Division of Thoracic and Cardiovascular Surgery, West China Hospital, Sichuan University, China.
J Renin Angiotensin Aldosterone Syst. 2013 Sep;14(3):204-11. doi: 10.1177/1470320312460897. Epub 2012 Oct 16.
Mitral valvular disease is strongly related to atrial fibrillation (AF), but the different types of mitral valvular disease have a different prevalence of AF. In this study we explored the expressions of the circulating and local renin-angiotensin-aldosterone system (RAAS) in order to determine the relationship between circulating and local RAAS expressions and its effects on AF in different types of mitral valvular disease patients. Our study group consisted of 24 mitral valvular disease patients scheduled for mitral valve replacement surgery. Peripheral blood samples and left atrial appendage tissue samples were obtained from all patients. Radioimmunoassay was performed to assess the expression levels of circulating and local renin, angiotensin II and aldosterone. In mitral valvular diseases, linear correlation analyses were done for local and circulating renin, angiotensin II and aldosterone; the p values were 0.979, 0.518 and 0.125, respectively. Expression levels of local angiotensin II, circulating angiotensin II and local aldosterone were significantly increased in the AF group compared with sinus rhythm; the p values were 0.023, 0.042 and 0.035, respectively. In mitral stenosis patients, AF was primarily associated with local angiotensin II (p=0.010), as well as being associated with circulating angiotensin II (p=0.038). In mitral regurgitation patients, AF was only significantly associated with local angiotensin II (p=0.038). Circulating and local RAAS expressions are associated with AF in mitral valvular disease patients. The levels of circulating and local RAAS expressions were different in AF patients with different types of mitral valvular diseases. The differentiation of circulating and local RAAS expression levels in AF patients between different types of mitral valvular disease can potentially improve the specific pharmacological interventions outcomes for these patients.
二尖瓣疾病与心房颤动（AF）密切相关，但不同类型的二尖瓣疾病的 AF 患病率不同。在这项研究中，我们探讨了循环和局部肾素-血管紧张素-醛固酮系统（RAAS）的表达，以确定循环和局部 RAAS 表达之间的关系及其对不同类型二尖瓣疾病患者 AF 的影响。我们的研究组包括 24 名因二尖瓣疾病而计划接受二尖瓣置换手术的患者。所有患者均采集外周血样本和左心耳组织样本。采用放射免疫法检测循环和局部肾素、血管紧张素 II 和醛固酮的表达水平。在二尖瓣疾病中，进行了局部和循环肾素、血管紧张素 II 和醛固酮的线性相关分析；p 值分别为 0.979、0.518 和 0.125。AF 组的局部血管紧张素 II、循环血管紧张素 II 和局部醛固酮的表达水平明显高于窦性心律组；p 值分别为 0.023、0.042 和 0.035。在二尖瓣狭窄患者中，AF 主要与局部血管紧张素 II 相关（p=0.010），也与循环血管紧张素 II 相关（p=0.038）。在二尖瓣反流患者中，AF 仅与局部血管紧张素 II 显著相关（p=0.038）。循环和局部 RAAS 表达与二尖瓣疾病患者的 AF 相关。不同类型二尖瓣疾病的 AF 患者的循环和局部 RAAS 表达水平不同。在不同类型二尖瓣疾病的 AF 患者中，循环和局部 RAAS 表达水平的差异可能改善这些患者的特定药物干预效果。
