三尖瓣关闭不全患者右心房心肌at-1 at-2及基质金属蛋白酶的表达-expression of at - 1 at - 2 and matrix metalloproteinase in right atrium myocardium of patients with tricuspid regurgitation.docxVIP
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三尖瓣关闭不全患者右心房心肌at-1 at-2及基质金属蛋白酶的表达-expression of at - 1 at - 2 and matrix metalloproteinase in right atrium myocardium of patients with tricuspid regurgitation
随着TR程度加重,MMP1表达减少(P0.05);AT-2在三组中表达无显著性差异(P=0.052)。MMP-2和MMP-9在三组中都有表达,但表达量极低。结论1随着TR程度增加,AT-1表达上调,而MMP1表达下调,表明AT-1和MMP1参与了TR患者右心房重构。2MMP2、MMP9在TR组和对照组患者的右心房心肌组织中都有表达,但具体表达量的高低尚待进一步研究。3TR的程度与右心房内径,三尖瓣瓣环收缩末期内径和三尖瓣瓣环舒张末期内径及肺动脉高压相关。关键词三尖瓣关闭不全;右心房重构;血管紧张素受体;基质金属蛋白酶;Theexpressionofangiotensinreceptor1,2andmatrixmetalloproteinasesinrightatrialtissueofpatientswithtricuspidregurgitationName:WuChangliSupervisor:XiaoXuejunAbstractBackgroundTricuspidregurgitation(TR)isusuallyadiseasewithleftvalvediseaseandpulmonaryhypertension.TRcouldenlargerightheartandtherightatrialstructuralremodeling.Renin-angiotensin-aldosteronesystemandmatrixmetalloproteinasesareinvolvedinleftventricularremodelinginpatientswithatrialfibrillation.ObjectivesToexamineexpressionofangiotensinreceptor1,2andmatrixmetalloproteinase1,2,9inrightatrialtissueandexplorethemolecularcharacterizationofrightatrialremodelinginducedbytricuspidregurgitation.MaterialandmethodsSelectionofpatientsPatientswithleftheartvalvediseaseassociatedTRunderwentopenheartsurgerywererandomlychoosedbetweenJune,2011andMay2012inGuangdongGeneralHospital.AcuteTRcausedbyinfectiousendocarditisorinjurywasexclused.ThepatientsweregroupedintothreegroupsaccordingtoTRareameasuredinpreoperativeechocardiography:GroupA:Mild-to-moderate(1TRarea≤10cm2);GroupB:Severe(TRarea10cm2)andGroupCcontrol(TRarea≤1cm2).Someparametersofrightheartfunctioncheckedbyechocardiographypreoperativelywererecorded,suchasrightatrialdiameter,rightventricularejectionfraction,tricuspidannulusdiameterinend–systole,tricuspidannulusdiameterinend-diastoleandthepulmonaryarterysystolicpressureandsoon.MethodsRightatrialmyocardialspecimen(about200mg)wereobtainedfromtherightatriallongitudinalincisionAftercardiopulmonarybypasswasestablishedandcardiacarrested.Thespecimenwereplacedintoliquidnitrogenfreezerimmediately.Foreachsample,AT-1,2andMMP1proteinlevelsweremeasuredbywesternblot.MMP2,MMP9proteinweredisplayedbyZymographytechniques.Compareexpressionofangiotensinreceptor1,2andmatrixmetalloprotein
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