Objective To reveal the role of serum ACE2/Ang (1-7)in the occurrence of atrial fibrillation (AF)and find new targets for the prevention and treatment of AF by analyzing the correlation between the serum concentration of ACE2/Ang (1-7 )in patients with rheumatic valvular heart disease and the occurrence of AF. Methods We collected the basic clinical information and peripheral venous blood of patients with rheumatic heart valve disease (totally 46 patients,including 24 with AF and 22 with SR).ELISA method was used to detect the serum concentration of ACE2,Ang (1-7)and AngⅡ in the serum samples.Then the differences and correlation between the two groups were analyzed.Results In the AF group ① the diameter of the left atrium was significantly greater than that in the SR group [(60.70±3.08 vs.48.15±2.16)mm,P<0.05];② the serum concentration of AngⅡ was significantly higher than that in the SR group [(45.88±2.87 vs.35.78±1.08)pg/mL, P<0.05],AngⅡ and left atrium diameter were positively correlated (Pearson test,P<0.05);③ the serum concentrations of ACE2 [(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]and Ang (1-7)[(146.05±17.61 vs. 321.71±36.50)pg/mL,P<0.05]were significantly lower than those in the SR group,and negatively correlated with left atrium diameter (Pearson test,P<0.05);④ the serum concentration of Ang (1-7)was negatively correlated with AngⅡ concentration (Pearson test,P<0.05).Conclusion For patients with rheumatic valvular heart disease,ACE2/Ang (1-7 )may play a protective role in the occurrence of AF via antagonizing AngⅡ and inhibiting atrial remodeling.%目的：分析风湿性心脏瓣膜病患者血清 ACE2/Ang(1~7)的浓度与心房颤动发生之间的相关性,探讨 ACE2/Ang(1~7)在风湿性心脏瓣膜病房颤发生中的作用,探寻房颤的预防及治疗的新靶点。方法收取风湿性心脏瓣膜病患者[46例,其中心房颤动(AF)组24例,窦性心律(SR)组22例]基本临床资料及外周静脉血,用 ELISA法检测血清中ACE2、Ang(1~7)、AngⅡ的浓度,分析两组间的差异及相关性。结果 AF组可见以下改变：①左心房直径明显大于SR组[(60.70±3.08 vs.48.15±2.16)mm,P<0.05]；②血清 AngⅡ浓度[(45.88±2.87 vs.35.78±1.08)pg/mL, P<0.05]明显高于 SR组,同时 AngⅡ与左心房直径呈正相关(Pearson检验,P<0.05)；③血清 ACE2浓度[(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]及 Ang(1~7)浓度[(146.05±17.61 vs.321.71±36.50)pg/mL,P<0.05]显著低于 SR组,与左心房直径呈负相关(Pearson检验,P<0.05)；④血清 Ang(1~7)与 AngⅡ浓度呈负相关(Pearson检验,P<0.05)。结论在风湿性心脏瓣膜病患者中,ACE2/Ang(1~7)可能通过拮抗 AngⅡ抑制心房的重构,对于房颤的发生具有保护作用。
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