Objective:To explore the relationship between matrix metalloproteinase-2( MMP-2 ) with its tissue inhibitor( TIMP-2 ) expression and the efficacy of radiofrequency modified maze procedure in patients of atrial fibrillation( AF )with simultaneous rheumatic valve disease surgery.rnMethods: A total of 80 AF patients received radiofrequency modified maze procedure with simultaneous rheumatic valve disease surgery were retrospectively studied. The patients were divided into two groups according to 6 months post-operative condition. Sinus rhythm group,n = 56 and AF group, n = 24. The mRNA and protein expression of MMP-2 and TIMP-2 in left atrial appendage tissue were measured by RT-PCR and Western blot analysis. Type Ⅰ and type Ⅲ collagen volume fraction( CVF- Ⅰ and CVFⅢ )were examined by Picrosirius red stain.rnResults: The mRNA and protein expression of MMP-2 were significantly increased in AF group than those in Sinus rhythm group as( 126. 75±47. 67 )vs. ( 62. 43±31. 41 ),P = 0. 001 and( 140. 33±35. 17 )vs. ( 82. 57±29. 56 ),P<0. 001. CVF-Ⅰ was also higher in AF group than that in Sinus rhythm group as( 18. 16±3. 22 )vs. ( 11. 66±3. 38 ), P<0. 001. There were no statistic differences in TIMP-2 expression, no difference of CVF- Ⅲ between two groups. The mRNA and protein expression of MMP-2 were positively related to CVF- I( r = 0. 575, P<0. 001 ),( r = 0. 637, P<0. 001 )and positively related to left atrial dimension( r = 0. 465 ,P = 0. 003 ),( r = 0. 571 ,P<0. 001 )respectively.Conclusion: MMP-2 expression in left atrial appendage tissue was positively related to left atrial size and CVF-Ⅰ, it associated with the efficacy of radiofrequency modified maze procedure in AF patients with simultaneous rheumatic valve disease surgery.%目的:探讨左心耳组织中基质金属蛋白酶-2(MMP-2)和金属蛋白酶组织抑制因子-2(TIMP-2)的表达对风湿性心脏瓣膜病(风心病)瓣膜手术同期行心房颤动(房颤)射频消融疗效的影响.方法:风心病瓣膜手术同期慢性房颤射频消融术患者共80例,根据术后6个月随访结果分为房颤消除组(n=56)和房颤未消除组(n=24).以逆转录聚合酶链反应法和蛋白质印迹法检测左心耳组织中MMP-2和TIMP-2的信使核糖核酸(mRNA)和蛋白表达,天狼猩红染色偏振光显微镜观察Ⅰ型和Ⅲ型胶原容量分数(CVF-Ⅰ和CVF-Ⅲ).结果:房颤未消除组心房组织MMP-2的mRNA及蛋白表达较房颤消除组明显增加(126.75±47.67 vs.62.43±31.41,P<0.001;140.33±35.17 vs.82.57±29.56,P<0.001),CVF-Ⅰ也较房颤消除组明显增加(18.16±3.22 vs.11.66±3.38,P<0.001).两组之间TIMP-2的mRNA和蛋白表达及CVF-Ⅲ无明显区别.左心耳组织MMP-2的mRNA和蛋白表达与CVF-I呈显著正相关(r=0.575,P<0.001;r=0.637,P<0.001),左心耳组织中MMP-2的mRNA和蛋白表达与左心房直径也呈显著正相关(r=0.465,P=0.003;r=0.571,P<0.001).结论:左心耳组织MMP-2表达与左心房大小和心房纤维化程度相关并影响瓣膜手术同期射频消融治疗房颤的疗效.
展开▼
