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目的:心脏重构与慢性心力衰竭(CHF)关系密切,钙调神经磷酸酶(calcineurin,CaN)是一种Ca2+敏感性磷酸酶,其信号通路可能参与CHF的发病过程,本研究旨在了解左室构型与外周淋巴细胞和心肌组织中CaN表达之间的关系。方法:选择因瓣膜性心脏病住院接受心外科手术治疗的患者38例(男20例,女18例,年龄48.87±9.58岁),利用彩色多普勒超声心动图测量患者的心腔内径和室壁厚度,计算左室质量指数(LVMI)和相对室壁厚度(RWT),然后根据二者确定左室构型。取患者外周静脉血及少量左室乳头肌,分别提取外周淋巴细胞和心肌组织的总RNA,采用半定量逆转录多聚酶链反应技术(RT-PCR)测定CaN催化亚基(CnA)的α(CnAα)和b(CnAβ)异构体mRNA水平。结果:资料完整的患者共有36人,他们的左室构型分别为:正常构型(17例)、向心性重构(1例)、离心性肥厚(17例)和向心性肥厚(1例)。与正常构型的患者相比,离心性肥厚患者淋巴细胞中的CnAαmRNA水平较高(0.7671±0.1450vs0.6786±0.0928;P=0.042),而淋巴细胞中的CnAβ以及心肌中的CnAα和CnAβ均无明显差异(P>0.05),该结果与性别比例、年龄、血压水平以及心率无关。另外,LVMI与淋巴细胞中CnAαmRNA水平存在正相关(Pearsonr=0.381,P=0.026)。结论:CnAαmRNA水平在瓣膜性心脏病合并左室离心性肥厚的患者外周淋巴细胞中明显升高,并且与LVMI存在相关性。
AIM: Cardiac remodeling is closely related to chronic heart failure (CHF). Calcineurin (CaN) is a Ca2 + -sensitive phosphatase signaling pathway that may be involved in the pathogenesis of CHF. This study aimed to understand the role of left Relationship between chamber configuration and CaN expression in peripheral lymphocytes and myocardium. Methods: Thirty-eight patients (20 males and 18 females, aged 48.87 ± 9.58 years) hospitalized for valvular heart disease undergoing cardiac surgery were enrolled in this study. Color Doppler echocardiography was used to measure intracardiac diameter and wall Thickness, calculate left ventricular mass index (LVMI) and relative wall thickness (RWT), and then determine the left ventricular configuration based on both. Peripheral venous blood and a small amount of left ventricular papillary muscle were taken from the patients and the total RNA of peripheral lymphocytes and myocardium were extracted respectively. The mRNA and protein expression of CnAα (CnAα) in CaN catalytic subunit (CnA) were determined by semi-quantitative reverse transcriptase-polymerase chain reaction (RT- ) And b (CnAβ) isoform mRNA levels. Results: A total of 36 patients with complete data had normal left ventricular configuration (n = 17), concentric remodeling (n = 1), eccentric hypertrophy (n = 17) and concentric hypertrophy ). CnAα mRNA levels in lymphocytes of patients with eccentric hypertrophy were higher than those of normal controls (0.7671 ± 0.1450 vs 0.6786 ± 0.0928; P = 0.042), whereas CnAβ in lymphocytes and CnAα and CnAβ in myocardium There was no significant difference (P> 0.05). The result was not related to sex ratio, age, blood pressure level and heart rate. In addition, there was a positive correlation between LVMI and CnAα mRNA levels in lymphocytes (Pearson r = 0.381, P = 0.026). CONCLUSION: CnAα mRNA levels in peripheral blood lymphocytes of patients with valvular heart disease complicated with left ventricular eccentric hypertrophy were significantly increased, and correlated with LVMI.