CAJ | 학술논문

目的：探讨肌浆网钙ATP酶2a（SERCA2a）过表达对急性心房颤动（AF）兔心房肌电重构及结构重构的影响。方法36只成年新西兰大白兔，随机分为假手术组作为对照组（Control组，n＝12）、腺病毒/绿色荧光蛋白＋AF组（rAd/GFP＋AF组，n＝12）、腺病毒/SERCA2a＋绿色荧光蛋白＋AF组（rAd/SERCA2a/GFP＋AF组，n＝12）。采用快速心房起搏（频率600次/min）制作急性AF模型。观察各组起搏0、4、8、12、24 h心房有效不应期的变化；应用超声测量左右心房内径、左心室射血分数；荧光显微镜下观察心肌组织绿色荧光表达情况。结果 rAd/SERCA2a/GFP＋AF组自起搏12 h后AERP较rAd/GFP＋AF组延长（P＜0.05）。rAd/SERCA2a/GFP＋AF组与rAd/GFP＋AF组相比较，兔左右心房直径增大，但增加不显著（P＞0.05）；EF值升高，两组有统计学差异（P＜0.05）。rAd/SERCA2a/GFP＋AF组兔心肌冰冻切片在荧光显微镜下可见弥漫绿色荧光。结论以rAd为载体介导SERCA2a基因转导在心房肌组织中过表达可以抗快速起搏引起的AERP缩短，可有效逆转快速心房起搏兔心房肌的电重构及结构重构，有望成为一种潜在的治疗AF的方法。
목적：탐토기장망개ATP매2a（SERCA2a）과표체대급성심방전동（AF）토심방기전중구급결구중구적영향。방법36지성년신서란대백토，수궤분위가수술조작위대조조（Control조，n＝12）、선병독/록색형광단백＋AF조（rAd/GFP＋AF조，n＝12）、선병독/SERCA2a＋록색형광단백＋AF조（rAd/SERCA2a/GFP＋AF조，n＝12）。채용쾌속심방기박（빈솔600차/min）제작급성AF모형。관찰각조기박0、4、8、12、24 h심방유효불응기적변화；응용초성측량좌우심방내경、좌심실사혈분수；형광현미경하관찰심기조직록색형광표체정황。결과 rAd/SERCA2a/GFP＋AF조자기박12 h후AERP교rAd/GFP＋AF조연장（P＜0.05）。rAd/SERCA2a/GFP＋AF조여rAd/GFP＋AF조상비교，토좌우심방직경증대，단증가불현저（P＞0.05）；EF치승고，량조유통계학차이（P＜0.05）。rAd/SERCA2a/GFP＋AF조토심기빙동절편재형광현미경하가견미만록색형광。결론이rAd위재체개도SERCA2a기인전도재심방기조직중과표체가이항쾌속기박인기적AERP축단，가유효역전쾌속심방기박토심방기적전중구급결구중구，유망성위일충잠재적치료AF적방법。
ObjectiveTo explore the effects of sarcoplasmic reticulum calcium ATPase2a (SERCA2a) gene on atrial electrical remodeling and structure remodeling in atrial fibrillation (AF) rabbits by 24 h rapid atrial pacing.MethodsThirty-six New Zealand rabbits were randomized into three groups (n=12), including control group, rAd/GFP+AF group and rAd/SERCA2a/GFP+AF group, AF was induced by rapid atrial pacing (600 beats/min) for 24 hours in each animal of rAd/GFP+AF group and rAd/SERCA2a/GFP+AF group, each animal of control group was not paced. The changes of atrial effective refractory period (AERP) were observed 0, 4, 8, 12, 16 and 24 hours after pacing. Left and right atrial diameter and left ven-tricular ejection fraction (EF) were examined by cardiac ultrasonography. Animals were scarified to observe expression of the green fluorescent protein in the myocardial frozen section of rabbits in rAd/SERCA2a/GFP+AF group under the inverted fluorescence microscope. ResultsAERP was markedly prolonged in rAd/SERCA2a/GFP+AF group compared with rAd/GFP+AF group after pacing for 12 hours(P<0.05). Compared with rAd/GFP+AF group, the left and right atrial volume of rabbits in rAd/SERCA2a/GFP+AF group were enlarged but the increase was not significant (P>0.05), left ven-tricular ejection fraction (EF) was increased significantly (P<0.05); Under the fluorescence microscope, widespread green fluorescence was observed in the myocardial frozen section of rabbits in rAd/SERCA2a/GFP+AF group.ConclusionThese results support the hypothesis that overexpression of SERCA2a is able to reverse the atrial electrophysiologic remodeling and structure remodeling in AF rabbits induced by rapid atrial pacing.It is expected to become a potential method for the treatment of AF.