氯通道ClC-1、ClC-2在人心房肌的表达及与心房颤动的关系

目的研究氯通道ClC-1和ClC-2基因在人心房组织的表达及与心房颤动(AF)的关系。方法将71例风湿性心瓣膜病接受换瓣手术患者分为三组,窦性心律(SR)组31例,阵发性房颤(PAF)组7例,慢性房颤(CAF)组33例,于术中获取右心耳组织,应用半定量逆转录-聚合酶链反应(RT-PCR)检测心房组织ClC-1和ClC-2的mR-NA相对含量。结果①ClC-1、ClC-2基因在人心房组织有表达。②与SR组比较,PAF组ClC-1的mRNA表达增加但无统计学意义(1.05±0.22vs1.01±0.13,P>0.05),CAF组的表达明显增加(1.25±0.18vs1.01±0.13,P<0.001),CAF组较PAF组亦明显增加(P<0.01)。ClC-1的mRNA表达水平与左房内径、AF持续时间呈正相关(r=0.344,P=0.003)(r=0.405,P<0.001)]。③与SR组比较,PAF组ClC-2的mRNA表达无增加(1.03±0.14vs1.04±0.15,P>0.05),CAF组的表达明显增加(1.26±0.13vs1.04±0.15,P<0.001),CAF组较PAF组亦明显增加(P<0.01)。ClC-2的mRNA表达与左房内径、AF持续时间呈正相关(r=0.441,P<0.001)(r=0.331,P=0.005)]。结论AF患者ClC-1、ClC-2的mRNA表达水平的增加可能是心房肌电重构的分子基础。

Chloride channels ClC-1 and ClC-2 gene expression in human atrial tissue and their relationship with atrial fibrillation

Objective To investigate gene expression of chloride channel ClC-1 and ClC-2 in human atrial tissue and their relationship with atrial fibrillation(AF).Methods Right atrial appendage specimens were obtained from 33 patients with chronic AF(CAF group),7 with paroxysmal AF(PAF group) and 31 matched controls in sinus rhythm(SR group) who underwent the open-heart surgery.Semi-quantitative polymerase chain reaction(RT-PCR) was used to examine the mRNA expression of ClC-1 and ClC-2 channels in atrial tissue.Results ①There were chloride channels ClC-1 and ClC-2 gene expressing in human atrial tissue.②The content of ClC-1 mRNA in CAF group was significantly higher than that in SR group(1.25±0.18 vs 1.01±0.13,P<0.001).There was no significant difference between PAF group(1.05±0.22) and SR group although the content of ClC-1 mRNA was slightly higher than that in SR group(P>0.05).The significant difference was observed between CAF group and PAF group(P<0.01).ClC-1 expression at mRNA level was positively correlated with left atrial dimension and AF duration(r=0.344,P=0.003)(r=0.405,P<0.001)].③ The content of ClC-2 mRNA in CAF group was significantly higher than that in SR group(1.26±0.13 vs 1.03±0.14,P<0.001),There was no significant difference between PAF group(1.04±0.15) and SR group(P>0.05).The significant difference was observed between CAF group and PAF group(P<0.01).ClC-2 expression at mRNA level was positively correlated with left atrial dimension and AF duration(r=0.441,P<0.001)(r=0.331,P=0.005)].Conclusions Increased gene expression of chloride channel ClC-1 and ClC-2 may serve as the molecular basis of atrial tissue electrical remodeling in patients with AF.