[Relationship between atrial fibroblast proliferation/fibrosis and atrial fibrillation in patients with rheumatic heart disease].
OBJECTIVE
To investigate the association between gene expressions of basic fibroblast growth factor (bFGF), smooth muscle alpha-actin (alpha-SMA) and proliferating cell nuclear antigen (PCNA) and atrial fibrosis in patients with atrial fibrillation (AF).


METHODS
The right atrial tissue samples were taken from 75 patients with rheumatic heart disease underwent heart valve replacement surgery (34 patients with sinus rhythm, 11 patients with paroxysmal AF and 30 patients with persistent AF) and stained with picrosirius red for quantitative analysis of collagen accumulation. The mRNA and protein levels of bFGF, alpha-SMA and PCNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemical technique, respectively.


RESULTS
The percent volume fraction of collagen (CVF) was the highest in persistent AF group and the lowest in the sinus rhythm group (all P < 0.01). CVF significantly correlated with AF duration (r = 0.390, P = 0.010) and left atria (LA) dimension (r = 0.320, P = 0.005). The mRNA and protein levels of bFGF, alpha-SMA and PCNA were significantly higher in the persistent AF group than those in the paroxysmal AF group (all P < 0.05) and significantly higher in both AF groups than those in the sinus rhythm group (P < 0.05-0.01). The mRNA and protein levels of bFGF were positively correlated with CVF (r = 0.330, P = 0.004 and r = 0.292, P = 0.013, respectively), AF duration (r = 0.330, P = 0.005 and r = 0.299, P = 0.010, respectively) and left atrial dimension (r = 0.342, P = 0.003 and r = 0.285, P = 0.015, respectively).


CONCLUSIONS
The increased gene expressions of bFGF, alpha-SMA and PCNA in atrium during AF may contribute to atrial fibrosis by promoting fibroblast proliferation in AF patients.
Department of Cardiology, Fujian Provincial Hospital, Fujian Provincial Research Institute of Cardiovascular Diseases, Fuzhou 350001, China. asialin@sina.com
Ya-Zhou
YZ
Lin
Jin-Ming
JM
Cai
Lin
L
Chen
Zhi-Ping
ZP
Yang
Jian-Cheng
JC
Zhang
Wei
W
Wu
Dan
D
Ke
Chun-Xuan
CX
Xu
D000199:Actins / Q000235:genetics; D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000235:genetics* / Q000473:pathology*; D049109:Cell Proliferation; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000235:genetics; D005347:Fibroblasts / Q000166:cytology*; D005355:Fibrosis; D015870:Gene Expression; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D032383:Myocytes, Cardiac / Q000166:cytology; D018809:Proliferating Cell Nuclear Antigen / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics; D012214:Rheumatic Heart Disease / Q000235:genetics / Q000473:pathology; D055815:Young Adult
C541116:ACTA2 protein, human; D000199:Actins; D018809:Proliferating Cell Nuclear Antigen; D012333:RNA, Messenger; D016222:Fibroblast Growth Factor 2