title: Does the expression of transforming growth factor β-1: affect the outcome of the radiofrequency modified maze procedure in patients with rheumatic atrial fibrillation?
abstract: We investigated whether the expression of transforming growth factor β-1 in the left atrial appendage affected the outcome of the radiofrequency modified maze procedure in patients with rheumatic valve disease and long-standing persistent atrial fibrillation.Messenger RNA and protein expression of transforming growth factor β-1 and volume fractions of collagen types I and III were measured in 80 patients with rheumatic valve atrial fibrillation who underwent valve surgery with the radiofrequency modified maze procedure; the same was done in a control group of 20 patients with rheumatic valve disease and sinus rhythm who underwent valve surgery alone.At 6 months' follow-up, atrial fibrillation recurred in 24 of the 80 patients in the study group. The messenger RNA and protein expressions of transforming growth factor β-1, collagen type I volume fraction, and left atrial dimension had increased gradually in the control group and in the study subgroups that maintained sinus rhythm or relapsed into atrial fibrillation (P <0.05). The messenger RNA and protein expressions of transforming growth factor β-1 correlated positively with collagen type I volume fraction (r=0.723, P <0.001 and r=0.745, P <0.001, respectively) and left atrial dimension (r=0.762, P <0.001 and r=0.765, P <0.001, respectively). In the sinus rhythm-maintained subgroup, the patients who regained functional atrial contraction had lower messenger RNA and protein expression of transforming growth factor β-1 than did the patients who failed to retain such function (P <0.05).We conclude that the expression of transforming growth factor β-1 in the resected left atrial appendage affects the recurrence of atrial fibrillation and restoration of functional left atrial contraction after the radiofrequency modified maze procedure.
authors.affiliation: Department of Cardiovascular Surgery, Cardiovascular Institute & Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Sheng-Shou
authors.initials: SS
authors.lastname: Hu
authors.forename: Yun-Hu
authors.initials: YH
authors.lastname: Song
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D020517:Atrial Appendage / Q000737:chemistry / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000209:etiology / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D002681:China; D024042:Collagen Type I / Q000032:analysis; D024061:Collagen Type III / Q000032:analysis; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D020127:Recovery of Function; D012008:Recurrence; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000235:genetics / Q000378:metabolism; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D053773:Transforming Growth Factor beta1 / Q000032:analysis* / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D024061:Collagen Type III; D012333:RNA, Messenger; C508960:TGFB1 protein, human; D053773:Transforming Growth Factor beta1