三尖瓣关闭不全患者右心房心肌AT-1、AT-2及基质金属蛋白酶的表达

Expression of angiotensin receptor 1,2 and matrix metalloproteinases in right atrial tissue of patients with tricuspid regurgitation

目的检测慢性三尖瓣关闭不全(tricuspid incompetence,TR)患者右心房心肌组织中血管紧张素受体(angiotensin receptor,AT)-1、AT-2及基质金属蛋白酶(matrix metalloproteinase,MMP)1、MMP2、MMP9的表达,探讨TR患者右心房重构的分子生物学特征。方法选择左心瓣膜病变合并TR患者60例,术前按照心脏超声心动图显示TR面积的大小将患者分为3组:A组为轻至中度TR组(1 cm2<TR≤10 cm2);B组为重度TR组(TR>10 cm2);C组为对照组(TR≤1 cm2)。取患者右心房心肌组织标本,置于液氮中保存,western-blot检测AT-1、AT-2和MMP1表达,酶谱法检测MMP2、MMP9活性。结果随着TR面积增加,肺动脉高压、三尖瓣瓣环收缩期内径及舒张期内径显著增大,差异有统计学意义(P<0.05)。与C组相比,A、B两组AT-1及MMP1表达明显增加,差异有统计学意义(P<0.05)。结论随着TR程度增加,AT-1、MMP1的表达发生了改变,提示其参与了TR患者右心房重构。

Objectives To examine the expressions of angiotensin receptor（AT） 1,2 and matrix metalloproteinase （MMP） 1,2,9 in right atrial tissue of patients with chronic tricuspid regurgitation （TR）, and explore the molecular characterization of right atrail remodeling in patients with chronic TR. Methods Right atrial tissue were obtained from 60 patients with left heart valve disease associated TR in open heart surgery. The patients were divided into three groups according to TR area measured in preoperative eehocardiography ： group A was mild-to-moderate TR group （ 1 em2 〈 TR area≤ 10 cm2） ; group B was sevever TR group（TR area 〉10 cm2） and group C was control group（TR area ≤ 1 era2）. For each sample, AT-1 ,AT-2 and MMP1 protein levels were measured by western blot, and MMP2, MMP9 protein were displayed by zymography techniques. Results With TR area increasing, pulmonary hypertension and tricuspid ring diameter in both systolic and diastolic phases significantly increased （P〈0.05）. Compared with group C, expressions of AT-1 and MMP1 in group A and group B ,^-ere significantly higher（P〈0.05）. Conclusions With TR area growing, expressions of AT-1, MMP1 change, which indicates that they are involved in atrium structure remodeling of patients with TR.