中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2012年
1期
46-50
,共5页
魏玲%苏瑶%李雪梅%肖力屏%马玲%付莉%王莲%李丽娟%陈黔%魏伟%张丽萍%付瑞敏
魏玲%囌瑤%李雪梅%肖力屏%馬玲%付莉%王蓮%李麗娟%陳黔%魏偉%張麗萍%付瑞敏
위령%소요%리설매%초력병%마령%부리%왕련%리려연%진검%위위%장려평%부서민
热休克蛋白47%心房颤动%心肌纤维化%心房重构%结构重构
熱休剋蛋白47%心房顫動%心肌纖維化%心房重構%結構重構
열휴극단백47%심방전동%심기섬유화%심방중구%결구중구
Heat shock protein 47%Atrial fibrillation%Myocardial fibrosis%Atria remodeling%Structural remodeling
目的 探讨胶原特异性分子伴侣--热休克蛋白47( HSP47)在心房颤动(房颤)的发生和维持中的作用.方法 60例行心脏手术的患者分为3组,其中窦性心律组20例,阵发性房颤组20例,持续性房颤组20例,术中获取右心耳心房组织,采用实时荧光定量(FQ-PCR)方法检测HSP47的mRNA表达；同时采用ELISA方法检测上述60例患者血液标本血清中PⅠCP,PⅢNP的浓度.应用超声心动图测定左心房内径,并研究三者的相互关系.结果 ①与窦性心律组比较,HSP47mRNA水平在阵发性房颤组,持续性房颤组心房组织中明显增加( P＜0.05,P＜0.05),且持续性房颤组较阵发性房颤组亦明显增加(P＜0.05).②与窦性心律组相比,房颤患者血清PⅠCP、PⅢNP含量明显增高、左心房明显扩大(P＜0.05),且持续性房颤组PⅠCP、PⅢNP含量及左心房内径高于阵发性房颤组(P＜0.05)；且血清中心肌纤维化指标PⅠCP、PⅢNP含量与左心房内径间呈显著的正相关关系.③经相关性分析得出房颤患者心肌组织中HSP47mRNA水平与血清中PⅠCP、PⅢNP含量呈独立的正相关；与左心房内径亦呈正相关关系.(r=0.831,P＜0.01；r=0.842,P＜0.01；r=0.780,P＜0.01).结论 ①房颤患者存在心肌纤维化及左心房扩大,两者呈正相关关系.提示房颤患者存在左心房结构重构,心肌纤维化在左心房结构重构中起重要作用.②心房组织中HSP47基因表达显著增加,并与房颤的严重程度密切相关,提示可能与房颤的发生和维持有关.③心房组织中HSP47的表达与心肌纤维化指标及左心房内径呈正相关,提示HSP47的表达增加可能是影响心肌纤维化的分子机制之一,与房颤患者心房结构重构密切相关.
目的 探討膠原特異性分子伴侶--熱休剋蛋白47( HSP47)在心房顫動(房顫)的髮生和維持中的作用.方法 60例行心髒手術的患者分為3組,其中竇性心律組20例,陣髮性房顫組20例,持續性房顫組20例,術中穫取右心耳心房組織,採用實時熒光定量(FQ-PCR)方法檢測HSP47的mRNA錶達；同時採用ELISA方法檢測上述60例患者血液標本血清中PⅠCP,PⅢNP的濃度.應用超聲心動圖測定左心房內徑,併研究三者的相互關繫.結果 ①與竇性心律組比較,HSP47mRNA水平在陣髮性房顫組,持續性房顫組心房組織中明顯增加( P＜0.05,P＜0.05),且持續性房顫組較陣髮性房顫組亦明顯增加(P＜0.05).②與竇性心律組相比,房顫患者血清PⅠCP、PⅢNP含量明顯增高、左心房明顯擴大(P＜0.05),且持續性房顫組PⅠCP、PⅢNP含量及左心房內徑高于陣髮性房顫組(P＜0.05)；且血清中心肌纖維化指標PⅠCP、PⅢNP含量與左心房內徑間呈顯著的正相關關繫.③經相關性分析得齣房顫患者心肌組織中HSP47mRNA水平與血清中PⅠCP、PⅢNP含量呈獨立的正相關；與左心房內徑亦呈正相關關繫.(r=0.831,P＜0.01；r=0.842,P＜0.01；r=0.780,P＜0.01).結論 ①房顫患者存在心肌纖維化及左心房擴大,兩者呈正相關關繫.提示房顫患者存在左心房結構重構,心肌纖維化在左心房結構重構中起重要作用.②心房組織中HSP47基因錶達顯著增加,併與房顫的嚴重程度密切相關,提示可能與房顫的髮生和維持有關.③心房組織中HSP47的錶達與心肌纖維化指標及左心房內徑呈正相關,提示HSP47的錶達增加可能是影響心肌纖維化的分子機製之一,與房顫患者心房結構重構密切相關.
목적 탐토효원특이성분자반려--열휴극단백47( HSP47)재심방전동(방전)적발생화유지중적작용.방법 60례행심장수술적환자분위3조,기중두성심률조20례,진발성방전조20례,지속성방전조20례,술중획취우심이심방조직,채용실시형광정량(FQ-PCR)방법검측HSP47적mRNA표체；동시채용ELISA방법검측상술60례환자혈액표본혈청중PⅠCP,PⅢNP적농도.응용초성심동도측정좌심방내경,병연구삼자적상호관계.결과 ①여두성심률조비교,HSP47mRNA수평재진발성방전조,지속성방전조심방조직중명현증가( P＜0.05,P＜0.05),차지속성방전조교진발성방전조역명현증가(P＜0.05).②여두성심률조상비,방전환자혈청PⅠCP、PⅢNP함량명현증고、좌심방명현확대(P＜0.05),차지속성방전조PⅠCP、PⅢNP함량급좌심방내경고우진발성방전조(P＜0.05)；차혈청중심기섬유화지표PⅠCP、PⅢNP함량여좌심방내경간정현저적정상관관계.③경상관성분석득출방전환자심기조직중HSP47mRNA수평여혈청중PⅠCP、PⅢNP함량정독립적정상관；여좌심방내경역정정상관관계.(r=0.831,P＜0.01；r=0.842,P＜0.01；r=0.780,P＜0.01).결론 ①방전환자존재심기섬유화급좌심방확대,량자정정상관관계.제시방전환자존재좌심방결구중구,심기섬유화재좌심방결구중구중기중요작용.②심방조직중HSP47기인표체현저증가,병여방전적엄중정도밀절상관,제시가능여방전적발생화유지유관.③심방조직중HSP47적표체여심기섬유화지표급좌심방내경정정상관,제시HSP47적표체증가가능시영향심기섬유화적분자궤제지일,여방전환자심방결구중구밀절상관.
Objective To stud the role of the expression of heat shock protein 47 (HSP47) in atrial tissues in atrial fibrillation (AF) generation and maintenance.Methods The right atrial tissues and blood-serum samples were harvested from 60 patients during cardiac surgery.Of them,20 patients were in sinus rhythm,20 patients had persistent AF and 20 patients had paroxysmal AF.The expression of HSP47 mRNA was evaluated by Real-time Fluorescence Quantitative PCR,and the concentrations of carboxyterminal propeptide of type Ⅰ procollagen (PⅠCP) and amino-terminal propeptide of typeⅢ procollagen (PⅢNP)in serum were measured by enzyme linkedimmunosorbent assay (ELISA).The left atrial diameters were measured by UCG.Results (1) The HSP47 mRNA level significantly increased both in paroxysmal AF and persistent AF groups compared with the sinus rhythm group(P＜0.05).The significant increase in HSP47 was also observed in the persistent AF compared with paroxysmal AF group(P＜0.05).(2)Compared with controls,the concentrations of serum PⅠCP,PⅢNP and left atrial diameter were significantly increased in patients with AF(P＜0.05).The significant increase was also observed in the persistent AF compared with paroxysmal AF groups in the concentrations of serum PⅠCP,P Ⅲ NP and left atrial diameter (P＜0.05 ).(3) There was a conspicuous and independent direct correlation between the expression of HSP47 and the PⅠCP,P Ⅲ NP and left atrial diameter(r =0.831,P＜0.01 ; r =0.842,P＜0.01 ;r=0.780,P＜0.01 ).Conclusions There was a positive correlation between myocardial fibrosis and left atrial enlargementin the patients with atrial fibrillation.The HSP47 gene is highly expressed in right atrial tissues in atrial fibrillation,it indicates that HSP47 gene related with the generationand maintenance of atrial fibrillation.The expression of HSP47 in right atrial tissues was correlated with PⅠCP,PⅢNP and left atrial diameter and demonstrated that the increase in expression of HSP47maybe one of the molecule mechanisms of myocardial fibrosis and closely related with structural atrial remodeling.
