Key result
Chronic AF linked to ~4-fold higher myocardial intracellular calcium and downregulated calcium-handling proteins.
Why the study?
The role of atrial muscle Ca2+ handling proteins in electrical remodeling of atrial fibrillation and their relationship with anatomical structural changes was unclear.
Case-Control (n=16)
Chronic atrial fibrillation is associated with intracellular calcium overload and downregulation of key calcium handling proteins, which correlate with atrial structural changes.
Answers are grounded in this paper and cite their sources.
Altered Ca²⁺ handling may sustain AF; hypothesis-generating for remodeling therapies, should not yet change practice.
目的探讨心房肌Ca2+调控蛋白(calcium handling proteins)在心房颤动(atrial fibrilation,AF)电重构中的作用及与解剖学结构改变的关系.方法测定10例慢性AF患者和6例对照组心房肌Ca2+含量和细胞膜L型Ca2+通道(L-type calcium channel)、肌浆网钙泵(sarcoplasmic reticulum calciumadenodinetriphosphatase,SR Ca2+-ATPase)、磷酸受纳蛋白(phospholamban)、兰尼碱受体(ryanodine receptor)和肌集钙蛋白(calsequestrin)的信使核糖核酸(messenger ribonucleic acid,mRNA)表达;测量AF患者左、右心房内径、二尖瓣口面积和肺动脉收缩压.结果与对照组比较,AF患者心肌细胞内Ca2+含量增加[(1 330±770)μg/ml vs(302±31)μg/ml,P<0.01];细胞膜L型Ca2+通道、SR Ca2+-ATP ase和兰尼碱受体mRNA下调[(0.65±0.30)v(0.97±0.19),P<0.01;(0.73±0.13)vs(1.10±0.11),P<0.001;(0.71±0.25)vs(0.90±0.13),P<0.05].SRCa2+-ATPasemRNA表达与左心房内径中度负相关(r=-0.56,P<0.05);与二尖瓣口面积正相关(r=0.70,P<0.05);细胞膜L型Ca2+通道mR-NA表达与二尖瓣口面积显著正相关(r=0.84,P<0.01).结论频率相关的细胞内Ca2+超负荷可能是AF电重构的始动因素,心房肌Ca2+调控蛋白异常是Ca2+超负荷的分子生物学机制,Ca+调控蛋白mRNA表达异常与左心房解剖学改变之间存在内在联系.
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张薇 et al. (2002) conducted a case-control in Chronic atrial fibrillation (n=16). Chronic atrial fibrillation vs. Controls was evaluated on Myocardial intracellular Ca2+ content (μg/ml) (p=<0.01). Chronic atrial fibrillation was associated with increased myocardial intracellular Ca2+ content and downregulated mRNA expression of key calcium handling proteins.
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