结缔组织生长因子、肝细胞生长因子与风湿性心脏病心房颤动患者心房纤维化的关系

目的:检测风湿性心脏病心房颤动患者心房组织中结缔组织生长因子(CTGF)、肝细胞生长因子(HGF)、MAPKs信号通路分子的磷酸化水平,探讨房颤心房纤维化的可能分子机制.方法:21例风湿性心脏病患者于术中获取约200 mg的右心房肌组织,分为窦律(SR)组11例和房颤(AF)组10例.Masson病理染色观察心房纤维化,免疫组化测定心房肌组织中CTGF、HGF的蛋白表达,western blot测定心房肌组织中MAPKs信号通路分子的磷酸化水平.结果:与SR组比较,CTGF、MAPKs信号通路分子的磷酸化水平及胶原容积分数在AF组显著增加,而HGF的蛋白表达量显著降低,差异具有统计学意义(P＜0.001).结论:风湿性心脏病房颤患者心肌组织中CTGF的表达增加及HGF的表达降低,可能激活了MAPKs信号通路分子的磷酸化表达,从而促进心房纤维化,参与房颤的发生与维持.

Relationship of CTGF,HGF,and Atrial Fibrosis in Rheumatic Heart Disease Patients with Atrial Fibrillation

Objective: To investigate the alteration of connective tissue growth factor(CTGF),hepatocyte growth factor(HGF),and the level of phosphorylation of MAPKs signaling pathway molecules in rheumatic heart disease patients with atrial fibrillation,and to probe the possible molecular mechanisms of atrial fibrosis.Methods: About 200 mg right arterial tissue was taken from 21 rheumatic heart disease patients(11 sinus rhythm,10 atrial fibrillation) by cardiac surgery.Masson staining was used to observe the degree of atrial fibrosis,the protein expression of CTGF and HGF were measured by immunohistochemistry technique,and the level of phosphorylation of MAPKs signaling pathway molecules was detected by Western blot.Results: Compared with that respectively in SR group,the protein expression of CTGF,the level of phosphorylation of MAPKs signaling pathway molecules and collagen volume fraction significantly increased in AF group,but the protein expression of HGF markedly reduced in AF(P<0.001).Conclusion: In the myocardial tissue of patients with rheumatic heart disease,increased CTGF and decreased HGF expression may contribute to activate the MAPKs signal pathway.As a result,it could promote atrial fibrosis,and then participate in the occurrence and maintain of atrial fibrillation.