非瓣膜性心房颤动复律后左心房收缩功能改变与心房肌细胞凋亡的关系  

The relationship between left atrial systolic function after conversion to sinus rhythm and apoptosis of atrial myocardium in patients with nonvalvular atrial fibrillation

作　　者：张平洋[1] 曹衡[2] 吴玲[1] 倪薇华[2] 何晓虹[1] 张幼祥[1] 吴成权[1] 董静[1] 张建鑫[1] 

机构地区：[1]南京医科大学附属南京第一医院心内科,南京210006 [2]安徽皖南医学院附属医院

出　　处：《临床心血管病杂志》2007年第3期176-178,共3页Journal of Clinical Cardiology

摘　　要：目的:研究非瓣膜性心房颤动患者复律后左房收缩功能改变与心房肌细胞凋亡之间的关系。方法:超声观察27例患者(病例组)经药物复律后第1、15、30天时的二尖瓣血流并与15例窦性心律者(对照组)作比较,TUNEL法了解受检者的心房肌细胞凋亡指数。结果:病例组患者复律后15d的房缩期二尖瓣峰速血流、速度积分显著增大,且此后的2周内渐渐增大,而同期的左室舒张早中期血流蜂速、速度积分减小。与对照组相比,病例组心房肌细胞凋亡指数增高[(7.68±1.08)%:(2.16±0.59)%,P<0.05],而复律后第30天时房缩期二尖瓣血流仍较对照组显著减小(P<0.05)。相关分析显示:心房颤动患者心房肌细胞凋亡指数与30d内房缩期二尖瓣峰速血流变化率及速度积分变化率之间呈良好负相关(r=-0.58或-0.52,P<0.05)。结论:心房颤动患者恢复窦性心律后左房收缩功能的改变与其心房肌细胞凋亡有相关性,后者可能在一定程度上参与了影响患者复律后左房功能恢复的过程。Objective：To explore relationship between recovery of left atrial systolic function after conversion to sinus rhythm and apoptosis of atrial myocardium in patients with nonvalvular atrial fibrillation. Method：Transmitral Doppler Patterns in 15 subjects with sinus rhythm were examined and those in 27 patients with nonvalvula atrial fibrillation were followed up within the first day, 15 th and 30 th day after cardioversion. Cardiomyocyte apoptosis was identified by in situ TDT-mediated dUTP nick end labeling （TUNEL） in the patients. Result：There was a significient increase in the peak A-wave velocity during the first two weeks and a gradual increase within the later two weeks while the peak E-wave velocity was decreased. Compared with those in the subjects with sinus rhythm, cardiomyocyte apoptosis index was higher in the patients with nonvalvula atrial fibrillation while the peak A-wave velocity on 30 th day lower. And the cardiomyocyte apoptosis index was correlated significently with the changed rate of peak A-wave velocity（Ap） and the changed rate of velocity-time integral of A-wave（Ai） （r= -0.58;-0.52, P〈0.05）. Conclusion：There was a relationship to some degree between the change of left atrial systolic function and apoptosis of atrial myocardium in patients with nonvalvular atrial fibrillation. Cardiomyocyte apoptosis might influence the recovery of left atrial systolic function after conversion to sinus rhythm.

关 键 词：心房颤动 左心房收缩功能 细胞凋亡 

分 类 号：R541.7[医药卫生—心血管疾病]