孤立性心房颤动患者血生物标志物与心脏MR左心室心肌固有T_(1)值关系研究

A study on the relationship between biomarkers and left ventricular myocardial native T_(1) value in patients with lone atrial fibrillation

目的分析孤立性心房颤动(房颤)患者外周血Ⅲ型前胶原氨基端肽(PIIINP)、Ⅰ型胶原羧基端交联肽(CTXI)、高敏C反应蛋白(hs-CRP)和心脏MR(CMR)T_(1) mapping左心室心肌固有T_(1)值的关系。方法前瞻性入组2017年7月至2018年6月在北京安贞医院就诊的孤立性房颤患者55例(孤立性房颤组),均排除其他相关疾患。另20名年龄、性别匹配的健康志愿者作为对照组同期进行检查提供正常参考值范围。所有入组者均1周内完成外周血PIIINP、CTXI、hs-CRP和CMR检查。CMR检查包括电影序列、非增强T_(1) mapping序列和延迟强化序列。采用t检验、Mann-Whitney U检验或χ^(2)检验比较房颤患者与对照组以上指标差异;采用Spearman相关分析明确房颤患者左心室心肌固有T_(1)值与血生物标志物指标之间的关系。结果入组孤立性房颤患者均为阵发性房颤。与对照组比较,房颤患者PIIINP为5.83(3.52,12.40)ng/ml,CTXI为4.63(3.31,6.82)μg/ml,hs-CRP为3.41(1.72,6.61)mg/L,左心室心肌固有T_(1)值为(1261±23)ms,以上指标均高于对照组(P均<0.05)。左心室心肌固有T_(1)值与PIIINP(r=0.492,P<0.05)、hs-CRP(r=0.516,P<0.05)呈正相关,与CTXI(r=0.021,P>0.05)无相关性。结论孤立性房颤患者PIIINP、CTXI、hs-CRP均升高,且PIIINP、hs-CRP与左心室心肌固有T_(1)值升高相关。

Objective To investigate the relationship between serum procollagenⅢamino terminal peptide(PIIINP),collagen I carboxyl terminal cross-linking peptide(CTXI),high-sensitivity C-reactive protein(hs-CRP)and cardiac magnetic resonance(CMR)T_(1) mapping value in patients with lone atrial fibrillation(AF).Methods Fifty-five patients with lone AF in Beijing Anzhen Hospital from July 2017 to June 2018 were prospectively enrolled.Another 20 healthy volunteers were examined at the same time to provide normal reference range.All patients completed PIIINP,CTXI,hs-CRP and CMR examination within one week.CMR examination including cine,pre-contrast T_(1) mapping,and late gadolinium enhancement sequences.We used t test,Mann-Whitney U test or chi square test to compare the difference of the above indexes between AF patients and the control group.Spearman correlation analysis was used to determine the associations between left ventricular native T_(1) value and blood biomarker in AF patients.Results All the patients were paroxysmal AF with an average age of(48±10)years,of which 46(83.6%)were male.The PIIINP,CTXI,hs-CRP,left ventricular native T_(1) value of AF patients were 5.83(3.52,12.40)ng/ml,4.63(3.31,6.82)μg/ml,3.41(1.72,6.61)mg/L and(1261±23)ms,respectively,which all significant higher than those in healthy subjects(all P<0.05).The native T_(1) value of left ventricular myocardium was positively correlated with PIIINP(r=0.492,P<0.05)and hs-CRP(r=0.516,P<0.05),but not with CTXI(r=0.021,P>0.05).Conclusions The PIIINP,CTXI and hs-CRP increased in patients with lone AF,PIIINP and hs-CRP were correlated with elevated native T_(1) value of left ventricular myocardium.