Predictive value of serum miR-30a-5p and PGC-1α to recurrence in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation

Xu Zuoting; Peng Chao; Zhi Juan

doi:10.3969/j.issn.1674-4055.2025.06.10

Abstract：Objective To investigate the predictive value of microRNA-30a-5p(miR-30a-5p)and peroxisome proliferator-activated receptor gamma coactivator 1α(PGC-1α)postoperative recurrence in patients with paroxysmal atrial fibrillation(PAF)after radiofrequency catheter ablation(RFCA).Methods PAF patients received RFCA were selected into PAF group(n=155)from Department of Cardiovascular Medicine in People's Hospital of Xingyi City from June 2021 to June 2023.The PAF group was divided,according to postoperative follow-up results,into recurrence group(n=62)and non-recurrence group(n=93),and meanwhile the healthy individuals who had normal results of physical examination(n=155)were selected into control group.The levels of miR-30a-5p and PGC-1α were detected by using qRT-PCR and ELISA in 2 groups,and heart parameters were compared between 2 groups.The target binding sites of miR-30a-5p and PGC-1α were predicted by using ENCORI database,and correlation among miR-30a-5p,PGC-1α and heart parameters was analyzed by using Pearson method.The clinical materials were given single-factor analysis in 2 groups.The influence factors for post-RFCA recurrence were analyzed by using Logistic regression analysis.The predictive value of miR-30a-5p and PGC-1α to post-RFCA recurrence was reviewed by using ROC curve.The relationship among high/low expressions of miR-30a-5p and PGC-1α and recurrence rate was compared by using χ2 test.Results The expression of miR-30a-5p was higher,and expression of PGC-1α was lower in PAF group than those in control group(P＜0.05).The left atrial diameter(LAD)and left ventricular diastolic diameter(LVDD)were higher,and left ventricular ejection fraction(LVEF)and left ventricular fraction shortening(LVFS)were lower in PAF group than those in control group(P＜0.05).MiR-30a-5p had a target binding site with PGC-1α,and miR-30a-5p was negatively correlated to PGC-1α in PAF patients(r=-0.804,P＜0.05).The level of miR-30a-5p was positively correlated to LAD and LVDD,and negatively correlated to LVEF and LVFS.The level of PGC-1α was negatively correlated to LAD and LVDD,and positively correlated to LVEF and LVFS(P＜0.05).LAD,LVDD and miR-30a-5p were higher,and LVEF,LVFS and PGC-1α were lower in recurrence group than those in non-recurrence group(P＜0.05).MiR-30a-5p(OR=3.526),LAD(OR=2.269)and LVDD(OR=2.987)were risk factors,and PGC-1α(OR=0.398),LVEF(OR=0.527)and LVFS(OR=0.506)were protective factors for postoperative recurrence in PAF patients(P＜0.05).The results of ROC curve analysis showed that,in predicting postoperative recurrence in PAF patients,AUC of miR-30a-5p combined with PGC-1α was 0.934,which was superior to miR-30a-5p(Z=3.125,P＜0.05)alone or PGC-1α(Z=3.752,P＜0.05)alone.The recurrence rate was lower in patients with lower miR-30a-5p expression than that in whose with higher miR-30a-5p expression(χ2=18.162,P＜0.05),and recurrence rate was higher in patients with lower PGC-1α expression than that in whose with higher lower PGC-1α expression(χ2=32.766,P＜0.05).Conclusion In PAF patients,miR-30a-5p was upregulated,and PGC-1α was downregulated,and combination of miR-30a-5p and PGC-1α has a higher predictive value to postoperative recurrence after RFCA.