AIM  To investigate the expression level of periodin protein in serum of patients with heart failure complicated with atrial fibrillation and its diagnostic and prognostic value.

  METHODS   212 patients with heart failure treated in the Second People’s Hospital of Fuyang City, Anhui Province from September 2020 to may 2021 were studied, Patients were divided into heart failure with atrial fibrillation (HF-AF) group (110 cases) and heart failure with sinus rhythm (HF-SR) group (102 cases) according to whether they were complicated with atrial fibrillation receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum periodin protein expression level, and COX risk model was used for prognosis analysis.

  RESULTS  Compared with HF-SR group, the proportion of patients with coronary heart disease in HF-AF group was lower, total bilirubin γ- Glutamyl transpeptidase, platelet count, hemoglobin, Glomerular filtration rate (EGFR), brain natriuretic peptide (BNP) and serum Periostin protein increased significantly (all P<0.01). Pearson correlation analysis showed that the level of periodin in hf-sr group was positively correlated with diastolic blood pressure (P<0.05), NYHA grade (P<0.05) and brain natriuretic peptide (P<0.01), and negatively correlated with LVEF (P<0.05). In hf-af group, periodin and diastolic blood pressure (P<0.05), hypertension (P<0.05), NYHA grade (P<0.05), brain natriuretic peptide (P<0.01), alanine aminotransferase (P<0.05) γ- Glutamyltranspeptidase (P<0.05) and brain natriuretic peptide were positively correlated (P<0.01), and negatively correlated with LVEF (P<0.01) and EGFR (P<0.01), When the critical value of ROC curve was 42.53 ng/L, the AUC of periodin in the diagnosis of HF-SR was 0.721 (0.666～0.785), the sensitivity and specificity were 70.69% and 77.98% respectively, and the AUC of periodin in the diagnosis of HF-AF was 0.847 (0.789～0.902), the critical value was 46.33 ng/L, the sensitivity and specificity were 85.34% and 83.21% respectively. Hanley McNeil analysis showed that the AUC for the diagnosis of HF-AF was significantly higher than that for the diagnosis of HF-SR (P<0.05) (OR=2.012, 95% CI 1.052～3.862) was a risk factor for rehospitalization or cardiovascular death in patients with HF. The event free survival rate of patients with serum periodin < 48.82 ng/L was higher than that of patients with serum periodin≥48.82 ng/L (P<0.05). The serum periodin level of HF-AF≥52.26 ng/L (OR =1.864, 95%CI 1.026～3.854) was a risk factor for rehospitalization or cardiovascular death in patients with HF-AF (P<0.05), the event free survival rate of patients with serum periodin level < 52.26 ng/Lwas higher than that of patients with serum periodin≥52.26 ng/L (P<0.05). CONCLUSION T he level of serum periodin in patients with HF-AF is higher than that in patients with HF-SR, which is an independent risk factor affecting the prognosis of the disease, and the value of periodin in the diagnosis of patients with HF-AF is significantly higher than that in patients with HF-SR.