title: OPG/RANK/RANKL axis in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery.
abstract: OBJECTIVE
  To investigate the expression of the osteoprotegerin (OPG)/receptor activator of nuclear factor-ĸB (RANK)/RANK ligand (RANKL) axis in the stabilization of spontaneously restored sinus rhythm (SR) in permanent atrial fibrillation (AF) patients after mitral valve (MV) surgery and study its clinical significance.
  
  
  METHODS
  Clinical data, biopsies of right atrial appendages were collected from 135 permanent AF patients who spontaneously restored SR after conventional isolated MV replacement. A comparison was made between patients who had recurrence of AF within 7 days and patients with persistent SR for more than 7 days.
  
  
  RESULTS
  AF patients had an increased expression of RANK, RANKL, and the RANKL/OPG ratio compared to SR patients, and the degree of fibrosis was lower in SR compared to AF in the atria. Moreover, the expressions of RANK, RANKL, and the RANKL/OPG ratio were positively correlated with the degree of fibrosis.
  
  
  CONCLUSIONS
  These findings suggest that the OPG/RANK/RANKL axis plays important roles in the stabilization of restored SR after MV surgery by stimulating AF-related atrial remodeling in AF patients.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xi
authors.forename: Hailong
authors.initials: H
authors.lastname: Cao
authors.forename: Jinfu
authors.initials: J
authors.lastname: Zhu
authors.forename: Oluf Dimitri
authors.initials: OD
authors.lastname: Røe
authors.forename: Mingna
authors.initials: M
authors.lastname: Li
authors.forename: Yanhu
authors.initials: Y
authors.lastname: Wu
authors.forename: Dongjin
authors.initials: D
authors.lastname: Wang
authors.forename: Yijiang
authors.initials: Y
authors.lastname: Chen
mesh_terms: D001281:Atrial Fibrillation / Q000378:metabolism*; D005260:Female; D006325:Heart Atria / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D053244:Osteoprotegerin / Q000378:metabolism*; D053245:RANK Ligand / Q000378:metabolism*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000378:metabolism*
chemical_list: D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human