Platelet-Derived Growth Factor-A Overexpression Correlates with Atrial Fibrosis in the Patients with Atrial Fibrillation Secondary to Rheumatic Valvular Disease

Objective: To investigate the relationship between platelet-derived growth factor-A (PDGF-A) and atrial fibrosis in patients who have developed atrial fibrillation (AF) secondary to rheumatic valvular disease. Methods: 84 selected patients participated in the current study who have developed rheumatic heart disease and were going to have a cardiac surgical operation. In the current study, whole subjects were divided into two group, they were atrial fibrillation (AF) group (the quantity is thirty-nine) and sinus rhythm (SR) group (the quantity is forty-five). Before the operation, complete clinical data was available for the whole patients. During the operation, the right atrial tissue (0.3 - 0.5 mm3) was disserted from every patient. Right atrial fibrosis was observed by Masson staining and the distribution of PDGF-A in right atrium specimen was observed by immunohistochemistry. RT-PCR techniques were applied to admeasure the mRNA expressions of PDGF-A in patients’ atrial tissue. At the same time, western-Blot techniques were employed to admeasure the protein expressions of PDGF-A. Results: In baseline clinical characteristics, in both AF group and SR group, there was no apparently difference between them (P > 0.05);compared with SR group, the diameters of left atrium and right atrium in AF group were apparently increased (P Conclusion: Atrial remodeling plays an important role in patients with valvular atrial fibrillation;PDGF-A in patients with AF was highly expressed in the right atrial, and was closely related with atrial fibrosis.

Current progress of computational modeling for guiding clinical atrial fibrillation ablation

Atrial fibrillation(AF)is one of the most common arrhythmias,associated with high morbidity,mortality,and healthcare costs,and it places a significant burden on both individuals and society.Anti-arrhythmic drugs are the most commonly used strategy for treating AF.However,drug therapy faces challenges because of its limited efficacy and potential side effects.Catheter ablation is widely used as an alternative treatment for AF.Nevertheless,because the mechanism of AF is not fully understood,the recurrence rate after ablation remains high.In addition,the outcomes of ablation can vary significantly between medical institutions and patients,especially for persistent AF.Therefore,the issue of which ablation strategy is optimal is still far from settled.Computational modeling has the advantages of repeatable operation,low cost,freedom from risk,and complete control,and is a useful tool for not only predicting the results of different ablation strategies on the same model but also finding optimal personalized ablation targets for clinical reference and even guidance.This review summarizes three-dimensional computational modeling simulations of catheter ablation for AF,from the early-stage attempts such as Maze III or circumferential pulmonary vein isolation to the latest advances based on personalized substrate-guided ablation.Finally,we summarize current developments and challenges and provide our perspectives and suggestions for future directions.