Introduction: Sympathetic nervous system disorder promotes atrial fibrillation (AF), and neuropeptide Y (NPY) is an important neurotransmitter. This study aimed to explore the predictive value of plasma NPY in patients with AF. Methods: Five hundred seventy-six patients were divided into AF (including paroxysmal and long-standing persistent AF; 360) and sinus rhythm (SR) groups (216). NPY level was detected using enzyme-linked immunosorbent assay, and NPY mRNA expression level was detected using quantitative polymerase chain reaction. Logistic regression was used to analyse the risk factors for AF; the correlations between blood NPY level and age, body mass index (BMI), left ventricular ejection fraction, left atrial diameter (LAD), and European Heart rate Association (EHRA) score in patients with AF were determined. The receiver operating characteristic (ROC) curve was utilised to predict AF. Results: Plasma NPY levels were found to be higher in patients with AF than in patients with SR and in patients with long-standing persistent AF than in patients with paroxysmal AF; blood NPY mRNA levels were higher in the paroxysmal and long-standing persistent AF groups compared to the SR group (p < 0.05). Increased age {odds ratio (OR) = 1.201 (95% confidence interval [CI]: 1.01, 1.427)} and high NPY [OR = 1.239 (95% CI: 1.022, 1.501)] were factors found to affect AF detrimentally. NPY was associated with BMI (r = 0.5856, p < 0.05), LAD (r = 0.4023, p < 0.05), and EHRA score (r = 0.898, p < 0.05). The ROC curve for the predictive value of plasma NPY levels for AF showed an area under the curve (AUC) value of 0.919 (p < 0.05), while that for long-standing persistent AF showed an AUC of 0.784 (p < 0.05). Conclusion: Circulating NPY may be a promising molecular biomarker of AF.

1.
Roth
GA
,
Mensah
GA
,
Johnson
CO
,
Addolorato
G
,
Ammirati
E
,
Baddour
LM
.
Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study
.
J Am Coll Cardiol
.
2020 Dec
76
25
2982
3021
.
2.
Chen
PS
,
Chen
LS
,
Fishbein
MC
,
Lin
SF
,
Nattel
S
.
Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy
.
Circ Res
.
2014 Apr
114
9
1500
15
.
3.
Tan
AY
,
Zhou
S
,
Ogawa
M
,
Song
J
,
Chu
M
,
Li
H
.
Neural mechanisms of paroxysmal atrial fibrillation and paroxysmal atrial tachycardia in ambulatory canines
.
Circulation
.
2008
;
118
(
9
):
916
25
.
4.
Habecker
BA
,
Anderson
ME
,
Birren
SJ
,
Fukuda
K
,
Herring
N
,
Hoover
DB
.
Molecular and cellular neurocardiology: development, and cellular and molecular adaptations to heart disease
.
J Physiol
.
2016
;
594
(
14
):
3853
75
.
5.
Mehra
R
,
Tjurmina
OA
,
Ajijola
OA
,
Arora
R
,
Bolser
DC
,
Chapleau
MW
.
Research opportunities in autonomic neural mechanisms of cardiopulmonary regulation: a report from the national heart, lung, and blood institute and the national institutes of health office of the director workshop
.
JACC Basic Transl Sci
.
2022 Mar
7
3
265
93
.
6.
Herring
N
.
Autonomic control of the heart: going beyond the classical neurotransmitters
.
Exp Physiol
.
2015 Apr
100
4
354
8
.
7.
Prod’Homme
T
,
Weber
MS
,
Steinman
L
,
Zamvil
S
.
A neuropeptide in immune-mediated inflammation, Y
.
Trends Immunol
.
2006 Apr
27
4
164
7
.
8.
Esler
M
.
Pivotal role of the sympathetic nerves of the human heart in mental stress responses and triggered cardiovascular catastrophes
.
Auton Neurosci
.
2022 Jan
237
102925
.
9.
Kalla
M
,
Hao
G
,
Tapoulal
N
,
Tomek
J
,
Liu
K
,
Woodward
L
.
The cardiac sympathetic co-transmitter neuropeptide Y is pro-arrhythmic following ST-elevation myocardial infarction despite beta-blockade
.
Eur Heart J
.
2020 Jun
41
23
2168
79
.
10.
Ajijola
OA
,
Chatterjee
NA
,
Gonzales
MJ
,
Gornbein
J
,
Liu
K
,
Li
D
.
Coronary sinus neuropeptide Y levels and adverse outcomes in patients with stable chronic heart failure
.
JAMA Cardiol
.
2020 Mar
5
3
318
25
.
11.
Hindricks
G
,
Potpara
T
,
Dagres
N
,
Arbelo
E
,
Bax
JJ
,
Blomström-Lundqvist
C
.
2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC
.
Eur Heart J
.
2021 Feb
42
5
373
498
.
12.
van Delden
JJ
,
van der Graaf
R
.
Revised CIOMS international ethical guidelines for health-related research involving humans
.
JAMA
.
2017
;
317
(
2
):
135
6
.
13.
Shi
S
,
Tang
Y
,
Zhao
Q
,
Yan
H
,
Yu
B
,
Zheng
Q
.
Prevalence and risk of atrial fibrillation in China: a national cross-sectional epidemiological study
.
Lancet Reg Health West Pac
.
2022
;
23
:
100439
.
14.
Rajendran
PS
,
Challis
RC
,
Fowlkes
CC
,
Hanna
P
,
Tompkins
JD
,
Jordan
MC
.
Identification of peripheral neural circuits that regulate heart rate using optogenetic and viral vector strategies
.
Nat Commun
.
2019
;
10
(
1
):
1944
.
15.
Herring
N
,
Tapoulal
N
,
Kalla
M
,
Ye
X
,
Borysova
L
,
Lee
R
.
Neuropeptide-Y causes coronary microvascular constriction and is associated with reduced ejection fraction following ST-elevation myocardial infarction
.
Eur Heart J
.
2019
;
40
(
24
):
1920
29
.
16.
Tan
C
,
Green
P
,
Tapoulal
N
,
Lewandowski
AJ
,
Leeson
P
,
Herring
N
.
The role of neuropeptide Y in cardiovascular health and disease
.
Front Physiol
.
2018 Sep
9
1281
.
17.
Medzikovic
L
,
van Roomen
C
,
Baartscheer
A
,
van Loenen
PB
,
de Vos
J
,
Bakker
EN
.
Nur77 protects against adverse cardiac remodelling by limiting neuropeptide Y signalling in the sympathoadrenal-cardiac axis
.
Cardiovasc Res
.
2018
;
114
(
12
):
1617
28
.
18.
Linz
D
,
Mahfoud
F
,
Schotten
U
,
Ukena
C
,
Neuberger
HR
,
Wirth
K
.
Renal sympathetic denervation suppresses postapneic blood pressure rises and atrial fibrillation in a model for sleep apnea
.
Hypertension
.
2012
;
60
(
1
):
172
8
.
19.
Stavrakis
S
,
Morris
L
,
Takashima
AD
,
Elkholey
K
,
Van Wagoner
DR
,
Ajijola
OA
.
Circulating neuropeptide Y as a biomarker for neuromodulation in atrial fibrillation
.
JACC Clin Electrophysiol
.
2020 Nov
6
12
1575
6
.
20.
Zhu
P
,
Sun
W
,
Zhang
C
,
Song
Z
,
Lin
S
.
The role of neuropeptide Y in the pathophysiology of atherosclerotic cardiovascular disease
.
Int J Cardiol
.
2016 Oct
220
235
41
.
21.
Zhao
Y
,
Qin
F
,
He
B
,
Liu
X
.
Is NPY causing myocardial ischemia in patients with microvascular angina associated with its abnormal constrictor response at the microcirculation level
.
Int J Cardiol
.
2017 Nov
247
52
.
22.
Stadiotti
I
,
Di Bona
A
,
Pilato
CA
,
Scalco
A
,
Guarino
A
,
Micheli
B
.
Neuropeptide Y promotes adipogenesis of human cardiac mesenchymal stromal cells in arrhythmogenic cardiomyopathy
.
Int J Cardiol
.
2021 Nov
342
94
102
.
23.
Heredia
MP
,
Delgado
C
,
Pereira
L
,
Perrier
R
,
Richard
S
,
Vassort
G
.
Neuropeptide Y rapidly enhances [Ca2+] transients and Ca2+ sparks in adult rat ventricular myocytes through Y receptor and PLC activation
.
J Mol Cell Cardiol
.
2005
;
38
(
1
):
205
12
.
24.
Herring
N
,
Kalla
M
,
Paterson
DJ
.
The autonomic nervous system and cardiac arrhythmias: current concepts and emerging therapies
.
Nat Rev Cardiol
.
2019
;
16
(
12
):
707
26
.
25.
Heredia
MP
,
Fernandez-Velasco
M
,
Benito
G
,
Delgado
C
.
Neuropeptide Y increases 4-aminopyridine-sensitive transient outward potassium current in rat ventricular myocytes
.
Br J Pharmacol
.
2002 Apr
135
7
1701
6
.
26.
Wynn
GJ
,
Todd
DM
,
Webber
M
,
Bonnett
L
,
McShane
J
,
Kirchhof
P
.
The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification
.
Europace
.
2014
;
16
(
7
):
965
72
.
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