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To investigate the expression and the possible role of transforming growth factor-beta 1 (TGF-β1) and connective tissue growth factor (CTGF) in atrial myocardial fibrosis of atrial fibrillation patients with rheumatic heart disease.
The right atrial muscles samples were obtained from 68 patients with rheumatic heart diseases (RHD) (30 sinus rhythm [SR], 38 atrial fibrillation [AF]) during heart valve replacement surgery. The expression of TGF-β1 mRNA, CTGF mRNA were detected by semiquantitative RT-PCR technique, the RT-PCR amplication production Reinhoit Zahl (RZ) were tested. The expression of CTGF protein were detected by immunohistochemistry technology. The area of myocardial fibrosis were measured by imaging analysis system, qualified by PU value. SPSS package was used to analyze the relationship between the expression of CTGF and the area of myocardial fibrosis.
Compared with SR group(RZ 0.2398±0.1252; RZ 0.3126±0.1532; PU 23.1613±1.9325), the expression of TGF-β1 mRNA, CTGF mRNA and CTGF protein expression in atrial muscle samples were all significantly increased in AF group, (RZ 0.7656±0.2162; RZ 0.8962±0.2863; PU 49.760±7.672; P < 0.01). The expression of CTGFmRNA in atrial muscles of RHD was correlated positively with the expression of TGF-β1 mRNA (r = 0.793, P<0.01). The expression of CTGFmRNA and CTGF protein in atrial muscles of RHD were both correlated positively with the area of myocardial fibrosis (r =0.865; 0.632, P < 0.01). The expression of TGF-β1 mRNA, CTGFmRNA and CTGF protein in atrial muscles of both groups didn't show correlation with gender, age and case history, but remarkably correlated with cardiac functional gradings (r = 0.563; 0.425; 0.332, P<0.05).
CTGF may play a significant role in myocardial fibrosis of RHD, and take part in the occurrence of atrial fibrillation.