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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