Disorganization of gap junction distribution in dilated atria of patients with chronic atrial fibrillation
Disorganization of gap junction distribution in dilated atria of patients with chronic atrial fibrillation
复制标题
DOI：
10.1253/circj.70.575
复制
发表时间：
2006-05-01
影响因子：
3.3
通讯作者：
Kodama, I
中科院分区：
文献类型：
--
作者：
Takeuchi, S;Akita, T;Kodama, I
背景房颤（AF）是一种与心房功能和形态重构相关的心律失常。我们研究了慢性房颤合并左房扩张（AD）患者心房组织中连接蛋白的分布和表达。方法与结果对慢性AF+AD （n=11）、窦性心律（SR, n=11）和SR+AD （n=4）患者在心脏手术中获得的心房组织进行免疫组化。在SR患者（对照组）中，连接蛋白（Cx） 43标记的插入椎间盘的特征是中心小点被周围大点包围。在AF+AD患者的左心房，嵌盘面积明显增大。虽然外围的Cx43标记得以保留，但中心标记点明显缺失。间隙连接所占面积略大于对照组，但显著大于对照组。SR+AD患者左心房出现类似AF+AD的间隙连接紊乱。Cx40的标记模式与Cx43基本相似。结论慢性房颤合并AD时，椎间盘间隙连接紊乱，很可能是由AD引起的，而不是由房颤本身引起的。这种间隙连接重构可能涉及心房传导特性的改变，但其潜在的致心律失常作用尚不清楚。
Background Atrial fibrillation (AF) is an arrhythmia associated with functional and morphological remodeling of atria. We investigated the distribution and the expression of connexins in atrial tissues from patients with chronic AF and left atrial dilatation (AD).Methods and Results Immunohistochemistry was performed in atrial tissues obtained during cardiac surgery from patients with chronic AF+AD (n=11), sinus rhythm (SR, n=11) and SR+AD (n=4). In SR patients (control), the connexin (Cx) 43 labeling of the intercalated disks seen en-face was characterized by small central spots surrounded by larger spots at the periphery. In the left atria from AF+AD patients, the area of the intercalated disk was significantly enlarged. Although peripheral Cx43 labeling was preserved, there was a striking loss of central labeling spots. The area occupied by gap junctions was slightly but significantly larger than that of the control. The left atria from patients with SR+AD showed gap junction disorganization analogous to AF+AD. The labeling patterns of Cx40 were essentially similar to those of Cx43.Conclusions In chronic AF with AD, gap junctions at the intercalated disk are disorganized, resulting most likely from AD but not from AF itself. This gap junction remodeling might be involved in altered atrial conduction properties, but its potential arrhythmogenic role remains unclear.