Relationship between serum monocyte chemoattractant protein-1 level and atrial fibrosis in patients with atrial fibrillation
Objective To observe the change of serum monocyte chemoattractant protein-1(MCP-1)in atrial fibrillation(AF)patients of different ages and to explore its correlations with serum aminoterminal propeptide of type Ⅲ procollagen(PⅢ NP)and procollagen type Ⅰ carboxy-terminal propeptide(P Ⅰ CP).Methods Totally 244 patients with AF in the First Affiliated Hospital of Xinjiang Medical University from May 2019 to December 2020(AF group)received echocardiography on the second day after admission and another 244 healthy subjects with sinus rhythm(control group)received echocardiography on the day of physical examination to measure the left atrial diameter(LAD)and left ventricular ejection fraction(LVEF).The serum MCP-1,P Ⅲ NP and P Ⅰ CP levels were detected by ELISA in two groups,and blood creatinine and D-dimer levels were detected in AF group.The gender,age,LAD,LVEF,serum MCP-1,PⅢNP,PⅠ CP,and percentages of patients with hypertension,diabetes,heart failure and stroke history were compared between two groups.AF group was treated with a comprehensive treatment plan including administration of anticoagulants,statins,angiotensin-converting enzyme inhibitors,angiotensin receptor antagonists and β-blockers.According to the age,AF group was divided into 142 patients aged ≥65 years(elderly AF group)and 102 patients aged＜65 years(adult AF group).The gender,age,CHA2DS2-VASc score,LVEF,LAD,levels of blood creatinine,D-dimer,MCP-1,PⅢNP and PⅠ CP,and percentages of patients with persistent AF,hypertension,diabetes,coronary heart disease,heart failure,stroke,and administration of anticoagulants,statins,angiotensin-converting enzyme inhibitors,angiotensin receptor antagonists and β-blockers were compared between elderly AF group and adult AF group.Pearson's correlation analysis was done to assess the correlations of serum MCP-1 level with P Ⅲ NP and P Ⅰ CP levels in AF patients.Results(1)The LAD was longer in AF group[(36.39±4.45)mm]than that in control group[(32.88± 3.13)mm](P＜0.05),the LVEF was lower in AF group[(62.82±3.35)％]than that in control group[(63.97± 3.32)％](P＜0.05),the levels of serum MCP-1,P Ⅲ NP and P Ⅰ CP,male ratio,and percentages of patients with heart failure and stroke were higher in AF group[(532.98±188.95)ng/L,(64.07±23.05)μg/L,(236.41±74.24)ng/L,71.30％,31.97％,40.16％]than those in control group[(224.30±63.47)ng/L,(38.67±13.66)μg/L,(148.14± 59.44)ng/L,48.40％,9.02％,13.93％](P＜0.05),and there were no significant differences in the age and percentages of patients with hypertension and diabetes between two groups(P＞0.05).(2)The CHA2DS2-VASc score,percentages of patients with persistent AF,hypertension,diabetes,coronary heart disease and stroke,and levels of serum MCP-1,PⅢ NP,P Ⅰ CP and D-dimer were higher in elderly AF group[4.03±1.72,52.11％,64.79％,32.39％,41.55,53.52％,(681.90±74.63)ng/L,(78.32±17.25)μg/L,(267.20±76.19)ng/L,(375.42± 43.03)μg/L]than those in adult AF group[2.51±1.46,33.33％,35.29％,11.76％,26.47％,21.57％,(325.70± 60.39)ng/L,(44.22±13.56)μg/L,(193.60±45.31)ng/L,(353.04±36.49)μg/L](P＜0.05),the LAD was longer in elderly AF group[(37.24±4.81)mm]than that in adult AF group[(35.20±3.58)mm](P＜0.05),the LVEF was lower in elderly AF group[(62.08±3.03)％]than that in adult AF group[(63.84±3.51)％](P＜0.05),and there were no significant differences in the blood creatinine level,male ratio,and percentages of patients with persistent AF,heart failure,and administration of anticoagulants,statins,angiotensin-converting enzyme inhibitors,angiotensin receptor antagonists and β-blockers between two groups(P＞0.05).(3)The serum MCP-1 level was positively correlated with both PⅢ NP and P Ⅰ CP levels in AF patients(r=0.855,P＜0.001;r=0.625,P＜0.001).Conclusion The MCP-1 level elevates with age in AF patients,and is positively correlated with P Ⅲ NP and P Ⅰ CP levels,and it can reflect the severity of atrial fibrosis.
atrial fibrillationmonocyte chemoattractant protein-1atrial fibrosisaminoterminal propeptide of type Ⅲprocollagenprocollagen type Ⅰ carboxy-terminal propeptide
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