Application of miRNA-320a detection after cryoablation of atrial fibrillation in predicting the risk of recurrence
10.3969/j.issn.1008-0074.2025.03.13
- VernacularTitle:房颤冷冻消融术后miRNA—320a检测在预测心房颤动复发风险的应用研究
- Author:
Biao KONG
1
;
Yan HUANG
1
;
Long ZHAO
1
Author Information
1. 镇江市第一人民医院心内科,江苏镇江 212000
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Cryosurgery;
MicroRNAs
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2025;34(3):350-355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors affecting the recurrence of atrial fibrillation(AF)after atrial fibril-lation cryoablation and the diagnostic value of miRNA-320a for it.Methods:A total of 210 AF patients who un-derwent atrial fibrillation cryoablation in Zhenjiang First People's Hospital between September 2017 and December 2023 were enrolled.According to the recurrence at 6 months after surgery,the patients were divided into no recur-rence group and recurrence group.Multivariate Logistic regression analysis was conducted to analyze the risk factors of recurrence in AF patients after atrial fibrillation cryoablation and nomogram model was established.Receiver op-erating characteristic(ROC)curve was plotted to analyze the diagnostic value of miRNA-320a for the recurrence of AF patients after atrial fibrillation cryoablation.Results:Within 6 months after surgery,98 cases(46.7%)re-curred,and 112 cases did not recur,and 4 recurrent cases were lost,and 6 non-recurrent cases were lost during fol-low-up.Compared with patients in the no recurrence group,those in recurrence group had significant higher pro-portion of persistent AF(59.6%vs.32.1%),left atrial diameter(LAD)[(44.30±5.05)mm vs.(36.40±4.07)mm],uric acid(UA)level[(346.17±46.98)μmol/L vs.(306.46±41.79)μmol/L],miRNA-320a expression[(1.16±0.07)vs.(0.79±0.06)],and significant lower left ventricular ejection fraction(LVEF)[(58.21±3.64)%vs.(62.54±5.71)%](P<0.001 all).Multivariate Logistic regression analysis showed that persistent AF,LAD,UA and miRNA-320a were independent risk factors for AF recurrence after atrial fibrillation cryoabla-tion(OR=2.301~3.645,P<0.01 all),while LVEF was its independent protective factor(OR=0.301,P<0.001).The nomogram model of AF recurrence was 4.656+0.427 × persistent AF+0.516 × LAD+0.551 × LVEF+0.547 × UA+0.413 × miRNA-320a.ROC curve analysis showed that miRNA-320a had a good diagnostic value for AF recurrence after atrial fibrillation cryoablation,and the AUC was 0.892(95%CI 0.814~0.945).In decision curve analysis(DCA),the threshold probability of miRNA-320a on the recurrence detection model of AF patients after atrial fibrillation cryoablation was over 75%,and the P value of goodness of fit test of calibration curve was 0.078.Conclusion:Persistent AF,LAD,LVEF,UA and miRNA-320a are factors affecting AF recurrence in AF patients after atrial fibrillation cryoablation.On this basis,a nomogram model could be established to evaluate the risk of AF recurrence,and miRNA-320a has good diagnostic value for it.