心力衰竭窦性心律患者右心耳肌细胞多种离子通道基因表达的变化  

Changes in gene expression of multiple ion channels in right atrial of patients with heart failurein in sinus rhythm

作　　者：高梅[1] 侯应龙[1] 王奖荣[1] 刘蔚[1] 孙慧[1] 刘鲁祁[2] 

机构地区：[1]山东省千佛山医院山东大学临床学院心内科,山东济南250014 [2]山东省千佛山医院山东大学临床学院心外科,山东济南250014

出　　处：《中国心脏起搏与心电生理杂志》2007年第5期426-429,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：山东省卫生厅资助课题(批准号:HC119)

摘　　要：目的通过对心力衰竭(HF)窦性心律(简称窦律)患者右心耳肌细胞多种离子通道mRNA水平的测定,试图揭示HF窦律患者心房肌多种离子通道电流变化的分子机制,并进一步揭示HF患者易患心房颤动(AF)的可能机制。方法采集HF组患者(18例)和心功能正常组患者(18例)的右心耳组织,应用逆转录-聚合酶链反应技术(RT-PCR)以GAPDH为内参照,测定瞬时外向钾电流(Ito1)通道的决定基因Kv4.3αmRNA、慢速激活的延迟整流钾电流(Iks)通道的决定基因KvLQT1mRNA、超速激活的延迟整流钾电流(Ikur)通道的决定基因Kv1.5mRNA、L-型Ca2+通道基因L-Caα1cmRNA、钠钙交换(NCX)基因mRNA表达水平。结果与心功能正常组比较,HF组患者Kv4.3αmRNA、KvLQT1mRNA、L-型Ca2+通道基因L-Caα1cmRNA表达均降低(P均<0.01),Kv1.5mRNA表达无明显变化(P>0.05),NCX基因mRNA表达升高(P<0.01)。结论HF患者心房肌细胞离子通道基因表达的变化可能是其相应离子电流改变的分子基础。HF介导的心房肌细胞离子通道重构在形成AF电生理基质中可能起重要作用,可能是HF易患AF的机制之一。Objective To investigate the alterations of ion channel gene expression of right atrial in patients with heart failure（HF） in sinus rhythm so as to understand the potential mechanisms of atrial fibrillation（AF） in HF. Methods Right atrial appendages were obtained from 18 patients with HF and 18 matched controls with normal cardiac function. All patients were in sinus rhythm. The mRNA expression of Itol （ Kv4.3α）, Iks（ KvLQT1 ）, Ikur（ Kvl. 5） ,L-type Ca^2＋ channel （ L-Caα1c ） and NCX was measured by reverse transcription-polymerase chain reaction and normalized to the mRNA level of glyceraldehydes-3-phosphate dehydrogenase. Results Compared to those in the control, mRNA expression of Itol （ Kv4. 3α）, Iks （KvLQT1）, and L-type Ca^2＋ channel （L-Caα1c） all reduced in patients with HF. The mRNA expression of Ikur （Kvl. 5 ）was not altered （P 〉 0. 05 ）in HF patients compared with the control, and the mRNA level of NCX increased in HF patients compared with the control（P 〈 0.01 ）. Conclusion The alterations of ion channel gene expression might be the molecular basis of the altered atrial cellular ion currents in patients with HF. HF-induced atrial ionic remodeling might play an important role in forming of AF substrate and contribute to the potential mechanisms of AF in HF.

关 键 词：心血管病学 心力衰竭 心房颤动 离子通道 基因表达 

分 类 号：R331.38[医药卫生—人体生理学]