ObjectiveTo evaluate the mid-term recovery of cardiac function after heart valve replacement and concomitant bipolar radiofrequency ablation for atrial fibrillation (AF). Methods Clinical data of 191 patients with heart valve disease and AF in the same surgical team of Xinqiao Hospital from January 2011 Jan to December 2013 was retrospectively analyzed. Heart valve replacement was performed for a control group (n=93), which includes 31 males and 62 females with their age of 48.33±7.55 years and AF duration of 4.80±2.03 years. Valve replacement and concomitant bipolar radiofrequency ablation was performed for a synchronism ablation group (n=98), which includes 27 males and 71 females with their age of 46.95±7.70 years and AF duration of 5.06±2.26 years. The echocardiogram, electrocardiogram and complications at hospitalization, 6 months, 1 year and 2 year after operation were analyzed. ResultsNo in-hospital death occurred. There were statistical differences in aortic cross-clamp time, cardiopulmonary bypass time, tricuspid ring, ICU stay, total volume of postoperative drainage between the two groups. All the patients were followed up for 2 years. Two years postoperatively, in the synchronism ablation group, 85 patients (86.73%) were followed up, 1 patient with cerebral embolism, 2 patients with cerebral hemorrhage. In the control group, 85 patients (91.40%) were followed up, 4 patients with cerebral embolism, 2 patients with cerebral hemorrhage. There were no death, cardiac rupture, and permanent cardiac pacemaker implantation in the two groups during the follow-up. One year and 2 years postoperative fractional shortening of the synchronism ablation group was significantly higher than those of the control group (37.18%±5.35% vs. 34.72%±6.40%, P=0.007; 37.95%±7.99% vs. 35.18%±5.15%, P=0.008). One year and 2 years postoperative left ventricular ejection fraction of the synchronism ablation group was significantly higher than that of the control group (66.27%±6.99% vs. 63.33%±8.14%, P=0.012). The rate of self-feeling cardiac function improvement in 1 year and 2 years after surgery of the synchronism ablation group was significantly higher than that of the control group (85.39% vs. 72.94%, P=0.005; 84.71% vs. 68.24%, P=0.005). ConclusionCardiac function of the mid-term after the valve replacement and concomitant bipolar radiofrequency ablation for atrial fibrillation obviously improves.
ObjectiveTo investigate different expressions of microRNA-1 (microR-1) microRNA-133(microR-133) microRNA-34a (microR-34a) and their possible target protein Ankyrin-B in right atrial appendage of patients with atrial fibrillation (AF) or sinus rhythm (SR) analyze their correlation,and explore novel mechanisms of the pathogenesis and development of AF in microRNA level. MethodsForty right atrial appendage samples of 40 patients with rheumatic heart disease who underwent heart valve replacement in Xinqiao Hospital,Third Military Medical University were included in this study. All the patients were divided into AF group including 8 males and 12 females with their age of 52.9±5.8 years and SR group including 9 males and 11 females with their age of 52.4±6.2 years. The expression of microR-1,microR-133 and microR-34a were examined with RTQ-PCR (real-time quantitative PCR) and calculated with delta delta Ct method. Different expressions of ankyrin-B between AF and SR group were examined with immunohistochemistry and Western Blotting. ResultsMicroR-1 expression of right atrial appendage of AF group was significantly lower than that of SR group (0.559±0.252 vs. 3.997±1.251,t=-21.455,P=0.000) microR-133 expression of AF group was significantly lower than that of SR group (0.630±0.238 vs. 5.514±1.549,t=24.133,P=0.000) and microR-34a expression of AF group was significantly higher than that of SR group (4.783±2.012 vs. 1.350±0.638,t=12.596,P=0.000). Immunohistochemistry and Western Blotting showed Ankyrin-B expression in right atrial appendage of AF group was significantly lower than that of SR group (0.66±0.45 vs. 1.09±0.42,t=-3.396,P=0.001). ConclusionMicroR-34a may take part in the pathogenesis and development of AF by regulating the expression of Ankyrin-B.