RESUMO
OBJECTIVE: To discuss the role of calcium-overloading in initiation and maintenance of atrial fibrillation (AF). METHODS: The right atrial appendages were obtained from 14 patients with AF and 12 patients with sinus rhythm. The mRNA expression of proteins influencing the calcium homeostasis was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and normalized to the mRNA level of glyceraldehyde-3- phosphate dehydrogenase. The left atrial diameter (LAD), mitral valvular area (MVOA), and systolic pulmonary arterial pressure were obtained by echocardiography before surgery. RESULTS: Compared to sinus rhythm group, the mRNA levels of L-type calcium channel alc, sarcoplasmic reticulum (SR), calcium adenosine triphosphatase (Ca2+ -ATPase), and ryanodine receptor type-2 (R(Y) R2) were significantly decreased (P < 0.01); the mRNA level of inositol triphosphate receptor type-1 (IP3R1) was significantly increased (P < 0.05). No changes in the mRNA expression of phospholamban and calsequestrin were observed between two groups (P > 0.05). Correlations were found between MVOA and mRNA levels of LVDC-Calc, SR Ca2+ -ATPase (r = 0.719, P = 0.004; r = 0.625, P = 0.017). The mRNA level of SR Ca2+ -ATPase was negatively correlated with LAD (r = -0.573, P = 0.032). CONCLUSIONS: Calcium loading may be responsible for the occurrence and maintenance of AF, and abnormal regulation in the mRNA expression may be the molecular mechanism of intracellular Ca2+ overload. The progressive nature of AF involves structural change.
