tgf‐β1信号通路在瓣膜病合并房颤患者心房结构重构中表达及意义的实验研究-expression and significance of tgf ‐ β 1 signaling pathway in atrial structural remodeling in patients with valvular disease and atrial fibrillation.docx

第三军医大学硕士学位论文 第三军医大学硕士学位论文 2 2 The Expression and Significance of TGF-β1 Signal Pathway in Structural Remodeling of Atrial Fibrillation Patients with Rheumatic Heart Valve Disease Abstract Background and Objective: Atrial fibrillation(AF), which is a variety of clinical manifestations of cardiovascular disease, is a common arrhythmia with high morbidity and mortality. As social aging process, atrial fibrillation has become an important issue affecting public health. However, the etiology and pathogenesis of atrial fibrillation has not yet completely clear. Domestic and international studies have shown that atrial structural remodeling plays important roles in occurrence, maintenance and recurrence after cardioversion of AF. And atrial fibrosis is considered to be a main performance of atrial structural remodeling. TGF-β1 is considered an important factor to promote fibrosis by TGF-β1 / Smad/ CTGF signal pathway, participating in the development of multiple organ fibrosis. Further study of the relationship between atrial fibrillation and atrial structural remodeling in atrial fibrosis, and the significance of TGF-β1 signal pathway in atrial structural remodeling, will help deepen the understanding of etiology and pathogenesis of atrial fibrillation. Thus, the aim of this study is to observe the expressions of TGF-β1 and Smad3 in atrial fibrillation(AF) patients with rheumatic heart valve disease(RHVD), and discuss their roles in structural remodeling of AF. Methods: Part 1: From March 2008 to June 2009, 483 cases with rheumatic heart valve disease accepted mitral valve replacements at Xinqiao Hospital. The records of the patients underwent valve replacements were discussed, including 365 cases mitral valve replacements (MVR), and 128 cases double valves replacements (DVR). All patients were divided into three groups: chronic AF (cAF) group, paroxysmal AF (pAF) group and sinus rhythm (SR) group, based on the presence or absence and the duration of AF. Thrombus were f