持续性心房颤动患者升主动脉弹性的变化及其与血清犬尿喹啉酸水平的相关性研究

Changes of ascending aorta elasticity in patients with persistent atrial fibrillation and its correlation with serum level of kynurenic acid

目的 应用超声心动图技术评价持续性心房颤动(PEAF)患者升主动脉弹性的变化及其与血清犬尿喹啉酸(KYNA)水平的相关性。方法 选取2019年1月至2021年5月门诊就诊的PEAF患者100例作为PEAF组,并分为年龄<75岁组(PEAFⅠ组)67例及年龄≥75岁组(PEAFⅡ组)33例;选取同期100名非心房颤动窦性心律患者为对照组。检测和对比各组升主动脉应变(AS)、升主动脉硬度指数(AoSI)、升主动脉扩张性(AoDIS)以及血清KYNA水平差异,并分析升主动脉弹性的变化与血清KYNA水平的关系。结果 对照组、PEAFⅠ组、PEAFⅡ组AS、AoDIS值依次降低,而AoSI值及血清KYNA水平依次升高(P<0.05)。Pearson相关分析显示,PEAF患者AS、AoSI、AoDIS值分别与血清KYNA水平呈显著正相关或负相关(r=-0.289、0.297、-0.257,P<0.05)。多元逐步线性回归分析结果显示,经调整其他相关因素后,血清KYNA水平分别为PEAF患者AS、AoSI和AoDIS的独立影响因素(P<0.05)。结论 PEAF患者升主动脉AS、AoDIS值降低,AoSI值升高,表明其升主动脉弹性受损,血管硬度增加,并与血清KYNA水平密切相关。

Objective To evaluate the changes of ascending aorta elasticity by echocardiography in patients with persistent atrial fibrillation(PEAF)and its correlation with serum level of kynurenic acid(KYNA).Methods A total of100patients with PEAF in the outpatient department of the Hospital from January 2019to May 2021were recruited as PEAF group.The PEAF group was further divided into age<75years old group(PEAFⅠgroup,n=67)and age≥75years old group(PEAFⅡgroup,n=33)according to the age,and 100patients with non-AF were selected as control group.The differences of ascending aortic strain(AS),ascending aortic stiffness index(AoSI),ascending aortic distensibility(AoDIS)and serum KYNA level in each group were detected and compared,and the relationship between the changes of ascending aortic elasticity and serum KYNA level was analyzed.Results The values of AS and AoDIS in control group,PEAFⅠgroup and PEAFⅡ group decreased in turn,while the value of AoSI and serum level of KYNA increased in turn(P<0.05).Pearson correlation analysis showed that the values of AS,AoSI,AoDIS in patients with PEAF were significantly positively or negatively correlated with the serum level of KYNA(r=-0.289,0.297,-0.257,P<0.05).Multiple stepwise linear regression analysis showed that after adjusting for other relevant factors,serum KYNA level were independent influencing factors of AS,AoSI,AoDIS in patients with PEAF(P<0.05).Conclusion The reduced values of AS and AoDIS and the elevated value of AoSI in patients with PEAF may indicate that the elasticity of ascending aortic is impaired and the stiffness of blood vessel is increased,and it was closely related to serum KYNA level.