Mendelian randomization provides evidence for a causal effect of serum insulin-like growth factor family concentration on risk of atrial fibrillation

BACKGROUND Atrial fibrillation(AF)is one of the most common persistent arrhythmias among adult cardiovascular diseases.It is important to identify potential risk factors for AF.Members of the insulin-like growth factor(IGF)family exert a variety of effects on various cell types in the context of the pathogenesis of cardiovascular diseases,and previous population-based studies indicate associations between IGF family members and AF.However,the causal effects of IGF family members in AF have not been evaluated.assess genetic relationships between IGF family members and AF.METHODS MR was performed based on genome-wide association study(GWAS)datasets,and concentration levels of 14 IGF family members were retrieved.An initial MR analysis was conducted to identify single nucleotide polymorphisms potentially associated with IGF serum concentrations.A GWAS meta-analysis including 60620 AF cases and 970216 control participants of European ancestry was then conducted to identify AF causal effects.Two-sample MR packages were used to perform MR analysis in R.MR-Egger,weighted median(WM),and inverse va-riance weighted(IVW)methods were used.RESULTS Core Tip:Due to the high prevalence of atrial fibrillation(AF),and adverse outcomes related to it,it is important to identify risk factors associated with development of the condition.Insulin-like growth factor(IGF)family members exert a variety of effects on various cell types in the context of the pathogenesis of cardiovascular diseases,and previous population-based studies indicate associations between IGF family members and AF.However,the causal effects of IGF family members in AF have not been evaluated.The results of the current study provide novel insights on the pathogenesis of AF,and implic-ations of serum IGF family member concentrations when assessing the risk of AF.The study generated evidence on the potential roles of developmental pathological effects in the pathogenesis of AF.Further observational and experimental studies are critically needed.

Prevalence of Atrial Fibrillation in China and Its Risk Factors

Objective To study the prevalence of atrial fibrillation （AF） and the relation with its risk factors in China. Methods A total of 19 363 participants （8635 males and 10 728 females） aged 〉35 years in geographically dispersed urban and rural regions of China were included in this cross-sectional survey. All participants received questionnaire, physical and blood examination. Echocardiography were performed for AF patients found in the survey. Results Of the 19 363 participants, 199 were diagnosed with AF. The estimated age-standardized prevalence of AF was 0.78% in men and 0.76% in women. The prevalence of AF in participants aged 〈60 years was 0.41% in men and 0.43% in women, and was 1.83% in both men and women aged 〉_60 years. About 19.0% of males and 30.9% of females with AF were diagnosed with valve disease. Age- and sex-adjusted multivariable logistic regression analysis revealed that myocardial infarction, left ventricular hypertrophy （LVH）, obesity, and alcohol consumption were associated with a increased risk of AF（P〈0.05）. Conclusion The age standardized prevalence of AF is 0.77% in the participants enrolled in the present study. The number of AF cases aged 〉35 years is 5.26 million according to 2010 Chinese Census. Most risk factors for AF, identified mainly in Western countries, are also detected in China.

Atrial Fibrillation during Cerebral Infarction in Brazzaville: Frequency and Predictive Factors

In order to contribute to the improvement of brain infarction management in Brazzaville, a cross-sectional and analytical study with prospective data collection was conducted in the cardiology and neurology departments of the Brazzaville University Hospital, from February 1 to July 31, 2018. It included patients hospitalized for cerebral infarction confirmed with imaging, and having done an etiological assessment with at least one electrocardiogram at rest and one of long duration. Among these 138 patients included, 11 had atrial fibrillation, equaling?a frequency of 7.9%. The mean age of AF patients was 71 ± 8.8 years. The cardiovascular risk factors found were hypertension in eight cases (72.7%), diabetes in five cases (45.5%), abdominal obesity in four cases (36.4%). AF was permanent in 10 cases (91%), and paroxysmal in one case (9%). It was valvular in three cases (27.3%) and non-valvular in eight cases (72.7%). The cardiopathy involved was hypertensive in seven cases (63.6%), ischemic and valvular in two cases each. The CHA2DS2-VASc score, calculated in eight patients, was an average of 2.2, and ≥2 in more than 80% of patients;HAS-BLED score of 2.4 on average was ≥?3 in more than 72% of patients. Digoxin was prescribed in seven cases (63.6%) and an anti-vitamin K in eight cases (72.7%). In multivariate analysis, age (OR = 20.10, p = 0.023), arterial hypertension (OR = 23.82, p = 0.011), and dyslipidemia (OR = 2.03, p = 0.032) were the predictive factors found. AF is infrequent during brain infarction in Brazzaville. This systematic research raises the problem of age in our context.

Analysis of Risk Factors Associated with Cognitive Dysfunction in Patients with Atrial Fibrillation

Objective: To discuss the risk factors of cognitive dysfunction in patients with atrial fibrillation. Methods: The 150 cases of patients with atrial fibrillation were analyzed in the first affiliated hospital of Nanchang University who were treated in the cardiovascular department, general medicine department and gerontology department from August 2018 to June 2019. We used Mini-Mental State Examination (MMSE) score to evaluate cognitive function of patients with atrial fibrillation. According to the level of education and MMSE score, patients with atrial fibrillation were divided into three groups: normal cognitive function group, mild cognitive impairment group (MCI) and dementia group. And then the demographic data, the previous use of taking drugs, the results of ultrasonic cardiogram (UCG) and laboratory test were analyzed. Results: 1) The basic situation of research object: a total of 150 patients with atrial fibrillation were enrolled in the study, and the average age of these patients was 65.05 ± 8.74 years old, which included 78 males (52%) and 72 females (48%). The mean MMSE score was 23.42 ± 4.65. According to MMSE score, 86 cases (57.3%) of cognitive dysfunction occurred in 150 patients with atrial fibrillation, which included 41 cases (27.3%) of mild cognitive impairment and 45 cases (30%) of dementia. 2) The comparison of general clinical data: there were significant differences in age, smoking, level of education, left ventricular ejection fraction, left atrial diameter, D-dimer, fibrinogen, homocysteine, platelet and previous use of taking warfarin, dabigatran, CCB, statins among the three groups (P < 0.05). 3) The linear correlational analysis between risk factors of cognitive function and MMSE score in patients with atrial fibrillation: there was a positive correlation between left ventricular ejection fraction and MMSE score, but age, left atrial diameter, homocysteine, low density lipoprotein, platelet, BMI, NT-proBNP, D-dimer were negatively correlated with MMSE score. 4) The risk factors with statistical significance in ANOVA were analyzed by ordinal and multinomial logistic regression, which showed that age (OR = 1.174, 95% CI: 0.091 - 0.231), the level of education (illiteracy OR = 4.162, 95% CI: -0.032 - 2.955, primary school OR = 2.751, 95% CI: -0.172 - 2.197, junior high school OR = 3.539, 95% CI: -0.048 - 2.577, senior high school and special secondary school OR = 1.332, 95% CI: -1.080 - 1.655), no CCB (OR = 1.174, 95% CI: 0.091 - 0.231), no warfarin (OR = 13.749, 95% CI: 1.480 - 3.762), no dabigatran (OR = 16.395, 95% CI: 1.462 - 4.131), D-dimer (OR = 2.745, 95% CI: -0.611 - 2.631), fibrinogen (OR = 3.228, 95% CI: 0.399 - 1.946) were related to the high occurrence of cognitive dysfunction. Conclusions: 1) Patients with atrial fibrillation had a higher risk of cognitive dysfunction (the incidence of 57.4%). 2) There was a positive correlation between left ventricular ejection fraction and MMSE score, but age, left atrial diameter, homocysteine, low density lipoprotein, platelet, BMI, NT-proBNP, and D-dimer were negatively correlated with MMSE score. 3) High level of education, previous use of taking warfarin and dabigatran etexilate were protective factors for cognitive function in patients with atrial fibrillation;but age, previous use of taking CCB, D-dimer and fibrinogen were the risk factors in patients with atrial fibrillation.

Chemical Synthesis and Cloning of Overlapping Concatenated Human Atrial Natriuretic Factor Gene with Gene Engineering

Eight oligonucleotide fragments were designed with the aid of a computer and synthesizedaccording to the amino add sequcnce of human atrial natriuretic factor(ANF).By means of an-nealing and ligation,these fragments were assembled into an overlapping concatenator consisting oftwo ANF genes ligated by TGATG for termination and initiation of translation.Theconcatenator was omserted into plasmid pRC23 and the recobinant DNA was transformed into E.coli strain TAP106.Analysis by restriction enzyme mapping,hybridization and DNA sequenongshowed that the orientation and reading frame of the gene were correct.

The dynamic changes of angiotensin Ⅱ and atrial natriuretic factor levels in hypothalamus and infarct volume of rats with foc

Changes of hypothalamus angiotensin Ⅱ (A Ⅱ) and atrial natriuretic factor (ANF) levels and infarct volume were measured in hypertension and normotension rats at different time after focal cerebral ischemia. The results showed that the hypothalamus ANF lev

New Onset of Atrial Fibrillation in a Medical ICU: Prevalence and Risk Factors

Objectives: To evaluate the prevalence and the risk factors of new onset atrial fibrillation (AF) in a single medical ICU. Methods: A prospective observational study was conducted in a 10 bed single medical ICU over a period of 18 months. All patients with sinus rhythm admitted in the medical ICU were included. Those presenting with any arrhythmia on admission, having a PACEMAKER or having undergone a recent cardiothoracic surgery were excluded. Results: Of the 377 patients included on the study, atrial fibrillation occurred in 26 patients (7%). Patients who developed AF were older, had higher severity scores on admission, and required significantly more fluids, catecholamine, and mechanical ventilation. They had a longer ICU and hospital LOS. ICU mortality was significantly higher in AF patients. Five inde- pendent risk factors of AF were identified by multivariate analysis: advanced age, the presence of COPD, sepsis, car- diogenic shock, and hypoxemia. Conclusion: AF occurs in approximately 7% of medical critically ill patients and is associated with age, a history of COPD, the presence of sepsis, cardiogenic shock and hypoxemia. AF occurs in more critically ill patients and is associated with increased morbidity and mortality.

Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly

Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: 1. In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF. 2.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes of AF in the elderly were CHD, hypertension and heart failure. In the elderly, comorbidities were frequent, and the management was a major therapeutic objective. 3.CRP, 1eft atria diameter were the independent risk factors for PeAF in the elderly.

Expression of PDGFR-α in Patients with Valvular Atrial Fibrillation

Objective: To investigate the expression of Platelet-derived growth factor receptor alpha (PDGFR-α) in patients who have valvular atrial fibrillation. Methods: In this research, eighty-four patients with rheumatic heart disease who were going to undertake cardiac surgery were included. The subjects were divided into two groups: the AF group and the sinus rhythm group, the quantities are 39 and 45 respectively. Before the surgery, baseline demographics, physical examination, routine laboratory testing, echocardiography, echocardiographic data and additional clinical data were available for all patients. The right atrial tissue of the subjects was separated during surgery, with an area of approximately 0.3 - 0.5 mm3. Immunofluorescence staining was used to analyze the distribution of PDGFR-α of atrial tissue. mRNA of PDGFR-α in atrial tissue were determined by real-time quantitative PCR (Polymerase Chain Reaction);Western-Blot technique was used to measure the protein of PDGFR-α in atrial tissue. Results: There were no significant differences (P > 0.05) in sex ratio, age, blood pressure, blood biochemistry, and other aspects of medical history between the two groups. However, the right and left atrium diameters in the AF group were markedly larger than those in the SR group (P α from right atrial tissue were obviously higher in the AF group than that in the SR group (P Conclusion: The expression of PDGFR-α in the right atrial tissue of patients with atrial fibrillation was found to be significantly higher.

Platelet-Derived Growth Factor-A Overexpression Correlates with Atrial Fibrosis in the Patients with Atrial Fibrillation Secondary to Rheumatic Valvular Disease

Objective: To investigate the relationship between platelet-derived growth factor-A (PDGF-A) and atrial fibrosis in patients who have developed atrial fibrillation (AF) secondary to rheumatic valvular disease. Methods: 84 selected patients participated in the current study who have developed rheumatic heart disease and were going to have a cardiac surgical operation. In the current study, whole subjects were divided into two group, they were atrial fibrillation (AF) group (the quantity is thirty-nine) and sinus rhythm (SR) group (the quantity is forty-five). Before the operation, complete clinical data was available for the whole patients. During the operation, the right atrial tissue (0.3 - 0.5 mm3) was disserted from every patient. Right atrial fibrosis was observed by Masson staining and the distribution of PDGF-A in right atrium specimen was observed by immunohistochemistry. RT-PCR techniques were applied to admeasure the mRNA expressions of PDGF-A in patients’ atrial tissue. At the same time, western-Blot techniques were employed to admeasure the protein expressions of PDGF-A. Results: In baseline clinical characteristics, in both AF group and SR group, there was no apparently difference between them (P > 0.05);compared with SR group, the diameters of left atrium and right atrium in AF group were apparently increased (P Conclusion: Atrial remodeling plays an important role in patients with valvular atrial fibrillation;PDGF-A in patients with AF was highly expressed in the right atrial, and was closely related with atrial fibrosis.

Analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis

Objective To analyse the risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Methods From January 2001 to December 2008,2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 females,the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group

导管消融术治疗老年持续性心房颤动的疗效分析

目的分析导管消融术治疗老年持续性心房颤动的疗效和术后复发的独立危险因素。方法纳入2019年1月至2021年12月于解放军总医院第一医学中心心血管内科接受导管消融术的持续性心房颤动患者194例,根据年龄分为老年组99例(≥60岁)及非老年组95例(<60岁)。比较2组患者手术特征、术后并发症及复发情况,分析老年组患者术后复发的独立危险因素。结果老年组年龄、B型钠尿肽、高血压、冠心病、CHA_(2)DS_(2)-VASc评分及HAS-BLED评分高于非老年组,男性、估算肾小球滤过率低于非老年组(P<0.05,P<0.01)。老年组左心房纤维化比例高于非老年组(30.3%vs 8.4%,P=0.001)。老年组术后出现1例心包积液,2例穿刺部位血肿,均经治疗后好转。老年组与非老年组术后1年成功率比较无显著差异(71.7%vs 69.5%,P=0.763);老年组与非老年组空白期复发率比较无显著差异(21.2%vs 21.1%,P=0.981)。心房颤动持续时间(HR=1.020,95%CI:1.007~1.032,P=0.002)和空白期复发(HR=6.781,95%CI:3.078~14.935,P=0.001)是老年组患者术后复发心房颤动的独立危险因素。结论导管消融术治疗老年持续性心房颤动安全有效,心房颤动持续时间长和空白期复发的老年患者术后1年内更容易出现复发。

老年心房颤动患者行消融术后再次复发的影响因素

目的 探讨老年心房颤动患者行消融术后再次复发的影响因素。方法 选取2020年1月至2023年1月于江苏省人民医院心血管内科行消融术的200例老年心房颤动患者为研究对象,按是否再次复发分为复发组(45例)和未复发组(155例)。采用logistic回归模型分析老年心房颤动患者行消融术后再次复发的影响因素。结果 两组肥胖、合并高血压、合并糖尿病、合并冠心病、合并睡眠呼吸暂停综合征、规律使用抗心律失常药物和左房内径比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,肥胖(OR=6.592,95%CI:2.773~15.671)、合并高血压(OR=67.982,95%CI:15.051~307.054)、合并糖尿病(OR=17.010,95%CI:3.892~74.339)、合并睡眠呼吸暂停综合征(OR=7.901,95%CI:2.102~29.703)和不规律使用抗心律失常药物(OR=29.988,95%CI:6.273~143.353)是老年心房颤动患者行消融术后再次复发的独立影响因素(P<0.05)。结论 肥胖、合并高血压、合并糖尿病、合并睡眠呼吸暂停综合征和规律使用抗心律失常药物是老年心房颤动患者行消融术后再次复发的影响因素。

体重指数对老年心房颤动患者导管消融术后复发的影响

目的探讨体重指数(BMI)与老年心房颤动患者导管消融术后复发的关系以及对心房颤动复发的预测价值。方法收集2018年1月至2019年12月入住安徽医科大学第一附属医院心血管内科并接受导管消融术的219例老年(≥60岁)心房颤动患者一般情况资料,体格测量资料,血液学、心脏超声影像学等指标,分析BMI值对老年心房颤动患者导管消融术后复发的影响以及对术后心房颤动复发的预测价值。结果BMI值、心房颤动类型为非阵发性以及左心房内径都是老年心房颤动患者导管消融术后心房颤动复发的影响因素,且BMI值对老年心房颤动患者导管消融术后复发有较好的预测价值(AUC=0.595,95%CI:0.526~0.662,P=0.016)。结论BMI值过高是老年心房颤动患者导管消融术后复发的独立影响因素,对老年心房颤动患者导管消融术后复发具有预测意义。

老年心房颤动患者导管射频消融术后复发现状及其影响因素

目的研究老年心房颤动(AF)患者导管射频消融术(RFCA)后复发现状及其影响因素。方法选取2019年1月至2019年12月上海交通大学医学院附属新华医院接受RFCA治疗的794例AF患者为样本开展研究,术后采用24 h动态心电图随访1年,根据是否复发将患者分为复发组和对照组,分析术后复发危险因素,建立logistic回归模型并评估其预测价值。采用SPSS 23.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。采用多因素logistic回归分析研究老年AF患者RFCA术后复发的影响因素。结果794例患者失访8例(1.01%),完成随访的786例患者中复发104例(15.25%)。多因素logistic回归分析显示,年龄(OR=1.113,95%CI 1.041~1.190)、糖尿病(OR=1.697,95%CI 1.018~2.831)、左房内径(LAD;OR=1.135,95%CI 1.025~1.257)、低密度脂蛋白胆固醇(LDL-C;OR=1.229,95%CI 1.044~1.446)以及超敏C反应蛋白(hs-CRP;OR=1.096,95%CI 1.004~1.197)为老年AF患者RFCA术后复发独立危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示:根据logistic回归模型预测AF患者RFCA术后复发风险的ROC曲线下面积为0.939(95%CI 0.885~0.973;P<0.001),Hosmer-Lemeshow检验显示预测值与实际观测值具有良好一致性(χ^(2)=1.279;P=0.461)。结论老年AF患者RFCA术后复发率较高,其中年龄、糖尿病、LAD、LDL-C和hs-CRP是术后复发的独立危险因素,根据上述因素建立的logistic回归模型对预测复发具有良好参考价值。

心源性缺血性脑卒中的临床特征及危险因素分析

目的:分析心源性缺血性脑卒中的临床特征及危险因素。方法:选取广安市人民医院2019年11月—2022年11月收治的210例缺血性脑卒中病人。根据急性脑卒中Org10172试验(TOAST)分型将病人分为心源性脑卒中(42例)、大动脉粥样硬化性脑卒中(73例)、腔隙性脑卒中(66例)、不明原因脑卒中(29例),比较不同TOAST分型脑卒中病人超声心动图参数,分析心源性缺血性脑卒中影响因素,评价超声心动图参数联合D-二聚体对心源性缺血性脑卒中的诊断价值。结果:心源性缺血性脑卒中病人左心房内径(LAD)大于其他TOAST分型脑卒中病人,左室射血分数(LVEF)及每搏输出量(SV)均小于其他TOAST分型脑卒中病人,D-二聚体及N末端B型脑钠肽前体水平均高于其他TOAST分型脑卒中病人,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,D-二聚体、LAD及SV均是心源性缺血性脑卒中的影响因素(P<0.05);受试者工作特征(ROC)曲线显示,D-二聚体、LAD、SV诊断心源性缺血性脑卒中的曲线下面积(AUC)分别为0.737,0.751,0.711,截断值分别为291.32 ng/mL、37.57 mm、70.16 mL,三者联合诊断的AUC为0.853,敏感度、特异度分别为73.81%、91.07%。结论:心源性缺血性脑卒中病人LAD增大,LVEF及SV均降低;D-二聚体、LAD及SV均是心源性缺血性脑卒中的危险因素;LAD、SV联合D-二聚体对心源性缺血性脑卒中有一定诊断价值,可辅助心源性缺血性脑卒中病人的快速筛选。

孤立性心房颤动致病基因TBX20新突变的发现及功能研究

目的:寻找孤立性心房颤动(房颤)致病基因TBX20新突变并研究其功能。方法:测序分析182例孤立性房颤患者和236名无房颤对照者的TBX20基因,以发现新的致房颤突变。克隆人TBX20基因,构建野生型TBX20表达质粒,通过定点诱变制备突变型TBX20表达质粒,借助脂质体将表达质粒转染HeLa细胞,应用双荧光素酶报告基因分析系统研究突变体的功能特性。结果:在1例散发性孤立性房颤患者中发现TBX20基因新突变,即NM_001077653.2:c.706A>T;p(.Lys236*)突变。该突变不存在于其他孤立性房颤患者和对照者。功能研究显示突变型TBX20对靶基因KCNH2的转录激活作用丧失。结论:TBX20基因功能障碍可能是部分房颤患者的分子病因,这对房颤的精准防治有潜在临床意义。

心尖肥厚型心肌病患者心房颤动的相关因素分析

目的:分析心尖肥厚型心肌病患者(apical hypertrophic cardiomyopathy,ApHCM)心房颤动的相关因素。方法:连续入组2011年4月至2019年4月在首都医科大学附属北京安贞医院入院治疗的心尖肥厚型心肌病患者125例,其中49例诊断为心房颤动(观察组),76例无心房颤动(对照组),心房颤动组平均年龄65.5岁,男性比例59.2%,非心房颤动组平均年龄59.5岁,男性比例84.2%。收集患者年龄、性别、合并疾病、治疗及超声心动图检查结果,采用单因素及多因素Logistic回归分析评估ApHCM患者心房颤动的相关因素。结果:与对照组相比,心房颤动组年龄更大、纽约心功能分级Ⅲ者更高、经皮冠状动脉介入治疗比例更低、射频消融术比例更高、住院时间更长(P<0.05)。两组心脏超声参数差异无统计学意义(P> 0.05)。多因素Logistic逐步回归分析表明女性(OR=3.170,95%CI:1.124~8.942,P=0.029)、LAD(OR=1.287,95%CI:1.149~1.440,P=0.000)是该人群发生心房颤动的危险因素,左心室后壁厚度与心房颤动发生呈负相关(OR=0.690,95%CI:0.484~0.984,P=0.041)。结论:心房颤动是影响ApHCM的关键因素之一,且发生率较高,而女性和LAD是心房颤动发生的危险因素,因此根据人群进行针对性、个体化的治疗尤为重要。

心房颤动患者血清生长分化因子-15的表达差异和临床意义

目的:检测心房颤动(简称房颤)患者血清生长分化因子-15(growth differentiation factor-15,GDF-15)水平,分析其表达水平与临床因素、生化指标和心房结构的相关性,进一步分析GDF-15与房颤类型和结构重构的关系。方法:纳入2017年10月至2019年10月于北京大学第三医院心内科住院的房颤患者,选择同期住院无房颤病史的窦性心律者为对照组。收集患者的临床资料,采用酶联免疫吸附反应法检测血清GDF-15水平。采用SPSS 23.0软件进行统计学分析。结果:入组156例房颤患者,其中持续性房颤组64例,阵发性房颤组92例;对照组38例。房颤组血清GDF-15水平明显高于对照组[1 112 (723, 1 525) ng/L vs. 697 (499, 825) ng/L,P<0.001],持续性房颤组血清GDF-15水平明显高于阵发性房颤组[1 140 (858, 1 708) ng/L vs. 1 090 (662, 1 374) ng/L,P=0.047],差异具有统计学意义。血清GDF-15预测房颤的受试者工作特征曲线下面积为0.736(95%CI:0.651~0.822,P<0.001),最佳临界值843.2 ng/L,其敏感性为68.2%,特异性为78.9%。血清GDF-15预测持续性房颤的受试者工作特征曲线下面积为0.594(95%CI:0.504~0.684,P=0.047),最佳临界值771.5 ng/L,其敏感性为82.8%,特异性为35.9%。相关分析显示房颤患者血清GDF-15水平与年龄(r=0.480,P<0.001)、左心房压力(left atrial pressure, LAP,r=0.300,P<0.001)正相关,与左心耳血流速度(left atrial appendage flow velocity, LAAV,r=-0.252,P=0.002)负相关。多重线性回归显示年龄和LAP对血清GDF-15的影响差异具有统计学意义(P<0.05)。Logistic回归分析表明GDF-15(OR=1.002,95%CI:1.001~1.003,P=0.004)和左心房前后径(left atrial diameter, LAD,OR=1.400, 95%CI:1.214~1.616,P<0.001)是房颤发生的独立危险因素。结论:房颤患者血清GDF-15水平显著升高,且持续性房颤患者血清GDF-15水平高于阵发性房颤患者,血清GDF-15表达水平与房颤及心房结构重构具有一定相关性。