vs 29.27(17.75,32.80)ng/ml,P=0.044].Multivariate Logistic regression analysis and ROC curve results:Serum ROCK1 protein levels(OR=1.126,P=0.032)were independent predictors of postoperative recurrence of paroxysmal atrial fibrillation,serum ROCK1 protein level>33.65ng/ml can predicted af recurrence after surgery with a sensitivity of 0.583 and a specificity of 0.792.In patients with sustained af who received radiofrequency ablation,the recurrence group was higher than the non-recurrence group in the duration of atrial fibrillation(month)[(28.56±8.11)vs(21.04±6.98),P=0.003]、CRP[(7.86±3.47)mg/L vs(5.14±3.81)mg/L,P=0.028]、LAD[(41.06±3.13)mm vs(38.29±3.57)mm,P=0.016]and serum ROCK1 levels[41.21(26.71,54.09)ng/ml vs 26.73(20.91,32.98)ng/ml,P=0.003].Multivariate logistic regression analysis and ROC curve results:Duration of af(OR=1.200,P=0.046)and serum ROCK1 protein levels(OR=1.134,P=0.031)were independent predictors of postoperative recurrence of persistent af,serum ROCK1 protein level>34.51ng/ml can predicted af recurrence after surgery,with a sensitivity of 0.688 and specificity of 0.833.Conclusion:Serum ROCK1 can be used as an adjunct in the diagnosis of atrial fibrillation;ROCK1 may be involved in the occurrence and development of atrial fibrillation by regulating left atrial remodeling;Serum ROCK1 can be used as a predictor of atrial fibrillation recurrence after ablation.