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首页> 外文期刊>Heart rhythm: the official journal of the Heart Rhythm Society >Left versus right atrial difference in dominant frequency, K(+) channel transcripts, and fibrosis in patients developing atrial fibrillation after cardiac surgery.
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Left versus right atrial difference in dominant frequency, K(+) channel transcripts, and fibrosis in patients developing atrial fibrillation after cardiac surgery.

机译：心脏手术后发生心房颤动的患者，左心房与右心房的主要频率，K（+）通道转录本和纤维化的差异。

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BACKGROUND: The development of atrial fibrillation (AF) after cardiac surgery is associated with adverse outcomes; however, the mechanism(s) that trigger and maintain AF in these patients are unknown. OBJECTIVE: The purpose of this study was to test our hypothesis that postoperative AF is maintained by high-frequency sources in the left atrium (LA) resulting from ion channel and structural features that differ from the right atrium (RA). METHODS: Forty-four patients with no previous history of AF who underwent cardiac surgery consented to LA and RA biopsies. Histologic sections evaluated fatty infiltration, fibrosis, and iron deposition; quantitative reverse transcription-polymerase chain reaction (RT-PCR) assessed ion channel expression. In a subset of 27 patients, LA and RA unipolar recording leads were also placed. In patients who developed AF, the dominant frequency (DF) for each lead was calculated using fast Fourier transform. RESULTS: DFs during AF were LA 6.26 +/- 0.8 Hz, RA 4.56 +/- 0.7 Hz (P <.01). RT-PCR revealed LA-to-RA differences in mRNA abundance for Kir2.3 (1.8:1) and Kir3.4 (2.3:1). While LA fibrosis was greater in patients developing AF compared with those remaining in normal sinus rhythm (10.8% +/- 11% vs. 3.8% +/- 3.5%; P = .03), the amount of LA fibrosis inversely correlated with the LA DF. CONCLUSIONS: This is the first demonstration of LA-to-RA frequency differences during postoperative AF, which are associated with LA-to-RA differences in mRNA levels for potassium channel proteins and LA fibrosis. These results strongly suggest that sources of AF after cardiac surgery are located in the LA and are stabilized by LA fibrosis.
机译：背景：心脏手术后房颤的发展与不良预后相关。然而，在这些患者中触发和维持房颤的机制尚不清楚。目的：本研究的目的是检验我们的假设，即离子通道和与右心房（RA）不同的结构特征导致左心房（LA）的高频源维持了房颤。方法：44例既往无AF史的接受心脏手术的患者同意进行LA和RA活检。组织学切片评估脂肪浸润，纤维化和铁沉积;定量逆转录聚合酶链反应（RT-PCR）评估离子通道表达。在27位患者的子集中，还放置了LA和RA单极记录导线。在发生房颤的患者中，使用快速傅里叶变换计算每根导线的主频（DF）。结果：AF期间的DF为LA 6.26 +/- 0.8 Hz，RA 4.56 +/- 0.7 Hz（P <.01）。 RT-PCR显示Kir2.3（1.8：1）和Kir3.4（2.3：1）的mRNA丰度存在LA-RA差异。尽管发生AF的患者的LA纤维化程度高于正常窦性心律患者（10.8％+/- 11％vs. 3.8％+/- 3.5％; P = .03），但LA纤维化程度与洛杉矶DF。结论：这是术后房颤期间LA-RA频率差异的首次证明，这与钾通道蛋白和LA纤维化的mRNA水平的LA-RA频率差异有关。这些结果强烈表明，心脏手术后的房颤来源位于洛杉矶，并通过洛杉矶的纤维化得以稳定。

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