Predictive Value Of Chymase Gene Polymorphisms For Atrial Fibrillation Recurrence After Radiofrequency Catheter Ablation

Background and ObjectiveAtrial fibrillation(AF)is the most common cardiac arrhythmia.Compared with antiarrhythmic drugs,although radiofrequency catheter ablation(RFCA)can significantly reduce the recurrence of AF,it remains relatively high.Recent studies have found that single nucleotide polymorphisms(SNPs)are associated with AF recurrence after RFCA.Chymase encoded by the chymase gene(CAM1)is regarded as a key enzyme that mediates the production of angiotensin II(Ang II)in the heart.We previously explored the correlation between five CAM1 SNPs(rs1800875,rs1956921,rs5244,rs1800876,and rs1885108)and AF in the Han population,and already discovered that the rs1800875 GG genotype may be a susceptible factor for AF.Therefore,this study intended to explore the association between these five CAM1 SNPs and AF recurrence after RFCA.Method1 From May 2013 to August 2016,74 patients who received RFCA for AF in the Department of Cardiology,the first affiliated Hospital of Zhejiang University Medical College were included.All the general clinical statistics,including basic clinical data,previous medical history,surgery data,laboratory and auxiliary examinations,were recorded.2 We followed up all patients for their symptoms,complications,medications,and statistics of electrocardiogram(ECG)and dynamic ECG.3 The sequencing sequences and results of 5 CAM1 SNPs of all the research subjects were collected and analyzed.4 Patients who underwent RFCA of AF were divided into non-recurrence group and recurrence group.The differences in clinical features,the genotype,allele,dominant gene model,recessive gene model,and codominant gene model frequency distributions of five CAM1 SNPs(rs1800875,rs1956921,rs5244,rs1800876 and rs1885108)were analyzed between the two groups.Univariate and multivariate logistic regression analysis were used to explore independent risk factors for AF recurrence after RFCA.Results1 All the patients were the Han population,followed-up for about 25.47±13.9months,39(52.7%)of which were not recurrent and 35(47.3%)of which were recurrent.2 Compared with the non-recurrence group,we observed that the non-paroxysmal atrial fibrillation,white blood cell,neutrophil granulocyte,lymphocyte,left atrial enlargement,right atrial enlargement,left atrial diameter(LAD),left atrial diameter from top to bottom,left atrial diameter in the medial-lateral,left atrial volume and left atrial volume index(LAVI)were significantly correlated with the AF recurrence group(all P<0.05),but not with gender,age,body mass index(BMI),hypertension,diabetes mellitus,smoking,drinking,AF history duration,surgical complications,preoperative drugs([angiotensin-converting enzyme inhibition(ACEI)] and/or [angiotensin II receptor blocker(ARB)]),blood lipids,uric acid,high-sensitivity C-reactive protein(hs-CRP)and other factors(all P> 0.05).3 Compared with the non-recurrence group,the genotype,allele,dominant gene model,recessive gene model,and codominant gene model frequency distributions of the five CAM1 SNPs(rs1800875,rs1956921,rs5244,rs1800876 and rs1885108)were not significantly associated with AF recurrence after RFCA(all P>0.05).4 Univariate and multivariate logistic regression analysis results showed that the LAVI was an independent risk factor for the AF recurrence after RFCA(OR=1.129,95%CI=1.004-1.269,P=0.042<0.05).ConclusionsThe five CAM1 SNPs(rs1800875,rs1956921,rs5244,rs1800876 and rs1885108)were not associated with the AF recurrence after RFCA.LAVI was an independent predictor of AF recurrence after RFCA.