曹哲哲, 马瑞彦, 蹇朝, 唐富琴, 肖颖彬. 心房肌细胞凋亡及凋亡相关基因在房颤心房重构中的意义[J]. 心脏杂志, 2019, 31(4): 408-413. DOI: 10.12125/j.chj.201811009
    引用本文: 曹哲哲, 马瑞彦, 蹇朝, 唐富琴, 肖颖彬. 心房肌细胞凋亡及凋亡相关基因在房颤心房重构中的意义[J]. 心脏杂志, 2019, 31(4): 408-413. DOI: 10.12125/j.chj.201811009
    Zhe-zhe CAO, Rui-yan MA, Zhao JIAN, Fu-qin TANG, Ying-bin XIAO. Significance of atrial myocyte apoptosis and apoptosis-related genes in atrial remodeling of atrial fibrillation[J]. Chinese Heart Journal, 2019, 31(4): 408-413. DOI: 10.12125/j.chj.201811009
    Citation: Zhe-zhe CAO, Rui-yan MA, Zhao JIAN, Fu-qin TANG, Ying-bin XIAO. Significance of atrial myocyte apoptosis and apoptosis-related genes in atrial remodeling of atrial fibrillation[J]. Chinese Heart Journal, 2019, 31(4): 408-413. DOI: 10.12125/j.chj.201811009

    心房肌细胞凋亡及凋亡相关基因在房颤心房重构中的意义

    Significance of atrial myocyte apoptosis and apoptosis-related genes in atrial remodeling of atrial fibrillation

    • 摘要:
      目的 分析风湿性心脏病患者房颤发生与发展的特点,探讨心房肌细胞凋亡以及凋亡相关基因表达变化在房颤心房重构中的意义。
      方法 统计分析瓣膜置换手术25例患者临床资料。根据心电图资料分为窦性心律组(10例)和房颤心律组(15例);术中取右心房组织,行Masson染色及天狼猩红染色,计算胶原容积分数(CVF)评价心房纤维化情况;运用TUNEL染色,荧光显微镜下观察两组细胞凋亡差异;用RT-qPCR检测两组样本凋亡相关基因的表达。
      结果 与窦律组比较,房颤组患者LADd和RADd显著增大(均P < 0.01),LVEF显著降低(P < 0.01)、CVF显著增大(P<0.05)、细胞凋亡率显著增高(P < 0.05)、TP53BAXSlug-SNAI2基因表达率显著增高(P < 0.05),而BCL-2BPM4的表达显著降低(P < 0.05)。Pearson相关分析显示LADd、RADd、心房细胞凋亡率和CVF之间存在相关性。
      结论 心房细胞的凋亡在心房重构纤维化形成过程中发挥重要作用,其机制与心肌细胞死亡后纤维组织代替性修复有关,调控心房肌细胞凋亡有望改善心房纤维化的形成。

       

      Abstract:
      AIM To analyze the pathogenesis and development of atrial fibrillation in rheumatic heart disease patients, and to explore the significance of apoptosis and apoptosis-related genes expression in atrial fibrillation.
      METHODS Clinical data of 695 patients with mitral valve replacement were evaluated according to ECG data divided into a sinus rhythm group (SN 10 cases) and an atrial fibrillation group (AF 15 cases). Right atrial tissue was taken intraoperatively, and atrial fibrosis was evaluated by collagen volume fraction. TUNEL assay was utilized to detect cardiomyocyte apoptosis. Real-time PCR was conducted to identify mRNA expression changes in apoptosis-related genes between the sinus rhythm group and the atrial fibrillation group.
      RESULTS Compared with the sinus rate group, the atrial fibrillation group significantly increased (P < 0.01), LVEF significantly decreased (P < 0.01). CVF significantly increased (P < 0.05). Apoptosis rate significantly increased (P < 0.05). TP53, BAX, slug-SNAL2 gene expression rate significantly increased (P < 0.05). BCL-2, BMP4 expression significantly decreased (P < 0.05). Pearson correlation analysis showed that there was a correlation between the, LADd, RADd, apoptosis rate of atrial myocytes and CVF.
      CONCLUSION Atrial myocytes apoptosis is important in the process of atrial remodeling and fibrosis, and its mechanism is related to the replacement fibrosis after myocardial cell death. The regulation of atrial myocytes apoptosis is expected to improve the formation of atrial fibrosis.

       

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