RESUMEN
Objective The purpose of this study is to determine whether atrial expression of hepatocyte growth factor (HGF), connective tissue growth factor (CTGF) and transforming growth factor-beta1 (TGF-13,) is altered in patients with rheumatic heart disease (RHD) and chronic atrial fibrillation (AF).Methods Atrial tissue was obtained from the right atrial appendage during heart surgery from 35 patients. In 27 patients with rheumatic heart disease, 8 patients had no history of AF, and 19 had chronic persistent AF (≥6 months cAF). Other 8 patients with congenital heart disease had no history of AF were the control group.The mRNA expression of HGF, CTGF, TGF-β1, collagen Ⅰ and collagen Ⅲ was measured by the real-time fluorescence quota polymerase chain reaction (real time PCR). The fibrosis of right atrial appendage was detected by HE and Masson staining. Results The amount of CTGF, TGF-β1, collagen Ⅰ and collagen Ⅲ was significantly increased in patients with sinus rhythm compared with the control group (P<0.05) and further increased in patients with chronic AF compared with patients with sinus rhythm (P<0.05). The amount of HGF was significantly decreased in patients with chronic AF compared with patients with sinus rhythm and the control group (P<0.05). But the difference of the latter two groups was not statistically significant.Correlation analysis demonstrated that the mRNA expression of collagen Ⅰ , collagen Ⅲ, TGF-β1, and CTGF in right atrial appendage of RHD and AF was positively correlated with the left atrial diameter and the area of myocardial fibrosis. Conclusion In human atrium with RHD, the mRNA expression of collagen Ⅰ , collagen Ⅲ, CTGF and TGF-β1, is up-regulated. HGF has anti-fibrosis function and the down-regulation of its mRNA expression in patients with RHD may be an important factor in the initiation or maintenance of AF.