Department of Cardiology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
Department of Medical Laboratory, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
Dis Markers. 2017;2017:8405196. doi: 10.1155/2017/8405196. Epub 2017 Aug 8.
The chronic high-dose right ventricular apical (RVA) pacing may have deleterious effects on left ventricular (LV) systolic function. We hypothesized that the expression changes of genes regulating cardiomyocyte energy metabolism and contractility were associated with deterioration of LV function in patients who underwent chronic RVA pacing. Sixty patients with complete atrioventricular block and preserved ejection fraction (EF) who underwent pacemaker implantation were randomly assigned to either RVA pacing ( = 30) group or right ventricular outflow tract (RVOT) pacing ( = 30) group. The mRNA levels of OPA1 and SERCA2a were significantly lower in the RVA pacing group at 1 month's follow-up (both < 0.001). Early changes in the expression of selected genes OPA1 and SERCA2a were associated with deterioration in global longitudinal strain (GLS) that became apparent months later ( = 0.002 and = 0.026, resp.) The altered expressions of genes that regulate cardiomyocyte energy metabolism and contractility measured in the peripheral blood at one month following pacemaker implantation were associated with subsequent deterioration in LV dyssynchrony and function in patients with preserved LVEF, who underwent RVA pacing.
慢性高剂量右心室心尖（RVA）起搏可能对左心室（LV）收缩功能产生有害影响。我们假设，调节心肌细胞能量代谢和收缩性的基因表达变化与接受慢性 RVA 起搏的患者 LV 功能恶化有关。60 名患有完全房室传导阻滞和射血分数（EF）保留的患者接受起搏器植入，随机分为 RVA 起搏（n = 30）组或右心室流出道（RVOT）起搏（n = 30）组。在 1 个月的随访中，RVA 起搏组的 OPA1 和 SERCA2a 的 mRNA 水平明显降低（均<0.001）。选定基因 OPA1 和 SERCA2a 的表达早期变化与随后数月出现的整体纵向应变（GLS）恶化相关（分别为=0.002 和=0.026）。在起搏器植入后 1 个月测量的外周血中调节心肌细胞能量代谢和收缩性的基因表达改变与接受 RVA 起搏的保留 LVEF 患者随后的 LV 不同步和功能恶化有关。
