| Objective:To investigate the changes in serum levels of endothelin-1(ET-1)and connective tissue growth factor(CTGF)in patients with atrial fibrillation(AF)and their value for predicting recurrence of AF after radiofrequency ablation(RFCA).Methods:Sixty-six patients with paroxysmal atrial fibrillation(PaAF)and 72 patients with persistent atrial fibrillation(PeAF)from July 2020 between January 2022 in our hospital were selected as AF group,including 100 patients who underwent radio frequency catheter ablation(RFCA),and 80 patients with sinus rhythm as control group,and in all the participants,the serum levels of ET-1 and CTGF were measured using enzyme-linked immunosorbent(ELISA)and Western blotting.At the same time,6 patients with atrial fibrillation who underwent surgery in the cardiac surgery department of our hospital from August 2020 to February 2021 were selected as the experimental group and 6 patients with sinus rhythm as the control group.The tissue samples of the right atrial appendage were taken intraoperatively,and the structure and morphology of myocardial cells and the degree of myocardial fibrosis were observed by HE staining and Masson staining.And the expressions of ET-1 and CTGF were detected by immunohistochemical staining and Western blot.Patients in the experimental group who underwent radiofrequency ablation were then followed up for 6 months to assess prognosis.In AF group,the patients receiving RFCA were followed up for 6 months following the procedure for assessment of the outcomes.Results:1.HE staining and Masson staining showed that compared with Control group(CON),myocardial cell structure was significantly destroyed and fibrosis degree was significantly increased in AF group.2.The Elisa results showed that,compared with Control group(Control,CON),the expression levels of ET-1 and CTGF in serum were significantly increased in Paroxysmal Atrial Fibrillation(PaAF)and Persistent Atrial Fibrillation(PeAF)groups,and PeAF group was significantly higher than PaAF group(P<0.01).3.Immunohistochemical results showed that compared with CON group,the protein expression levels of ET-1 and CTGF in AF group were significantly increased;Western blot results showed the same trend,and PeAF group was higher than PaAF group.(P<0.05).4.Pearson correlation analysis showed that ET-1 and CTGF levels were positively correlated with LAD size in all experimental groups(P<0.01),ET-1 was significantly positively correlated with CTGF level(P<0.01).5.Logistic regression analysis showed that ET-1 and CTGF were risk factors affecting the progression of AF.6.The Recurrence group(Recurrence,Re)and non-recurrence group(NRe)were divided according to follow-up results.The results showed that the postoperative ET-1 CTGF level of Re patients was higher than that of NRe patients,and the expression levels of ET-1 and CTGF before and after operation were positively correlated with the recurrence of PeAF,and ET-1、CTGF was an independent risk factor for postoperative recurrence of PeAF.Conclusions:1.The expression of ET-1 and CTGF was increased significantly in AF patients,which was positively correlated with the duration of AF,and it was significantly correlated with the occurrence and development of AF;2.The expression levels of ET-1 and CTGF were significantly increased in patients with AF recurrence group,and high levels of ET-1 and CTGF may indicate higher recurrence risk and worse prognosis in patients with AF,and both have predictive value for recurrence after radiofrequency ablation in PeAF patients. |
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