可溶性ST-2和Galectin-3水平与肥厚型心肌病患者室间隔心肌切除术后心房颤动的相关性分析

Association of soluble ST-2 and galectin-3 with new onset atrial fibrillation after ventricular septal myectomy in patients with hypertrophic cardiomyopathy

目的探讨可溶性ST-2和半乳糖凝集素-3（Galectin-3）水平与肥厚型心肌病患者行室间隔心肌切除术后心房颤动（房颤）的相关性。方法纳入2011年3月至2016年2月在阜外医院成人外科58病区行室间隔心肌切除术的肥厚型心肌病患者170例，收集患者临床资料。采用酶联免疫吸附法检测可溶性ST-2与Galectin-3浓度，分析术后房颤发生的相关因素。结果共16例于住院期间发生术后房颤。与无术后房颤患者相比，发生术后房颤的患者平均年龄更大[（49.8±9.6）岁对（42.1±14.2）岁，P=0.036]，吸烟患者比例更高（62.5%对38.3%，P=0.047）。两组患者之间可溶性ST-2[9.0（7.3~22.2）对12.6（8.7~18.0）ng/ml，P=0.37]和Galectin-3[7.2（6.2~9.9）对7.1（5.4~8.7）ng/ml，P=0.45]浓度差异无统计学意义。经多因素回归分析，年龄是术后房颤发生的独立危险因素[OR=1.065（95% CI 1.007~1.126），P=0.028]。结论可溶性ST-2和Galectin-3与肥厚型心肌病患者室间隔心肌切除术后房颤发生无相关。年龄增长可能是术后房颤发生的独立危险因素。

ObjectiveWe aimed to explore the association between soluble ST-2 and galectin-3 （Gal-3） levels and new onset atrial fibrillation after ventricular septal myectomy in patients with hypertrophic cardiomyopathy （HCM） .MethodsOne hundred seventy consecutive HCM patients who underwent ventricular septal myectomy in Fuwai Hospital from March 2011 to February 2016 were enrolled. Demographics, clinical characteristics and echocardiographic parameters of these patients were collected. Soluble ST-2 and Gal-3 levels were examined by Enzyme-linked immunosorbent assay （ELISA） . The association of these parameters with new onset postoperative atrial fibrillation （POAF） were assessed.ResultsPOAF was documented in 16 patients in hospital. POAF patients were older[ （49.8±9.6） years vs. （42.1±14.2） years, P=0.036]and had more smoking （62.5% vs. 38.3%, P=0.047） . Soluble ST-2 [9.0 （7.3-22.2） ng/ml vs. 12.6 （8.7-18.0） ng/ml, P=0.37]and Gal-3[7.2 （6.2-9.9） ng/ml vs. 7.1 （5.4-8.7） ng/ml, P=0.45]in patients with POAF were similar to that in those without POAF. In multivariable regression analysis, age （odds ratio 1.065, 95% CI 1.007-1.126, P=0.028） was an independent predictor of POAF.ConclusionPlasma soluble ST-2 and Gal-3 levels were not associated with the occurrence of POAF in patient with HCM who underwent ventricular septal myectomy. Advanced age might be an independent predictor of POAF in HCM patients after surgical ventricular septal myectomy.