OBJECTIVETo investigate the mRNA and protein expression of mineralocorticoid receptor (MR) in patients with atrial fibrillation.

METHODSTwenty-five patients with rheumatic heart valve disease, 12 in sinus rhythm and 13 in chronic atrial fibrillation (>or= 6 months), underwent transthoracic echocardiography and right and left atrial lateral wall tissue samples were obtained from these patients during mitral/aortic valve replacement operation. Realtime quantitative PCR and Western blot were used to determine the mRNA and protein expression of MR in atria specimens. The distribution of MR in human atria was analyzed by specific immunohistochemical staining.

RESULTSThe left atrial diameters increased markedly in atrial fibrillation group compared with that in sinus rhythm group (P<0.01). And the results showed that the level of mRNA and protein of MR were increased significantly in atrial fibrillation group compared with those in sinus rhythm group (P<0.01 or 0.05), whereas the expression of mRNA and protein of MR were found to be no difference between left atria and right atria both in fibrillation and sinus groups (all P>0.05). The special immunohistochemical staining demonstrated that MR was abundant in the human atrial myocardium and MRs were located mainly in the cytoplasm of atrial cells, which were more evident in atrial fibrillation group than those in sinus rhythm group.

CONCLUSIONThese findings suggested that MRs were upregulated in atrial fibrillation and aldosterone antagonists may be effective in treating atrial fibrillation.

Adult ; Atrial Fibrillation ; metabolism ; Humans ; Male ; Middle Aged ; Myocardium ; metabolism ; RNA, Messenger ; genetics ; Receptors, Mineralocorticoid ; metabolism

OBJECTIVETo compare the changes of both inward rectifying K(+) (Kir) current(I(k1)) density and mRNA expression level of Kir2.1, a major subfamily of Kir in chronic human atrial fibrillation (CAF) with those in normal sinus rhythm (NSR).

METHODSI(k1) density was measured with whole-cell patch clamp technique in single myocyte isolated by an enzymatic dissociation method from right atrial appendages in patients with CAF (n = 8) and those with NSR (n = 12). The mRNA expression levels of Kir2.1 was determined in right atrial appendages from CAF (n = 19) and NSR (n = 18) by semiquantitative reverse-transcription polymerase chain reaction (RT-PCR).

RESULTThe average resting membrane potentials were similar between CAF and NSR (-78.95 mV +/- 4.67 mV and -70.22 mV +/- 11.08 mV, P>0.05). I(k1) density in single myocyte significantly increased at hyperpolarized potential level (-100 mV) in CAF compared to that in NSR (-9.59 pA/pF +/- 2.47 pA/pF vs. -5.58 pA/pF +/- 2.52 pA/pF, P<0.01). The mRNA level of Kir2.1 was also significantly higher in CAF than that of NSR (0.50+/-0.16 vs. 0.34+/-0.09, P<0.05).

CONCLUSIONThe data suggest that Kir2.1 up-regulation and I(k1) current increase might contribute to the electrical remodeling in CAF patients.

Atrial Fibrillation ; genetics ; metabolism ; physiopathology ; Gene Expression ; Humans ; Myocytes, Cardiac ; metabolism ; physiology ; Patch-Clamp Techniques ; Potassium Channels, Inwardly Rectifying ; genetics ; metabolism ; RNA, Messenger ; genetics

Atrial Fibrillation (AF) is thought be caused by oxidative stress. Oxidative stress at the cellular level results from many factors, including exposure to alcohol, medications, cold, toxins or radiation. In this study we investigated gene transcriptional profiles on the human myocardial tissues from AF and oxidative stress conditions. Right atrial appendages were obtained from AF patients (n = 26) undergoing the Maze procedure, and from control patients (n = 26) who were in normal sinus rhythm and undergoing coronary artery bypass graft operation. To examine the effects of oxidative stress on AF, we used radioactive complementary DNA (cDNA) microarrays to evaluate changes in the expression of 1,152 known genes. This technology, which monitors thousands of genes simultaneously, gives us a better picture of the interactions between AF and oxidative stress. Total RNAs prepared from the retrieved tissues were used to synthesize(33)P-labeled cDNAs by reverse transcription and hybridized to cDNA microarrays. Gene expression profiles showed that 30 genes were upregulated and 25 were downregulated in AF patients compared with control patients. Moreover, comparison rank analysis revealed that the expression of five genes related to reactive oxygen species (ROS)-including flavin containing monooxygenase 1, monoamine oxidase B, ubiquitin specific protease 8, tyrosinase-related protein 1, and tyrosine 3-monooxygenase-increased by more than 2.0 of the Z-ratio, and two genes related to anti-oxidants including glutathione peroxidase 1, and heme oxygenase 2-decreased to the Z-ratio levels of <= -2.0. Apparently, a balanced regulation of pro- and anti-oxidation can be shifted toward pro-oxidation and can result in serious damage similar to that of human AF. Western blotting analysis confirmed the upregulation of tyrosinase-related protein 1 and tyrosine 3-monooxygenase and the downregulation of heme oxygenase 2. These results suggested that the gene expression pattern of myocardial tissues in AF patients can be associated with oxidative stress, resulting in a significant increase in ROS. Thus, the cDNA microarray technique was useful for investigating transcription profiles in AF. It showed that the intracellular mechanism of oxidative stress plays a pivotal role in the pathologic progression of AF and offers novel insight into potential treatment with antioxidants.
Atrial Appendage/metabolism ; Atrial Fibrillation/*genetics/*metabolism ; Blotting, Western ; DNA, Complementary/genetics ; *Gene Expression Profiling ; Gene Expression Regulation ; Human ; Myocardium/metabolism ; Oligonucleotide Array Sequence Analysis ; Oxidative Stress/*genetics ; Reactive Oxygen Species/metabolism ; Support, Non-U.S. Gov't

OBJECTIVETo study the relationship between atrial structural remodeling and the expressions of matrix metalloproteinase (MMPs) and their tissue inhibitors (TIMPs) in atrial fibrillation (AF).

METHODSBiopsy samples of the right atrial appendages were collected from 20 patients with sinus rhythm and 30 with AF undergoing heart valve replacement surgery for rheumatic heart diseases. All the patients received echocardiographic examination preoperatively. MMP-1, -3, -7, -9 and TIMP-1, -2, -3, -4 protein expressions were detected by immunohistochemistry and RT-PCR.

RESULTSCompared with those in patients with sinus rhythm, the AF patients had significantly increased left and right atrial diameters and mRNA levels of MMP-3, -7, -9 and TIMP-1, -2, -3, -4 (P<0.01). MMP-1 expression also showed an increase in AF patients, but the difference was no statistically significant from that in patients with sinus rhythm.

CONCLUSIONThe expressions of MMP-1, -3, -7, -9 and TIMP-1, -2, -3, -4 increase in fibrillating atrial tissue, which may contribute to atrial structural remodeling and atrial dilatation in AF patients.

Adult ; Aged ; Atrial Fibrillation ; enzymology ; pathology ; physiopathology ; Female ; Humans ; Male ; Matrix Metalloproteinases ; genetics ; metabolism ; Middle Aged ; Tissue Inhibitor of Metalloproteinases ; genetics ; metabolism

BACKGROUNDTumor necrosis factor-alpha (TNF-α) is a pleiotropic proinflammatory cytokine and contributes to many kinds of cardiovascular diseases via its receptors (TNFR1/TNFR2). We hypothesize that TNF-α plays a role in the pathogenesis of chronic atrial fibrillation (AF).

METHODSSixty-seven consecutive patients who were scheduled to have cardiac surgery were enrolled into the study. Thirty-one patients with rheumatic heart disease (RHD) and AF were enrolled as study group (AF group). The sinus rhythm (SR) control groups consisted of 20 patients with RHD and 16 patients with coronary artery disease (CAD). Peripheral blood sample was collected before the operation. About 5 mm(3) left atrial tissue was disserted during the operation and was separated into three parts for Western blotting, real time polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) analysis.

RESULTSCompared with the controls (RHD SR and CAD SR), the levels of TNF-α ((14.40 ± 5.45) pg/ml vs. (4.20 ± 3.19) pg/ml vs. (2.68 ± 2.20) pg/ml, P = 0.000) and its soluble receptor 1 (sTNFR1) ((1623.9 ± 558.6) pg/ml vs. (1222.3 ± 175.6) pg/ml vs. (1387.5 ± 362.2) pg/ml, P = 0.001) in plasma were higher in patients with AF. TNF-α level had positive correlation with the left atrial diameter (LAD) (r = 0.642, P = 0.000). Western blotting analysis showed that the protein levels of TNF-α (0.618 ± 0.236 vs. 0.234 ± 0.178 vs. 0.180 ± 0.103, P = 0.000) were higher in patients with AF. The RT-PCR analysis results demonstrated that the mRNA expression of TNF-α (0.103 ± 0.047 vs. 0.031 ± 0.027 vs. 0.023 ± 0.018, P = 0.000) increased in patients with AF. IHC analysis displayed that, comparing to the SR, the expression of TNF-α (0.125 ± 0.025 vs. 0.080 ± 0.027 vs. 0.070 ± 0.023, P = 0.000) increased in the AF group. The protein level and mRNA expression of TNF-α also had positive correlation with left atrium diameter (LAD) (r = 0.415, P = 0.000 and r = 0.499, P = 0.000).

CONCLUSIONSThe results revealed that TNF-α elevated in the plasma and left atrial tissue and had positive correlation with LAD in patients of chronic AF. TNF-α might involve in the pathogenesis of chronic AF.

Aged ; Atrial Fibrillation ; blood ; metabolism ; Blotting, Western ; Female ; Heart Atria ; metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha ; blood ; genetics ; metabolism

OBJECTIVETo discuss the role of calcium-overloading in initiation and maintenance of atrial fibrillation (AF).

METHODSThe right atrial appendages were obtained from 14 patients with AF and 12 patients with sinus rhythm. The mRNA expression of proteins influencing the calcium homeostasis was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and normalized to the mRNA level of glyceraldehyde-3- phosphate dehydrogenase. The left atrial diameter (LAD), mitral valvular area (MVOA), and systolic pulmonary arterial pressure were obtained by echocardiography before surgery.

RESULTSCompared to sinus rhythm group, the mRNA levels of L-type calcium channel alc, sarcoplasmic reticulum (SR), calcium adenosine triphosphatase (Ca2+ -ATPase), and ryanodine receptor type-2 (R(Y) R2) were significantly decreased (P < 0.01); the mRNA level of inositol triphosphate receptor type-1 (IP3R1) was significantly increased (P < 0.05). No changes in the mRNA expression of phospholamban and calsequestrin were observed between two groups (P > 0.05). Correlations were found between MVOA and mRNA levels of LVDC-Calc, SR Ca2+ -ATPase (r = 0.719, P = 0.004; r = 0.625, P = 0.017). The mRNA level of SR Ca2+ -ATPase was negatively correlated with LAD (r = -0.573, P = 0.032).

CONCLUSIONSCalcium loading may be responsible for the occurrence and maintenance of AF, and abnormal regulation in the mRNA expression may be the molecular mechanism of intracellular Ca2+ overload. The progressive nature of AF involves structural change.

Arrhythmia, Sinus ; metabolism ; Atrial Fibrillation ; metabolism ; pathology ; Calcium ; metabolism ; Calcium Channels ; biosynthesis ; genetics ; Calcium-Binding Proteins ; biosynthesis ; genetics ; Calcium-Transporting ATPases ; biosynthesis ; genetics ; Chronic Disease ; Heart Atria ; metabolism ; pathology ; Humans ; Mitral Valve ; pathology ; Myocardium ; metabolism ; RNA, Messenger ; biosynthesis

In order to investigate the changes in the expression of extracellular signal-regulated kinase (ERK1/ERK2) and angiotensin-converting enzyme (ACE) in the patients with atrial fibrillation (AF), 52 patients with rheumatic heart diseases were examined. Nineteen patients had chronic persistent AF (AF > or = 6 months, CAF), 12 patients had paroxymal AF (PAF) and 21 patients had no history of AF. The ERK expression was detected at the mRNA level by reverse transcription polymerase chain reaction, at the protein level by Western blotting and at atrial tissue level by immunohistochemistry. ERK-activating kinases (MEK1/2) and ACE were determined by Western blotting techniques. The expression of ERK2-mRNA was increased in the patients with CAF (74 +/- 19 U vs sinus rhythm: 32 +/- 24 U, P < 0.05). Activated ERK1/ERK2 and MEK1/2 were increased to more than 150% in the patients with AF compared to those with sinus rhythm. No significant difference between CAF and PAF was found. The expression of ACE was three-fold increased in the patients with CAF compared to those with sinus rhythm. Patients with AF showed an increased expression of ERK1/ERK2 in atrial interstitial cells and marked atrial fibrosis. An ACE-dependent increase in the amounts of activated ERK1/ERK2 in atrial interstitial cells may be one of molecular mechanisms for the development of atrial fibrosis in the patients with AF. These findings may have important impact on the treatment of AF.
Adult ; Aged ; Atrial Fibrillation ; enzymology ; etiology ; Female ; Gene Expression ; Heart Atria ; enzymology ; Humans ; Male ; Middle Aged ; Mitogen-Activated Protein Kinase 1 ; genetics ; metabolism ; Mitogen-Activated Protein Kinase 3 ; genetics ; metabolism ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; Rheumatic Heart Disease ; complications

OBJECTIVETo determine whether expression and activity of atrial gelatinases are altered in patients with atrial fibrillation (AF).

METHODSThe right atrial tissue samples were taken from 75 patients with rheumatic heart disease who underwent heart valve replacement surgery. 34 patients were in sinus rhythm, 11 patients had paroxysmal AF and 30 patients had persistent AF. The mRNA and protein level of MMP-2, MMP-9, TIMP-1, TIMP-2 were measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western-blotting analysis respectively. The activity of MMP-2 and MMP-9 was measured by zymographic analysis.

RESULTS(1) The mRNA level of MMP-2 increased significantly in the persistent AF group followed by the paroxysmal AF group compared with the sinus rhythm group (P < 0.01, respectively). MMP-9 mRNA expression remained compatible within groups (P > 0.05). MMP-2 and MMP-9 protein expression was prominent in the persistent AF group compared with the sinus rhythm and paroxysmal AF groups (P < 0.01), the significant difference was also observed between the paroxysmal AF and sinus groups (P < 0.05). (2) TIMP-1 and TIMP-2 expression at mRNA and protein level were all down-regulated in the persistent AF group compared with the sinus rhythm group (P < 0.05), however, the trends of reduction did not reach statistical significance in the paroxysmal AF group (P > 0.05) except that of the mRNA level of TIMP-2 (P < 0.05). (3) The activity of MMP-2 and MMP-9 significantly increased in both paroxysmal AF and persistent AF groups compared with the sinus rhythm group (P < 0.05). The significant difference in MMP-9 was also observed between the persistent AF and paroxysmal AF groups (P < 0.01). (4) MMP-2 and MMP-9 expression at mRNA and protein level were positively correlated with left atrial dimension and AF duration (P < 0.05) and were negatively correlated with the mRNA and protein level of TIMP-2 and TIMP-1 respectively (P < 0.01).

CONCLUSIONSThe upregulation of MMP-2,9 gene expression and activity, along with the selective downregulation of TIMP-1,2 may have contributed to the atrial structural remodeling during AF through influencing collagen metabolism.

Adolescent ; Adult ; Atrial Fibrillation ; genetics ; metabolism ; Female ; Gelatinases ; genetics ; metabolism ; Gene Expression ; Heart Atria ; metabolism ; Humans ; Male ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Middle Aged ; RNA, Messenger ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; metabolism ; Tissue Inhibitor of Metalloproteinase-2 ; genetics ; metabolism ; Young Adult

OBJECTIVETo determine the molecular mechanisms involved in atrial fibrosis which occurs in patients with atrial fibrillation (AF) and to investigate their effects on the initiation and maintenance of AF.

METHODSThe right atrial tissue samples were taken from 73 patients with rheumatic heart disease who underwent heart valve replacement surgery. 34 patients had no history of AF (sinus rhythm group), 9 patients had paroxysmal AF and 30 patients had persistent AF. The mRNA content of collagen type I, collagen type III, MMP-2, TIMP-1, TIMP-2, TIMP-3 and TIMP-4 was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and normalized to beta-actin or GAPDH.

RESULTSCompared to sinus rhythm group, the mRNA of collagen type I and MMP-2 increased significantly in the persistent AF group (all, P < 0.01), followed by the paroxysmal AF group (all, P < 0.05). The mRNA of collagen type III was slightly higher in both AF groups than in the sinus rhythm group, but the differences were not statistically significant (P > 0.05). The mRNA of TIMP-1, TIMP-2 and TIMP-3 was down-regulated in the persistent AF group (all, P < 0.01, respectively), however, the trends of reduction did not reach statistical significance in the paroxysmal AF group (P > 0.05). The mRNA of TIMP-4 remained compatible in each group. The mRNA of collagen type I was significantly correlated with left atrial dimension (r = 0.336, P = 0.004) and AF duration (r = 0.339, P = 0.003). The mRNA of MMP-2 was significantly correlated with the mRNA of TIMP-2 (r = -0.326, P = 0.006), the mRNA of collagen type I (r = 0.322, P = 0.006), left atrial dimension (r = 0.300, P = 0.011) and AF duration (r = 0.300, P = 0.010).

CONCLUSIONThe increased level of collagen type I associated with selective downregulation of TIMP-2 and upregulation of MMP-2 gene expression in atrium could be one of the molecular mechanisms of atrial fibrosis during atrial fibrillation, which correlates with the initiation and maintenance of AF.

Adolescent ; Adult ; Atrial Fibrillation ; metabolism ; pathology ; Collagen Type I ; genetics ; Female ; Fibrosis ; Humans ; Male ; Matrix Metalloproteinase 2 ; genetics ; Middle Aged ; Myocardium ; pathology ; RNA, Messenger ; analysis ; Tissue Inhibitor of Metalloproteinase-2 ; genetics ; Tissue Inhibitor of Metalloproteinases ; genetics

BACKGROUND/AIMS: Underlying cardiac pathology and atrial fibrillation (AF) affect the molecular remodeling of ion channels in the atria. Changes in the expression of these molecules have not been demonstrated in Korean patients with mitral valvular heart disease. Thus, the purpose of this study was to analyze ion channel expression in patients with chronic AF and mitral valvular heart disease. METHODS: A total of 17 patients (eight males and nine females; mean age, 57 +/- 14 years [range, 19 to 77]) undergoing open-heart surgery were included in the study. Twelve patients (seven with coronary artery disease and five with aortic valvular disease) had sinus rhythm, and five patients (all with mitral valvular disease) had chronic, permanent AF. A piece of right atrial appendage tissue (0.5 g) was obtained during surgery. RT-PCR was used to evaluate the expression of L-type Ca2+ channels, ryanodine receptor (RyR2), sarcoplasmic reticular Ca2+-ATPase (SERCA2), gene encoding the rapid component of the delayed rectifier Ikr (HERG), gene encoding calcium-independent transient outward current I(to1) (Kv4.3), gene encoding the ultrarapid component of the delayed rectifier Iku (Kv1.5), K+ channel-interacting protein 2 (KChIP2), hyperpolarization-activated cation channel 2 associated with the pacemaker current If (HCN2), and gene encoding Na+ channel (SCN5A). RESULTS: Reduced L-type Ca2+ channel, RyR2, SERCA2, Kv1.5, and KChIP2 expression and borderline increased HCN2 expression were observed in the patients with AF and mitral valvular heart disease. Left atrial diameter was negatively correlated with RyR2 and KChIP2 expression. Fractional area shortening of the left atrium was positively correlated with RyR2 and KChIP2 expression. CONCLUSIONS: Alterations in ion channel expression and the anatomical substrate may favor the initiation and maintenance of AF in patients with mitral valvular heart disease.
Adult ; Aged ; Aortic Valve Stenosis/metabolism ; Atrial Fibrillation/*metabolism ; Calcium/metabolism ; Chronic Disease ; Coronary Artery Disease/metabolism ; Female ; Heart Valve Diseases/*metabolism ; Humans ; Ion Channels/*genetics ; Male ; Middle Aged ; *Mitral Valve ; Potassium Channels/genetics ; Ryanodine Receptor Calcium Release Channel/genetics ; Sodium Channels/genetics