Relationship between serum TIMP4 mRNA and miR-29b expression and atrial fibrosis and recurrence after radiofrequency ablation in patients with atrial fibrillation

YANG Yan; LIU Hong; LI Shuang-fei; ZHU Ji-yan; ZHANG Da-yong

doi:10.3969/j.issn.1672-5301.2024.12.007

Abstract：Objective To explore the relationship between the expressionof serum matrix metalloproteinase inhibitor 4(TIMP4)mRNA,microribonucleic acid(miR-29b)in patients with atrial fibrillation(AF)and atrial fibrosis,and to analyze the correlation with recurrence after radiofrequency ablation.Method 142 patients with AF admitted to Sichuan Mianyang 404 Hospital from January,2022 to June,2023(the case group)and 90 healthy individuals(the control group)were selected.According to the recurrence situation,the patients were divided into the case group and the recurrence group(56 cases)and the non recurrence group(86 cases).The TIMP4 mRNA,miR-29b,type Ⅰ procollagen N-terminal propeptide(P Ⅰ NP),type Ⅲ procollagen N-terminal propeptide(PⅢNP)and laminin(LN)in the case group were compared between the two groups;The correlation between TIMP4 mRNA,miR-29b and fibrosis indicators in the case group and the relevant factors of recurrence after AF radiofrequency ablation,and evaluation of the predictive value of TIMP4 mRNA and miR-29b for recurrence after AF radiofrequency ablation were analyzed.Results The relative expression levels of TIMP4 mRNA and miR-29b in the peripheral blood of the case group were lower than those of the control group(P＜0.01),and the serum levels of P Ⅰ NP,PⅢNP and LN were higher than those of the control group(P＜0.01);the TIMP4 mRNA and miR-29b of the case group were negatively correlated with P Ⅰ NP,PⅢNP and LN(P＜0.05,P＜0.01);left atrial diameter(LAD),creatinine(Cr),uric acid(UA),P Ⅰ NP,PⅢNP,and LN of the recurrent group were higher than those of the non recurrent group(P＜0.01),and TIMP4 mRNA and miR-29b were lower than those of the non recurrent group(P＜0.01).Multivariate logistic regression analysis showed that LAD,PⅢNP,LN,TIMP4 mRNA,and miR-29b were the independent risk factors for recurrence after radiofrequency ablation;The AUC of ofrecurrence after AF radiofrequency ablation predicted with the combination of TIMP4 mRNA and miR-29b was 0.912(95％CI 0.831-0.961),which was higher than the prediction alone(Z=2.872,2.611,P=0.009,0.012).Conclusion The expression of serum TIMP4 mRNA and miR-29b in AF patients is negatively correlated with the degree of atrial fibrosis.Low expression of TIMP4 mRNA and miR-29b is an independent risk factor for recurrence after AF radiofrequency ablation.The combination of the two indicators has a higher clinical prediction for recurrence after AF radiofrequency ablation.