Objective To investigate the expression and clinical significance of serum bromodomain-containing protein 4(BRD4)in patients with atrial fibrillation(AF).Methods Patients with AF and patients with paroxysmal supraventricular tachycardia(PSVT)were chosen as AF group[n=74,further divided into paroxysmal AF group and sustained AF group]and control group(PSVT)group(n=73).fasting venous blood samples were collected from all patients in the morning.Serum BRD4 levels were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction(qRT-PCR).Transthoracic echocardiography was performed to measure left atrial anteroposterior diameter(LAAPD)and left ventricular ejection fraction(LVEF)of AF groups and PSVT groups before operation.Patients in the AF group underwent transesophageal echocardiography within 24 hours before operation to measure left atrial appendage peak emptying velocity(LAA-PEV).The left atrial local bipolar voltage was measured by high-density matrix mapping.According to the bipolar voltage,the AF patients were divided into LA Vs group(bipolar voltage＜0.5 mV)and normal voltage(NLAVs)group(bipolar voltage≥0.5 mV).According to the number of LAVs,patients in the LAVs group were divided into mild group(1 LAVs)and moderate group(2 or more LAVs).AF recurrence was followed up for 3 to 12 months after surgery in AF group.According to the recurrence after surgery,AF group was further divided into recurrence group(reAF group)and non-recurrence group(SR group).Spearman was used to analyze the correlation between serum BRD4 and LAAPD,LVEF,LAA-PEV,left atrial low voltage,postoperative recurrence and other indicators in AF group.Results The serum levels of BRD4 and LAAPD in AF group were higher than those of PSVT group(P＜0.05),and LVEF was lower than that of PSVT group(P＜0.05).Compared with the paroxysmal AF group,the number of recurrent AF patients,the number of left atrial low voltage patients,the BRD4 level and LAAPD in the sustained AF group were significantly higher(P＜0.05).The levels of BRD4 and LAAPD in peripheral venous blood of AF patients in LAVs group were higher than those of NLAVs group(P＜0.05),and LVEF and LAA-PEV were lower than those of NLAVs group(P＜0.05).The peripheral venous blood BRD4 level in the moderate LAVs group was higher than that of mild group(P＜0.05),and LVEF was lower than that of mild group(P＜0.05).The number of left atrial low voltage,BRD4 level and LAAPD in reAF group were higher than those of SR group(P＜0.05),LVEF and LAA-PEV were lower than those of SR group(P＜0.05).Conclusion Serum BRD4 expression level significantly increased in AF patients,which might have certain predictive value for the severity and postoperative recurrence of AF.
关键词
心房颤动/复发/溴结构域蛋白4/心房纤维化/低电压/左心耳最大排空流速
Key words
atrial fibrillation/recurrence/bromodomain-containing protein 4/atrial fibrosis/low-voltage/left atrial appendage peak emptying velocity
维普
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