Shingu Yasushige, Yokota Takashi, Takada Shingo, Niwano Haruki, Ooka Tomonori, Katoh Hiroki, Tachibana Tsuyoshi, Kubota Suguru, Matsui Yoshiro
Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Cardiol. 2018 Jan;71(1):65-70. doi: 10.1016/j.jjcc.2017.07.003. Epub 2017 Aug 12.
Post-operative atrial fibrillation (POAF) frequently occurs after cardiac surgery. However, the mechanisms of POAF have not been fully elucidated. We aimed to examine whether pre-operative atrial gene expression related to cardiac metabolism is changed in patients with POAF.
Right atrial tissue was obtained during surgery from 38 patients who underwent cardiac surgery from 2013 to 2015. Atrial expression levels were determined by reverse transcription polymerase chain reaction for the following genes: glucose transporter type 4, peroxisome proliferator-activated receptor-α, fatty acid translocase, carnitine palmitoyltransferase 1B, and fatty acid binding protein 3 (FABP3). To investigate fatty acid β-oxidation and tricarboxylic acid cycle capacities in the mitochondria, β-hydroxyacyl CoA dehydrogenase and citrate synthase activity levels were spectrophotometrically determined.
POAF within 7 days after surgery was observed in 18 (47%) patients. POAF patients were significantly older, had a larger left atrial diameter, and had reduced expression of FABP3, a fatty acids transport gene in the cytosol, compared to those in the non-POAF group. Reduced FABP3 expression predicted POAF independent of age and atrial size. In contrast, fatty acid β-oxidation enzymatic activity was comparable between the groups.
FABP3 gene expression in the atrium was reduced in patients with POAF. These findings suggest a potential link between altered fatty acid transport in the atrium and increased AF onset after cardiac surgery.
心脏手术后常发生术后房颤(POAF)。然而,POAF的发病机制尚未完全阐明。我们旨在研究POAF患者术前与心脏代谢相关的心房基因表达是否发生变化。
从2013年至2015年接受心脏手术的38例患者手术过程中获取右心房组织。通过逆转录聚合酶链反应测定以下基因的心房表达水平:4型葡萄糖转运蛋白、过氧化物酶体增殖物激活受体-α、脂肪酸转运蛋白、肉碱棕榈酰转移酶1B和脂肪酸结合蛋白3(FABP3)。为了研究线粒体中的脂肪酸β-氧化和三羧酸循环能力,采用分光光度法测定β-羟酰基辅酶A脱氢酶和柠檬酸合酶的活性水平。
18例(47%)患者术后7天内发生POAF。与非POAF组相比,POAF患者年龄显著更大,左心房直径更大,且细胞溶质中脂肪酸转运基因FABP3的表达降低。FABP3表达降低可独立于年龄和心房大小预测POAF。相比之下,两组之间的脂肪酸β-氧化酶活性相当。
POAF患者心房中FABP3基因表达降低。这些发现提示心房脂肪酸转运改变与心脏手术后房颤发作增加之间可能存在联系。