CAJ | 학술논문

目的研究心脏瓣膜病心房颤动(房颤)患者心房肌超极化激活环化核昔酸门控通道(HCN)各亚型及其调控因子环腺苷酸(cAMP)的基因转录,探讨房颤患者心房肌超极化激活电流(If)改变的分子机制.方法心外科心脏瓣膜病需开胸换瓣的病人45例,分为两组,其中房颤者27例,窦性心律者18例,术中取左心房组织,采用半定量逆转录-聚合酶链反应(RT-PCR)测定HCN1、HCN2、HCN4、cAMP的mRNA的含量.结果同窦性心律组相比,房颤组患者心房肌HCN2、HCN4的mRNA表达水平上调(P＜0.05),HCNI、cAMP的mRNA表达水平在房颤组患者中亦有增高,但差异无统计学意义(P＞0.05).HCN2的mRNA表达与左心房内径呈正相关(r=0.441,P=0.002).结论心房肌HCN2、HCN4的mRNA表达水平上调可能是心脏瓣膜病房颤患者心房肌If电流改变的重要分子基础,通过If的改变进一步参与心房的电重构.
목적 연구심장판막병심방전동(방전)환자심방기초겁화격활배화핵석산문공통도(HCN)각아형급기조공인자배선감산(cAMP)적기인전록,탐토방전환자심방기초겁화격활전류(If)개변적분자궤제.방법 심외과심장판막병수개흉환판적병인45례,분위량조,기중방전자27례,두성심률자18례,술중취좌심방조직,채용반정량역전록-취합매련반응(RT-PCR)측정HCN1、HCN2、HCN4、cAMP적mRNA적함량.결과 동두성심률조상비,방전조환자심방기HCN2、HCN4적mRNA표체수평상조(P＜0.05),HCNI、cAMP적mRNA표체수평재방전조환자중역유증고,단차이무통계학의의(P＞0.05).HCN2적mRNA표체여좌심방내경정정상관(r=0.441,P=0.002).결론 심방기HCN2、HCN4적mRNA표체수평상조가능시심장판막병방전환자심방기If전류개변적중요분자기출,통과If적개변진일보삼여심방적전중구.
Objective The purpose of this study is to evaluate the gene expression of atrial hyperpolarization-activated cyclic nucleotide-gated(HCN)channel informs and regulatory factor and to pursue the molocular mechanism of the hyperpolarization-activated current(If)changes in patients with atrial fibrillation(AF).Methods The left atrial tissue were obtained from 45 patients with valvular heart disease who underwent cardiac valve replacement.Twenty-seven patients were in sinus rhythm.18 patients were in chronic atrial fibrillation.The mRNA level of HCN1,HCN2,HCN4,cAMP were measured by semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR).Results Compared to sinus rhythm group,the mRNA level of HCN2 and HCN4 were increased(P＜0.05)in AF group.The mRNA of HCN1 Was slighfly higher in AF group,but the differences were not statistically significant(P＞0.05).The mRNA of HCN2 Was significantly correlated with the left atial dimension(r=0.441,P=0.002).Conclusion The increased mRNA level of atrial HCN2 and HCN4 may be very important molecular mechanism of If changes in patients with atrial fibrillation(AF),the changes of If were associated with electical remodeling.