射频消融术后有氧运动对房颤患者ACE2、Ang Ⅱ、Ang-(1-7)表达及预后影响

Effects of aerobic exercise after radiofrequency ablation on the expression of serum ACE2,Ang Ⅱ,Ang-(1-7)and prognosis in patients with atrial fibrillation

目的探究射频消融术后有氧运动对房颤患者血清血管紧张素转换酶2(ACE2)、血管紧张素Ⅱ(AngⅡ)、血管紧张素-1-7(Ang-(1-7))表达及预后的影响。方法选取2017年5月至2019年11月在中国人民解放军西部战区总医院心内科行射频消融术的72例阵发性房颤患者,按数字表随机分为研究组(36例)和对照组(36例)。两组术后均接受基础药物治疗,研究组患者从术后第3 d开始进行有氧运动干预,对照组仅进行有氧运动健康宣教,不进行规律有氧运动,持续1年后观察疗效。比较两组房颤发生、心功能指标、炎症反应指标及血清ACE2、AngⅡ、Ang-(1-7)表达情况,并统计术后干预不同时间窦性心律维持率。结果干预1年后,研究组房颤发作次数少于对照组,持续时间短于对照组,差异均有统计学意义(P<0.05)。两组左心室射血分数(LVEF)、6 min步行试验(6MWT)和血清ACE2、Ang-(1-7)表达水平均升高,左心房内径(LAD)、舒张末期室间隔厚度(IVST)及血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、AngⅡ水平均降低(P<0.05);且研究组各指标均明显优于对照组,差异均有统计学意义(P<0.05)。研究组窦性心律维持率83.33%,显著高于对照组的61.11%,差异有统计学意义(P<0.05)。结论射频消融术后进行有氧运动有助于尽快改善房颤患者症状,提高患者心功能,减轻机体炎症反应,纠正体内ACE2、AngⅡ、Ang-(1-7)表达水平,降低复发率。

Objective To explore the effect of aerobic exercise after radiofrequency ablation on the expression and prognosis of serum angiotensin-converting enzyme 2(ACE2),angiotensin Ⅱ(Ang Ⅱ)and angiotensin-1-7[Ang-(1-7)]in patients with atrial fibrillation. Methods From May 2017 to November 2019,72 patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation in the Department of Cardiology Department,the Western Theater General Hospital of the Chinese people’s Liberation Army were divided into the study group(36 cases)and the control group(36 cases)according to the random number table.Both groups received basic drug treatment after operation,the patients in the study group received aerobic exercise intervention from the third day after operation,while the control group only received aerobic exercise health education without regular aerobic exercise,and the curative effect was observed after 1 year. The occurrence of atrial fibrillation,cardiac function index,inflammatory reaction index and the expression of serum ACE2,Ang Ⅱ and Ang-(1-7)were compared between the two groups,and the maintenance rate of sinus rhythm at different time after intervention was counted. Results After one year of intervention,thefrequency of atrial fibrillation in the study group was significantly less than that in the control group,and the duration was significantly shorter than that in the control group(P<0.05). Left ventricular ejection fraction(LVEF),6-minute walk test(6 MWT)and levels of serum ACE2 and Ang-(1-7)increased in both groups,left atrial diameter(LAD),end diastolic inter ventricular septal thickness(IVST)and levels of serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and AngⅡdecreased(P<0.05). The indicators in the study group were significantly better than those in the control group(P<0.05). The sinus rhythm maintenance rate in the study group was 83.33%,which was significantly higher than that in the control group(61.11%)(P<0.05). Conclusion Aerobic exercise after radiofrequency ablation is helpful to improve the symptoms of patients with atrial fibrillation as soon as possible,improve the cardiac function,reduce the inflammatory reaction,correct the expression levels of ACE2,Ang Ⅱ,Ang-(1-7),and reduce the recurrence rate.