CBS 2019
CBSMD教育中心
中 文

左主干支架

Abstract

Recommended Article

Expansion or contraction of stenting in coronary artery disease? Impact of Staging Percutaneous Coronary Intervention in Left Main Artery Disease: Insights From the EXCEL Trial Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative EXCELling in Left Main Intervention Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies

Original ResearchVolume 117, Issue 4, 1 April 2021, Pages 1091–1102

JOURNAL:Cardiovasc Res. Article Link

Stretch-induced sarcoplasmic reticulum calcium leak is causatively associated with atrial fibrillation in pressure-overloaded hearts

Y Zhang, Y Qi, JJ Li, WJ He et al. Keywords: AF; hypertension; underlying mechanism

ABSTRACT

AIMS - Despite numerous reports documenting an important role of hypertension in the development of atrial fibrillation (AF), the detailed mechanism underlying the pathological process remains incompletely understood. Here, we aim to test the hypothesis that diastolic sarcoplasmic reticulum (SR) Ca2+leak in atrial myocytes, induced by mechanical stretch due to elevated pressure in the left atrium (LA), plays an essential role in the AF development in pressure-overloaded hearts.


METHODS AND RESULTS - Isolated mouse atrial myocytes subjected to acute axial stretch displayed an immediate elevation of SR Ca2+leak. Using a mouse model of transverse aortic constriction (TAC), the relation between stretch, SR Ca2+leak, and AF susceptibility was further tested. At 36 h post-TAC, SR Ca2+leak in cardiomyocytes from the LA (with haemodynamic stress), but not right atrium (without haemodynamic stress), significantly increased, which was further elevated at 4 weeks post-TAC. Accordingly, AF susceptibility to atrial burst pacing in the 4-week TAC mice were also significantly increased, which was unaffected by inhibition of atrial fibrosis or inflammation via deletion of galectin-3. Western blotting revealed that type 2 ryanodine receptor (RyR2) in left atrial myocytes of TAC mice was oxidized due to activation and up-regulation of Nox2 and Nox4. Direct rescue of dysfunctional RyR2 with dantrolene or rycal S107 reduced diastolic SR Ca2+leak in left atrial myocytes and prevented atrial burst pacing stimulated AF.


CONCLUSIONS -Our study demonstrated for the first time the increased SR Ca2+leak mediated by enhanced oxidative stress in left atrial myocytes that is causatively associated with higher AF susceptibility in pressure-overloaded hearts.