基质金属蛋白酶及其抑制剂对心房颤动心房结构重构的影响

Role of matrix metalloproteinase and tissue inhibitor of metalloproteinase in atrial structural remodeling in patients with atrial fibrillation

目的研究心房颤动(房颤)患者心房组织基质金属蛋白酶(MMPs)及其抑制剂(TIMPs)的基因表达,探讨其与心房结构重构的关系。方法选取因风湿性心脏病接受换瓣手术的患者共50例,其中窦性心律组20例,房颤组30例,术前进行超声心动图检查。于开胸手术时取右心耳标本,分别进行免疫组化染色检查、荧光定量PCR方法检测标本中MMP-1、MMP-3、MMP-7、MMP-9及TIMP-1、TIMP-2、TIMP-3、TIMP-4表达。结果与窦性心律组比较,房颤组左右心房内径均显著扩大(P<0.01,P<0.01),心房组织中MMP-1表达有增加,但差异无显著性,MMP-3、MMP-7、MMP-9及TIMP-1、TIMP-2、TIMP-3、TIMP-4基因表达显著增加(均为P<0.01)。结论房颤患者心房组织MMPs及其TIMPs的表达改变与心房重构有关。

Objective To study the relationship between atrial structural remodeling and the expressions of matrix metalloproteinase （MMPs） and their tissue inhibitors （TIMPs） in atrial fibrillation （AF）. Methods Biopsy samples of the right atrial appendages were collected from 20 patients with sinus rhythm and 30 with AF undergoing heart valve replacement surgery for rheumatic heart diseases. All the patients received echocardiographic examination preoperatively. MMP-1,-3,-7,-9 and TIMP-1,-2,-3,-4 protein expressions were detected by immunohistochemistry and RT-PCR. Results Compared with those in patients with sinus rhythm, the AF patients had significantly increased left and right atrial diameters and mRNA levels of MMP-3,-7,-9 and TIMP-1,-2,-3,-4 （P0.01）. MMP-1 expression also showed an increase in AF patients, but the difference was no statistically significant from that in patients with sinus rhythm. Conclusion The expressions of MMP-1,-3,-7,-9 and TIMP-1,-2,-3,-4 increase in fibrillating atrial tissue, which may contribute to atrial structural remodeling and atrial dilatation in AF patients.