TGF-beta1 expression and atrial myocardium fibrosis increase in atrial fibrillation secondary to rheumatic heart disease

Clin Cardiol. 2010 Mar;33(3):149-56. doi: 10.1002/clc.20713.

Abstract

Background: Atrial fibrosis was considered a structural basis for the development and sustaining of atrial fibrillation (AF). Transforming growth factor-beta1 (TGF-beta1) was one of the main factors for accelerating collagen production. The contribution of TGF-beta1 in the pathogenesis of AF needs further investigation.

Hypothesis: The altered expression and distribution of TGF-beta1 will be associated with the changes in atrial fibrosis in different types of AF patients with rheumatic heart disease (RHD).

Methods: Right atrial specimens obtained from 38 RHD patients undergoing mitral valve replacement surgery were divided into 3 groups: the sinus rhythm group (n = 8), the paroxysmal AF group (pAF; n = 10), and the chronic AF group (cAF; AF lasting >/= 6 mo; n = 20). The degree of atrial fibrosis, collagen content, serum levels, messenger RNA (mRNA), and protein expression of TGF-beta1 were detected.

Results: The collagen content, serum level, TGF-beta1 mRNA, and protein expression of the atrial tissue increased gradually in sinus rhythm, for both pAF and cAF groups, respectively. A positive correlation between TGF-beta1 and the degree of atrial fibrosis was also demonstrated (P < 0.05).

Conclusion: The TGF-beta1 expression in atrial tissue increased gradually in proportion to the degree of atrial fibrosis in AF and was associated with the type of AF, which suggests that TGF-beta1 is possibly involved in the pathogenesis of AF in RHD patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / pathology
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / pathology
  • Collagen / biosynthesis
  • Female
  • Fibrosis / etiology
  • Fibrosis / pathology
  • Heart Valve Prosthesis Implantation
  • Humans
  • Male
  • Mitral Valve
  • Myocardium / pathology*
  • RNA, Messenger
  • Rheumatic Heart Disease / complications*
  • Rheumatic Heart Disease / pathology
  • Risk Factors
  • Statistics as Topic
  • Stroke Volume
  • Transforming Growth Factor beta1 / biosynthesis*
  • Ventricular Function, Left
  • Young Adult

Substances

  • RNA, Messenger
  • Transforming Growth Factor beta1
  • Collagen