Gilbers M D, Bidar E, Maesen B, Zeemering S, Isaacs A, Crijns H, van Gelder I, Rienstra M, Verheule S, Maessen J, Stoll M, Schotten U
Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht, University of Maastricht, Maastricht, The Netherlands.
Neth Heart J. 2021 May;29(5):280-287. doi: 10.1007/s12471-021-01538-x. Epub 2021 Jan 27.
The development of atrial fibrillation (AF) is a complex multifactorial process. Over the past few decades, much has been learned about the pathophysiological processes that can lead to AF from a variety of specific disease models in animals. However, our ability to recognise these disease processes in AF patients is still limited, which has contributed to the limited progress in improving rhythm control in AF.
AIMS/OBJECTIVES: We believe that a better understanding and detection of the individual pathophysiological mechanisms underlying AF is a prerequisite for developing patient-tailored therapies. The RACE V Tissue Bank Project will contribute to the unravelling of the main molecular mechanisms of AF by studying histology and genome-wide RNA expression profiles and combining this information with detailed phenotyping of patients undergoing cardiac surgery.
As more and more evidence suggests that AF may occur not only during the first days but also during the months and years after surgery, we will systematically study the incidence of AF during the first years after cardiac surgery in patients with or without a history of AF. Both the overall AF burden as well as the pattern of AF episodes will be studied. Lastly, we will study the association between the major molecular mechanisms and the clinical presentation of the patients, including the incidence and pattern of AF during the follow-up period.
The RACE V Tissue Bank Project combines deep phenotyping of patients undergoing cardiac surgery, including rhythm follow-up, analysis of molecular mechanisms, histological analysis and genome-wide RNA sequencing. This approach will provide detailed insights into the main pathological alterations associated with AF in atrial tissue and thereby contribute to the development of individualised, mechanistically informed patient-tailored treatment for AF.
心房颤动（AF）的发生是一个复杂的多因素过程。在过去几十年中，通过各种动物特定疾病模型，我们对可导致AF的病理生理过程有了很多了解。然而，我们识别AF患者这些疾病过程的能力仍然有限，这导致在改善AF节律控制方面进展有限。
我们认为，更好地理解和检测AF潜在的个体病理生理机制是开发针对患者的个性化治疗的先决条件。RACE V组织库项目将通过研究组织学和全基因组RNA表达谱，并将这些信息与接受心脏手术患者的详细表型分析相结合，有助于揭示AF的主要分子机制。
越来越多的证据表明，AF不仅可能在术后头几天发生，也可能在术后数月和数年发生，我们将系统研究有或无AF病史患者心脏手术后头几年AF的发生率。将研究总体AF负担以及AF发作模式。最后，我们将研究主要分子机制与患者临床表现之间的关联，包括随访期间AF的发生率和模式。
RACE V组织库项目结合了接受心脏手术患者的深度表型分析，包括节律随访、分子机制分析、组织学分析和全基因组RNA测序。这种方法将提供对心房组织中与AF相关的主要病理改变的详细见解，从而有助于开发针对AF的个体化、基于机制的患者定制治疗。
