Objective To study the relationship between atrial structural remodeling and the expression of matrix metallo-proteinase (MMP) and B-type natriuretic peptide (BNP) during atrial fibrillation (AF). Methods Biopsies from right atrial appendages were taken from 20 patients with sinus rhythm and 30 patients with AF undergone heart valve replacement surgery for rheumatic heart diseases. All patients received plasma BNP concentration detection. Echocardiography datas were registrated preoperatively. MMP-1, -3, -7, -9 protein expressions were detected by RT-PCR. Results Compared with the sinus rhythm, the left and right atrial diameter and the mRNA level of MMP-3,-7,-9 and plasma BNP concentration were significantly increased in AF group (all P < 0.01). MMP-1 was increased in AF group in comparison to the sinus rhythm group but no statistics difference. Conclusion The expression of BNP and MMP-1,-3,-7,-9 increased in fibrillat-ing atrial tissue which may have contributed to the atrial structural remoldeling during AF.%目的 研究心房颤动患者心房组织基质金属蛋白酶(MMP)及血浆脑利钠肽(BNP)的表达,探讨二者与心肌重构的关系.方法 选取因风湿性心脏病接受换瓣手术的患者共50例,其中窦性心律组20例,房颤组30例,术前进行超声心动图检查.取静脉血测血浆BNP浓度,于开胸手术时取右心耳标本,使用荧光定量PCR方法检测标本中MMP-1、MMP-3、MMP-7、MMP-9的表达.结果 与窦性心律组比较,房颤组左右心房内径均扩大[(31.35±5.24)mm vs(42.30±4.02)mm;(30.20±7.47)mm vs(43.77±4.59)mm,均P < 0.01),BNP水平升高[(495±152)ng/L vs (802±276)ng/L,P < 0.01),心房组织中MMP-1表达有增加,但差异无统计学意义,MMP-3、MMP-7、MMP-9基因表达增加[(18.02±4.83)vs(21.49±6.19);(5.05±2.07)vs(6.75±2.20);(11.21±5.38) vs (19.13±4.29),均P < 0.01].BNP与MMP-3、MMP-7、MMP-9的表达成正相关(r = 0.278,0.405,0.399,P < 0.05).结论 房颤患者心房组织MMP及血浆BNP的表达改变与心房重构有关.
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