目的探讨长链非编码RNA(lncRNA)TCONS_00016478通过调控过氧化物酶增殖物激活受体γ辅助激活因子1α(PGC-1α)/过氧化物酶增殖物激活受体γ(PPARγ)信号通路影响实验性房颤兔心房肌能量代谢重构的机制。方法采用高通量二代测序技术检测房颤兔/非房颤兔右心房组织差异性表达lncRNAs,成年新西兰白兔18只,体质量2.0～2.5 kg,雌雄不拘,随机分为假手术组(行开胸术但不注射病毒)、阴性对照慢病毒组(右心房注射阴性对照慢病毒)和TCONS_00016478沉默慢病毒组(右心房注射TCONS_00016478沉默慢病毒),每组6只。感染病毒前及感染1周后分别使用心脏电生理仪行程序电刺激,检测心房有效不应期(AERP)与房颤诱发性。感染病毒1周后处死动物,取心房肌组织,采用qRT-PCR法检测RNA的表达,采用Western blotting法检测蛋白质的表达,采用PAS染色法和油红O染色法分别检测糖原和脂滴沉积。结果与感染病毒前相比,感染病毒1周后,TCONS_00016478沉默慢病毒组AERP缩短(80.667±1.453 vs 71.750±2.411,t=3.168,P=0.034);假手术组(80.083±1.044 vs 79.333±0.333,t=0.684,P=0.531)与阴性对照慢病毒组(81.083±2.599 vs 80.000±2.646,t=0.022,P=0.983)手术前后AERP差异无统计学意义。TCONS_00016478沉默慢病毒组病毒感染1周后,3只诱发房颤,假手术组和阴性对照慢病毒组均未诱发房颤。假手术组、阴性对照慢病毒组及TCONS_00016478沉默慢病毒组心房肌TCONS_00016478(F=126.042,P<0.001)、PGC-1α(F=43.998,P<0.001)、PPARγ(F=417.863,P<0.001)、葡萄糖转运蛋白-4(GLUT4)(F=98.043,P<0.001)及碱棕榈酰转移酶-1(CPT1)(F=105.096,P<0.001)基因表达量均差异有统计学意义。与假手术组相比,TCONS_00016478沉默慢病毒组心房肌TCONS_00016478在基因水平表达量降低(P<0.001),与能量代谢相关的蛋白质PGC-1α、PPARγ、GLUT4、CPT1在基因水平表达量降低(P<0.001),蛋白质水平表达量亦下降,差异有统计学意义(P<0.001);生物信�
欧洲心脏病学会(European Society of Cardiology,ESC)2022年发布的室性心律失常与心脏猝死的预防管理指南是对2015年ESC发布的指南的更新,其中有诸多新增内容与更新推荐。指南增加了公共基础生命支持、基因检测、危险评估等推荐,更新了室性心律失常的相关治疗推荐,目的是更好地指导临床。
心外膜脂肪组织(EAT)是位于心肌与心包脏层之间的代谢活跃的脂肪库。相比于人体其他内脏脂肪库,EAT不仅具有产热、机械保护的共同特性,还兼有独特分泌功能。研究证实,EAT与房颤的发生及射频消融术后复发相关。EAT导致房颤的机制尚未完全阐明,可能的机制涉及心肌纤维化、脂肪细胞浸润、神经调节失衡等。近年来,EAT受到高度关注,或许会成为预测房颤发生及房颤射频术后复发的一项危险因素。Epicardial adipose tissue (EAT) is an active metabolic fat reservoir located between the myocardi-um and the visceral layer of the pericardium. Compared to other visceral fat reservoirs in the hu-man body, EAT not only has common characteristics of heat production and mechanical protection, but also has unique secretion functions. Research has confirmed that EAT is associated with the oc-currence of atrial fibrillation and recurrence after radiofrequency ablation. The mechanism of EAT leading to atrial fibrillation has not been fully clarified, and the possible mechanism involves myo-cardial fibrosis, adipocyte infiltration, neuromodulation imbalance, etc. In recent years, EAT has received high attention and may become a risk factor for predicting the occurrence and recurrence of atrial fibrillation after radiofrequency surgery.
