Boldt Andreas, Wetzel Ulrike, Weigl Josef, Garbade Jens, Lauschke Jörg, Hindricks Gerhard, Kottkamp Hans, Gummert Jan Fritz, Dhein Stefan
University of Leipzig, Heart Center, Cardiovascular Surgery, Cardiology, Leipzig, Germany.
J Am Coll Cardiol. 2003 Nov 19;42(10):1785-92. doi: 10.1016/j.jacc.2003.07.014.
TIVES: We postulated a change of angiotensin II receptor subtype expression in patients with lone atrial fibrillation (AF) and AF with underlying mitral valve disease (MVD) both compared with sinus rhythm (SR).
Atrial fibrillation is a progressive disease associated with electrical and structural remodeling. Angiotensin II (ANGII) is involved in the process of myocardial remodeling. Actions of ANGII are mediated by ANGII receptor subtypes 1 and 2 (AT(1) and AT(2)).
Left atrial (LA) and right atrial (RA) tissue samples were obtained from patients with AF or SR with or without underlying MVD. The AT(1) and AT(2) protein levels were measured by quantitative Western blotting techniques.
The AT(1) protein level in the LA was significantly increased in patients with AF (all forms) compared with SR (p < 0.05), whereas AT(2) expression was not significantly altered. Comparison of the subgroups revealed a similar increase of AT(1) in both paroxysmal AF and chronic AF with or without MVD. Additionally, investigations of ANGII receptor subtypes in the RA did not exhibit any significant changes either in AT(1) or in AT(2) in patients with AF versus SR. Underlying MVD did not significantly affect AT(2) receptor subtype expression in LA.
Atrial fibrillation is associated with an up-regulation of AT(1) in LA, but not in RA, and did not appear to influence the AT(2) expression in the atrium. Because we found an enhanced expression of AT(1)in the LA, we conclude that AT(1) might be involved in the pathogenesis of AF in the LA.
目的：我们推测孤立性心房颤动（AF）患者以及合并二尖瓣疾病（MVD）的AF患者与窦性心律（SR）患者相比，血管紧张素II受体亚型表达存在变化。
心房颤动是一种与电重构和结构重构相关的进行性疾病。血管紧张素II（ANGII）参与心肌重构过程。ANGII的作用由血管紧张素II受体亚型1和2（AT(1)和AT(2)）介导。
从有或无潜在MVD的AF或SR患者获取左心房（LA）和右心房（RA）组织样本。通过定量蛋白质印迹技术测量AT(1)和AT(2)蛋白水平。
与SR相比，AF（所有类型）患者的LA中AT(1)蛋白水平显著升高（p < 0.05），而AT(2)表达无显著改变。亚组比较显示，阵发性AF和慢性AF患者（无论有无MVD）的AT(1)均有类似升高。此外，AF患者与SR患者相比，RA中ANGII受体亚型的研究未显示AT(1)或AT(2)有任何显著变化。潜在MVD对LA中AT(2)受体亚型表达无显著影响。
心房颤动与LA中AT(1)上调有关，但与RA无关，且似乎不影响心房中AT(2)的表达。由于我们发现LA中AT(1)表达增强，我们得出结论，AT(1)可能参与LA中AF的发病机制。
