Changes of serum levels of Angpt1 and endothelin-1 in patients with newly-onset atrial fibrillation after heart valve replacement and its clinical significance
10.3969/j.issn.1008-0074.2024.04.10
- VernacularTitle:心脏瓣膜置换术后新发心房颤动患者血清Angpt1、内皮素-1水平变化及其临床意义
- Author:
Jun-Jie FEI
1
;
Yong LUO
;
Jian CHEN
;
Jie CHEN
;
Jin-Ze LI
;
Lan-Ying GAO
Author Information
1. 成都市第三人民医院心脏大血管外科,四川成都 610000
- Keywords:
Atrial fibrillation;
Heart valve prosthesis implantation;
Angiopoietins
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2024;33(4):425-430
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the changes of serum levels of angiopoictin-1(Angpt1)and endothelin-1(ET-1)in patients with newly-onset atrial fibrillation(AF)after heart valve replacement,and analyze their clinical sig-nificance.Methods:A total of 130 patients who underwent heart valve replacement in our hospital from January 2020 to March 2022 were divided into no AF group(n=72)and AF group(n=58)according to presence of AF within 7d after surgery.Serum levels of Angpt1 and ET-1 were detected by ELISA in two groups;the correlation between serum Angptl and ET-1 was analyzed by Pearson method in AF patients;ROC curve analysis was used to analyze the predictive value of serum Angpt1 and ET-1 levels for postoperative AF in these patients;Logistic re-gression was used to analyze the influencing factors of postoperative AF in these patients.Results:The left atrial diameter(LAD),proportion of NYHA class Ⅳ and cardiopulmonary bypass time in AF group were significantly higher than those of no AF group(P＜0.05 or＜0.01).One day after surgery,compared with no AF group,serum Angpt1 level significantly reduced and ET-1 level significantly increased in AF group(P＜0.001 both).Pearson correlation analysis indicated that serum Angpt1 level was significant inversely correlated with ET-1 level in AF pa-tients(r=-0.366,P=0.005).ROC analysis indicated that area under the curve(AUC)of combined detection of serum Angpt1 and ET-1 in predicting AF after heart valve replacement was significantly higher than those of each single detection(Z=2.761,1.998,P=0.006,0.046).Multivariate Logistic regression analysis indicated that LAD,NYHA class Ⅳ,cardiopulmonary bypass time and postoperative ET-1 were independent risk factors for postoperative AF in these patients(OR=1.471～1.739,P＜0.05 or＜0.01),while postoperative Angpt1 was its independent protective factor(OR=0.634,P=0.004).Conclusion:Serum Angpt1 level significantly reduces and ET-1 level significantly increases in patients with newly-onset AF after heart valve replacement.Combined detec-tion of Angpt1 and ET-1 levels possesses high predictive value for postoperative AF.
