左室构型与钙调神经磷酸酶表达之间的关系

Relationship between left ventricular geometry and expression of calcineurin

目的:心脏重构与慢性心力衰竭(CHF)关系密切,钙调神经磷酸酶(calcineurin,CaN)是一种Ca2+敏感性磷酸酶,其信号通路可能参与CHF的发病过程,本研究旨在了解左室构型与外周淋巴细胞和心肌组织中CaN表达之间的关系。方法:选择因瓣膜性心脏病住院接受心外科手术治疗的患者38例(男20例,女18例,年龄48.87±9.58岁),利用彩色多普勒超声心动图测量患者的心腔内径和室壁厚度,计算左室质量指数(LVMI)和相对室壁厚度(RWT),然后根据二者确定左室构型。取患者外周静脉血及少量左室乳头肌,分别提取外周淋巴细胞和心肌组织的总RNA,采用半定量逆转录多聚酶链反应技术(RT-PCR)测定CaN催化亚基(CnA)的α(CnAα)和b(CnAβ)异构体mRNA水平。结果:资料完整的患者共有36人,他们的左室构型分别为:正常构型(17例)、向心性重构(1例)、离心性肥厚(17例)和向心性肥厚(1例)。与正常构型的患者相比,离心性肥厚患者淋巴细胞中的CnAαmRNA水平较高(0.7671±0.1450vs0.6786±0.0928;P=0.042),而淋巴细胞中的CnAβ以及心肌中的CnAα和CnAβ均无明显差异(P>0.05),该结果与性别比例、年龄、血压水平以及心率无关。另外,LVMI与淋巴细胞中CnAαmRNA水平存在正相关(Pearsonr=0.381,P=0.026)。结论:CnAαmRNA水平在瓣膜性心脏病合并左室离心性肥厚的患者外周淋巴细胞中明显升高,并且与LVMI存在相关性。

Objectlve：Cardlac remodeling is closely related to chronic heart failure （CHF）. Ca^2 ＋ -sensitive phosphatase, calcineurin, may be implicated in the process of CHF as a potential signaling molecule, so we aimed to investigate the relationship between left ven- tricular geometry and expression of calcineurin in peripheral lymophocytes and myocardium. Methods： The diameter of cardiac chambers and the thickness of ventricular wall were meassured by two-dimensional and M-mode echocardiography in 38 hospitalized patients with vavular heart disease （VHD） for cardiac operation （20 male and 18 female, age 48.87 ± 9.58 years）. Left ventricular geometry was determined according to left ventrieular mass index （LVMI） and relative wall thickness （RWT）. mRNA levels of α-and β-isoforms of caleineurin subunlt A（CnA） in peripheral lymphocytes and my.ocardium were assessed by reverse transcription polymerase chain reaction. Results：The data of 36 patients were available, Left ventrieular geometry was classified as normal （n= 17）, concentric remodeling （n= 1）, eccentric hypertrophy （n= 17） and concentric hypertrophy （n = 1）. In comparison with the group of normal geometry, the mRNA level of CnA α-isoform in peripheral lymphocytes in patients with eccentric hypertrophy was much higher （0.7671 ±0. 1450 vs 0.6786 ±0.0928; P = 0.042）, while the CnA β-isoform in lymphocytes as well as the CnA α-and β-isoforms in myocardimn were not significantly different in alcove two groups （ P 〉 0.05）. These findings were independent of gerder, age, blood pressure and heart rate. In addition, a positive relatiormship was revealed between LVMI and mRNA level of CnA α-isoform （Pearson r = 0.381, P = 0.026）. Conclusion： The mRNA level of CnA α-isoform in peripheral lymphocytes was significantly elevated in patients with VHD and left ventrieular eccentric hypertrophy, and it was positively eorrelted with LVMI.