Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (3): 49-57.doi: 10.6040/j.issn.1671-7554.0.2018.179

Previous Articles    

Risk factors of recurrent atrial fibrillation after radiofrequency catheter ablation

CHEN Linlin1, YI Shaolei2, WANG Weizong1, LI Zhan1, ZHANG Yong1, ZHANG Yujiao1,REN Manyi1, XIE Xinxing3, LIU Tongbao2, HOU Yinglong1   

  1. 1. Department of Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China;
    2. Department of Cardiology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    3. Department of Cardiology, Rizhao International Hospital, Rizhao 276800, Shandong, China
  • Published:2022-09-27

PDF (PC)

128

Abstract: Objective To evaluate recurrence-related risk factors of atrial fibrillation(AF)after radiofrequency catheter 山 东 大 学 学 报 (医 学 版)57卷3期 -陈琳琳,等.预测心房颤动患者射频消融术后复发的危险因素 \=-ablation(RFCA). Methods A total of 270 patients who underwent RFCA were enrolled as the AF group, and 100 healthy subjects as the control group. Clinical baseline information and peripheral venous blood of the two groups were collected. Biochemical markers and miRNA expressions were detected. During the follow-up of 12 months, the patients were divided into the recurrence group and non-recurrence group, and further divided into paroxysmal AF and persistent AF subgroups. Univariate analysis and Logistic regression analysis were used to screen out relevant hazards after RFCA. The area under the receiver operating characteristic(ROC)curve(AUC)in the AF subgroups was analyzed to judge the accuracy of predictive factors. Results The univariate analysis showed statistical differences in the expressions of miRNA-21, miRNA-133, miRNA-150, miRNA-206 and miRNA-328 between the control group and AF group(P<0.05), and statistical differences in the AF type, electric conversion, duration of disease, CHADS2 scoring, left atrial diameter(LAD), left ventricular ejection fraction(LVEF), uric acid and miRNA-21 expression between the recurrence group and non-recurrence group(P<0.05). Logistic regression analysis revealed that LAD(OR=1.187, P=0.031)and miRNA-21 expression(OR=1.226, P=0.012)in the paroxysmal AF subgroup had statistical significance. LAD(OR=1.125, P=0.035), course of disease(OR=1.023, P=0.019), and miRNA-21 expression(OR=1.177, P=0.032)in the persistent AF subgroup had statistical significance. In the paroxysmal AF subgroup, LAD was used as the index to calculate AUC, and the result was 0.750. When miRNA-21 expression and LAD together served as the comprehensive index, AUC=0.844 was derived. AUC measured by the combination of LAD, course of disease and miRNA-21 expression in the persistent AF group also had reference value. Conclusion LAD and miRNA-21 expression are independent recurrence-related risk factors after RFCA in patients with paroxysmal AF, while LAD, miRNA-21 expression and duration of disease are independent recurrence-related risk factors for persistent AF.

Key words: Atrial fibrillation, Radiofrequency catheter ablation, Atrial fibrillation recurrence, miRNA, Risk factors

CLC Number: 

  • R541.7+5
[1] Wilke T, Groth A, Mueller S, et al. Incidence and prevalence of atrial fibrillation:an analysis based on 8.3 million patients [J]. Europace, 2013, 15(4):486-493.
[2] 周自强, 胡大一, 陈捷, 等. 中国心房颤动现状的流行病学研究[J]. 中华内科杂志, 2004, 43(7):491-494. ZHOU Ziqiang, HU Dayi, CHEN Jie, et al. An epidemiological survey of atrial fibrillation in China [J]. Chinese Journal of Internal Medicine, 2004, 43(7):491-494.
[3] Tops LF, Schalij MJ, Bax JJ. Imaging and atrial fibrillation:the role of multimodality imaging in patient evaluation and management of atrial fibrillation [J]. Eur Heart J, 2010, 31(5):542-551.
[4] Haegeli LM, Calkins H. Catheter ablation of atrial fibrillation:an update [J]. Eur Heart J, 2014, 35(36):2454-2459.
[5] Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation:recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design [J]. Europace, 2012, 14(4):528-606.
[6] Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS [J]. Eur Heart J, 2016, 37(38):2893-2962.
[7] Balk EM, Garlitski AC, Alsheikh-Ali AA, et al. Predictors of atrial fibrillation recurrence after radiofrequency catheter ablation:a systematic review [J]. J Cardiovasc Electrophysiol, 2010, 21(11):1208-1216.
[8] Epicoco Md G, Sorgente Md PhD A. Predictors of atrial fibrillation recurrence after catheter ablation [J]. J Atr Fibrillation, 2014, 6(5):1016.
[9] Guarnieri DJ, DiLeone RJ. MicroRNAs:a new class of gene regulators [J]. Ann Med, 2008, 40(3):197-208.
[10] Shi KH, Tao H, Yang JJ, et al. Role of microRNAs in atrial fibrillation:new insights and perspectives [J]. Cell Signal, 2013, 25(11):2079-2084.
[11] Adam O, Lohfelm B, Thum T, et al. Role of miR-21 in the pathogenesis of atrial fibrosis [J]. Basic Res Cardiol, 2012, 107(5):278.
[12] Lu Y, Zhang Y, Wang N, et al. MicroRNA-328 contributes to adverse electrical remodeling in atrial fibrillation [J]. Circulation, 2010, 122(23):2378-2387.
[13] Liu Z, Zhou C, Liu YZ, et al. The expression levels of plasma micoRNAs in atrial fibrillation patients [J]. PLoS One, 2012, 7(9):e44906. doi:10.1371/journal.pone.0044906.
[14] Zhang YJ, Zheng SH, Geng YY, et al. MicroRNA profiling of atrial fibrillation in canines:miR-206 modulates intrinsic cardiac autonomic nerve remodeling by regulating SOD1 [J]. PLoS One, 2015, 10(3):e0122674. doi:10.1371/journal.pone.0122674.
[15] Cooley N, Cowley MJ, Lin RC, et al. Influence of atrial fibrillation on microRNA expression profiles in left and right atria from patients with valvular heart disease [J]. Physiol Genomics, 2012, 44(3):211-219.
[16] Luo X, Yang B, Nattel S. MicroRNAs and atrial fibrillation:mechanisms and translational potential [J]. Nat Rev Cardiol, 2015, 12(2):80-90.
[17] McManus DD, Tanriverdi K, Lin H, et al. Plasma microRNAs are associated with atrial fibrillation and change after catheter ablation(the miRhythm study)[J]. Heart Rhythm, 2015, 12(1):3-10.
[18] Cappato R, Calkins H, Chen SA, et al. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation [J]. Circ Arrhythm Electrophysiol, 2010, 3(1):32-38.
[19] McCready JW, Smedley T, Lambiase PD, et al. Predictors of recurrence following radiofrequency ablation for persistent atrial fibrillation [J]. Europace, 2011, 13(3):355-361.
[20] DAscenzo F, Corleto A, Biondi-Zoccai G, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation: a meta-analysis [J]. Int J Cardiol, 2013, 167(5):1984-1989.
[21] Moon J, Lee HJ, Kim JY, et al. Prognostic implications of right and left atrial enlargement after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation [J]. Korean Circ J, 2015, 45(4):301-309.
[22] Earley MJ, Abrams DJ, Staniforth AD, et al. Catheter ablation of permanent atrial fibrillation:medium term results [J]. Heart, 2006, 92(2):233-238.
[23] Gilad S, Meiri ET, Yogev Y, et al. Serum microRNAs are promising novel biomarkers [J]. PLoS One, 2008, 3(9):e3148. doi:10.1371/journal.pone.0003148.
[24] Sardu C, Santamaria M, Paolisso G, et al. microRNA expression changes after atrial fibrillation catheter ablation [J]. Pharmacogenomics, 2015, 16(16):1863-1877.
[25] 赵晟, 杨诺, 岳语喃, 等. 射频消融术改变心房颤动患者外周血微小RNA表达谱[J]. 中华老年心脑血管病杂志, 2015, 17(7):725-731. ZHAO Sheng, YANG Nuo, YUE Yunan, et al. Radiofrequency ablation of atrial fibrillation rebalances atrial ion current remodeling by regulating miRNAs [J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2015, 17(7):725-731.
[26] 朱瓦力, 伍伟锋. 心房颤动患者心房组织中微小RNA-21和金属基质蛋白酶-2表达水平改变及意义[J]. 中华心律失常学杂志, 2011, 15(2):132-135. ZHU Wali, WU Weifeng. MicroRNA-21 and matrix metalloprotease-2 in patients with rheumatic valvular heart disease and atrial fibrillation [J]. Chinese Journal of Cardiac Arrhythmias, 2011, 15(2):132-135.
[27] Barana A, Matamoros M, Dolz-Gaitón P, et al. Chronic atrial fibrillation increases microRNA-21 in human atrial myocytes decreasing L-type calcium current [J]. Circ Arrhythm Electrophysiol, 2014, 7(5):861-868.
[28] Thum T, Gross C, Fiedler J, et al. MicroRNA-21 contributes to myocardial disease by stimulating MAP kinase signalling in fibroblasts [J]. Nature, 2008, 456(7224):980-984.
[1] YAO Xue, LU Ranran, SUN Shuling, GAO Cuiping, XIAO Ru, WANG Shuhui. Establishment of a risk prediction scoring model for nosocomial infection in rheumatic heart disease patients after valve replacement surgery [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 90-96.
[2] HUANG Huining, DU Juanjuan, SUN Yi, HOU Yinglong, GAO Mei. Hydrogen sulfide alleviates acute obstructive sleep apnea-induced atrial fibrillation by regulating oxidative stress through glutaredoxin-1 [J]. Journal of Shandong University (Health Sciences), 2022, 60(1): 1-5.
[3] CHEN Liyu, XIAO Juan, LYU Xianzhong, DUAN Baomin, HONG Fanzhen. Risk factors influencing prognosis of lower extremity deep vein thrombosis in pregnant and parturient women [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 38-42.
[4] Haipeng SI,Wencan ZHANG,Le LI,Xin ZHOU. Research advances on risk factors, diagnosis and treatment of Kümmell's disease [J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 25-32.
[5] CAI Fanfan, JI Congshan, YANG Shifeng, GU Hui, YUAN Xianshun, LIU Hongwu, QIN Songnan, GAO Lin, WANG Ruopeng, WANG Ximing. Clinical application of third-generation double-source CT in coronary CT angiography for patients with atrial fibrillation [J]. Journal of Shandong University (Health Sciences), 2021, 59(2): 14-18.
[6] HUANG Bosong, CONG Hongliang. Anticoagulant therapy of non-valvular atrial fibrillation in 1,430 middle-aged patients with moderate-risk thromboembolism [J]. Journal of Shandong University (Health Sciences), 2021, 59(10): 47-56.
[7] CHEN Qingyi, ZHANG Xuan, WANG Juan, SUN Jiwei, CAO Danfeng, CAO fenglin. Risk factors and cumulative effects of suicidal ideation in pregnant women [J]. Journal of Shandong University (Health Sciences), 2021, 59(1): 91-94.
[8] SHI Shuang, LI Juan, MI Qi, WANG Yunshan, DU Lutao, WANG Chuanxin. Construction and application of a miRNAs prognostic risk assessment model of gastric cancer [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 47-52.
[9] YU Zhigang, ZHOU Fei. Management of non-lactational infectious breast abscesses [J]. Journal of Shandong University (Health Sciences), 2018, 56(9): 1-5.
[10] TIAN Zhongyan, LI Yuqian, LIU Xiaotian, SHI Yuanyuan, ZHANG Haiqing, ZHANG Xia, QIAN Xinling, YIN Lei, ZHAO Jingzhi, WANG Chongjian. Relationship between PSMD6 gene rs831571 locus polymorphism and the susceptibility of T2DM: a case-control study [J]. Journal of Shandong University (Health Sciences), 2018, 56(7): 51-56.
[11] ZHANG Xiuling, ZHANG Lei, LIU Dan, LIANG Jiangjiu. Association of ApoE gene polymorphism and risk of atrial fibrillation among Han people in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2018, 56(3): 79-84.
[12] DING Yanfei, YANG Zhuoxin, ZHENG Wenwen, YUAN Wenjie, GAO Yanjing. Risk factors of portal vein thrombosis in patients with liver cirrhosis [J]. Journal of Shandong University (Health Sciences), 2018, 56(12): 13-18.
[13] WEI Jinqiu, ZHANG Yujiao, LI Zhan, WANG Ximin, CHEN Linlin, DU Juanjuan, ZHANG Yong, XIE Xinxing, HOU Yinglong. Effects of GCH1 on atrial autonomic nerve remodeling by regulating tetrahydrobiopterin in A-TP canines [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 8-12.
[14] SUN Qijing, CHEN Fangfang, LI Chunxiao, ZHANG Caiqing. Clinical value of PNI and HGB in evaluating the prognosis of the middle to late stage non-small cell lung cancer patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 55-59.
[15] DENG Ke, LIU Yi, GAI Zhongtao. Susceptibility of mesenchymal stem cells to enterovirus 71 and differential expression of miRNA [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(3): 25-31.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd