Kangavari Simon, Oh Yong-Seog, Zhou Shengmei, Youn Ho-Joong, Lee Man-Young, Jung Wook-Sung, Rho Tae-Ho, Hong Soon-Jo, Kar Saibal, Kerwin Walter F, Swerdlow Charles D, Gang Eli S, Gallik Donna M, Goodman Jeffrey S, Chen Yii-Der Ida, Chen Peng-Sheng
Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center and the David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90048, USA.
Heart Rhythm. 2006 Oct;3(10):1150-5. doi: 10.1016/j.hrthm.2006.06.033. Epub 2006 Jul 8.
In animal models, expression of nerve growth factor (NGF) is increased after necrotic myocardial injury. Whether radiofrequency (RF) catheter ablation increases NGF expression in humans is unclear.
The purpose of this study was to determine NGF concentrations in the aorta, coronary sinus, and peripheral veins before and after RF ablation in patients.
We sampled blood from aorta and either great cardiac vein (group 1, N = 18) or proximal (group 2, N = 20) coronary sinus before and after RF ablation. In group 3 (N = 21), peripheral venous blood was sampled before and after RF ablation and then up to postoperative day 7. In group 4 (N = 10), we sampled peripheral venous blood during diagnostic electrophysiologic study. The NGF concentration was determined by enzyme-linked immunosorbent assay. Transcardiac NGF concentration was the difference in NGF concentrations between coronary sinus and aorta.
There was no change in transcardiac NGF concentrations in groups 1 and 2. In group 3, the NGF level did not change significantly from before the procedure (17.10 +/- 15.80 ng/mL) to immediately after the procedure (14.46 +/- 10.36 ng/mL). However, NGF levels increased significantly to 31.24 +/- 19.82 ng/mL (N = 21, P <.0001) on postoperative day 1, 26.23 +/- 16.89 ng/mL (N = 20, P <.001) on postoperative day 2, and 22.01 +/- 11.35 ng/mL (N = 16, P = .003) on postoperative day 3. NGF concentrations did not change significantly in group 4.
RF ablation did not result in a detectable increase of transcardiac NGF concentration immediately after the procedure. However, the systemic NGF concentration increased significantly on postoperative days 1 to 3, suggesting that RF ablation resulted in increased NGF expression.
在动物模型中，坏死性心肌损伤后神经生长因子（NGF）的表达会增加。射频（RF）导管消融术是否会增加人类体内NGF的表达尚不清楚。
本研究的目的是测定患者在射频消融术前和术后主动脉、冠状窦和外周静脉中的NGF浓度。
我们在射频消融术前和术后从主动脉以及心大静脉（第1组，N = 18）或冠状窦近端（第2组，N = 20）采集血液。在第3组（N = 21）中，在射频消融术前和术后采集外周静脉血，然后持续至术后第7天。在第4组（N = 10）中，我们在诊断性电生理研究期间采集外周静脉血。通过酶联免疫吸附测定法测定NGF浓度。跨心脏NGF浓度是冠状窦和主动脉之间NGF浓度的差值。
第1组和第2组的跨心脏NGF浓度没有变化。在第3组中，NGF水平从手术前（17.10 +/- 15.80 ng/mL）到手术后即刻（14.46 +/- 10.36 ng/mL）没有显著变化。然而，术后第1天NGF水平显著升高至31.24 +/- 19.82 ng/mL（N = 21，P <.0001），术后第2天为26.23 +/- 16.89 ng/mL（N = 20，P <.001），术后第3天为22.01 +/- 11.35 ng/mL（N = 16，P =.003）。第4组的NGF浓度没有显著变化。
射频消融术后即刻并未导致可检测到的跨心脏NGF浓度增加。然而，术后第1至3天全身NGF浓度显著升高，表明射频消融导致NGF表达增加。
