Meng Fei, Han Jie, Wang Jiangang, Zhang Haibo, Xu Chunlei, Meng Xu
Cardiac Valve Center, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
J Thorac Dis. 2018 Dec;10(12):6563-6568. doi: 10.21037/jtd.2018.11.126.
Cardiac sympathetic nervous system is usually activated in cardiopulmonary bypass (CPB) surgery, accompanied by excessive release of norepinephrine (NE). Neuropeptide Y (NPY) has been shown to regulate NE release in the terminal of sympathetic fiber, which is a target for regulating heart function. The expression of NPY and NPY receptor (NPYR) genes in the human atrial tissues during CPB in cardiac surgery was investigated in the present study.
A few discarded atrial tissues before and after CPB were collected in 22 patients with rheumatic cardiac valve diseases. The transcriptional levels of NPY and NPYRs were monitored by real-time quantitative polymerase chain reaction (RT-qPCR) method. Moreover, the correlation between the mRNA levels of NPY/NPYRs and the clinical data were investigated in detail.
The mRNA levels of NPY Y1 and NPY Y5 genes were statistically attenuated in male patients after CPB. Conversely, the expression of NPY, NPY Y1 and NPY Y5 genes were enhanced in female patients. Correlation analysis suggested that there was a significant negative correlation between cardiac ejection fraction (EF) after CPB with the atrial transcriptional level of NPY in male patients.
These results suggested that the expression of NPY/NPYRs in human atrial tissue during CPB was gender specific and activated NPY signaling was only identified in female patients. The elevated expression level of NPY in male patients was correlated with lower cardiac EF after CPB.
在体外循环（CPB）手术中，心脏交感神经系统通常会被激活，同时伴随着去甲肾上腺素（NE）的过度释放。神经肽Y（NPY）已被证明可调节交感神经纤维末端的NE释放，这是调节心脏功能的一个靶点。本研究调查了心脏手术CPB期间人心房组织中NPY和NPY受体（NPYR）基因的表达情况。
收集22例风湿性心脏瓣膜病患者CPB前后的少量废弃心房组织。通过实时定量聚合酶链反应（RT-qPCR）方法监测NPY和NPYR的转录水平。此外，还详细研究了NPY/NPYR的mRNA水平与临床数据之间的相关性。
CPB后男性患者中NPY Y1和NPY Y5基因的mRNA水平在统计学上有所降低。相反，女性患者中NPY、NPY Y1和NPY Y5基因的表达增强。相关性分析表明，CPB后男性患者的心脏射血分数（EF）与心房NPY转录水平之间存在显著负相关。
这些结果表明，CPB期间人心房组织中NPY/NPYR的表达具有性别特异性，且仅在女性患者中发现NPY信号被激活。男性患者中NPY表达水平的升高与CPB后较低的心脏EF相关。
