Department of Physiology, Amsterdam Cardiovascular Sciences, Heart Failure, and Arrhythmias, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
JACC Clin Electrophysiol. 2023 Jul;9(7 Pt 2):1097-1107. doi: 10.1016/j.jacep.2023.02.018. Epub 2023 May 24.
Perpetuation of atrial fibrillation (AF) is rooted in derailment of molecular proteostasis pathways that cause electrical conduction disorders that drive AF. Emerging evidence indicates a role for long noncoding RNAs (lncRNAs) in the pathophysiology of cardiac diseases, including AF.
In the present study, the authors explored the association between 3 cardiac lncRNAs and the degree of electropathology.
Patients had paroxysmal AF (ParAF) (n = 59), persistent AF (PerAF) (n = 56), or normal sinus rhythm without a history of AF (SR) (n = 70). The relative expression levels of urothelial carcinoma-associated 1 (UCA1), OXCT1-AS1 (SARRAH), and the mitochondrial lncRNA uc022bqs.q (LIPCAR) were measured by means of quantitative reverse-transcription polymerase chain reaction in the right atrial appendage (RAA) or serum (or both). A selection of the patients was subjected to high-resolution epicardial mapping to evaluate electrophysiologic features during SR.
The expression levels of SARRAH and LIPCAR were decreased in RAAs of all AF patients compared with SR. Also, in RAAs, UCA1 levels significantly correlated with the percentage of conduction block and delay, and inversely with conduction velocity, indicating that UCA1 levels in RAA reflect the degree of electrophysiologic disorders. Moreover, in serum samples, SARRAH and UCA1 levels were increased in the total AF group and ParAF patients compared with SR.
LncRNAs SARRAH and LIPCAR are reduced in RAA of AF patients, and UCA1 levels correlate with electrophysiologic conduction abnormalities. Thus, RAA UCA1 levels may aid staging of electropathology severity and act as a patient-tailored bioelectrical fingerprint.
心房颤动(AF)的持续存在源于分子伴侣蛋白稳态途径的偏离,这些途径导致电传导障碍,从而驱动 AF。新出现的证据表明长非编码 RNA(lncRNA)在包括 AF 在内的心脏疾病的病理生理学中发挥作用。
在本研究中,作者探讨了 3 种心脏 lncRNA 与电病理程度的关系。
患者分为阵发性 AF(ParAF)组(n=59)、持续性 AF(PerAF)组(n=56)和无 AF 病史的窦性节律(SR)组(n=70)。通过定量逆转录聚合酶链反应(qRT-PCR)在右心耳(RAA)或血清(或两者)中测量尿路上皮癌相关 1(UCA1)、OXCT1-AS1(SARRAH)和线粒体 lncRNA uc022bqs.q(LIPCAR)的相对表达水平。选择部分患者进行高分辨率心外膜标测,以评估 SR 期间的电生理特征。
与 SR 相比,所有 AF 患者的 RAA 中 SARRAH 和 LIPCAR 的表达水平降低。此外,在 RAA 中,UCA1 水平与传导阻滞和延迟的百分比显著相关,与传导速度呈负相关,表明 RAA 中的 UCA1 水平反映了电生理障碍的程度。此外,在血清样本中,总 AF 组和 ParAF 患者的 SARRAH 和 UCA1 水平与 SR 相比均升高。
lncRNA SARRAH 和 LIPCAR 在 AF 患者的 RAA 中减少,UCA1 水平与电生理传导异常相关。因此,RAA 中的 UCA1 水平可能有助于分期电病理严重程度,并作为患者定制的生物电指纹。