The Study Of Relationship Between Myofibroblasts And Low Voltage Zone Of The Epicardial Mapping In AF

Objective: To study the relationship between myofibroblasts(MFBs)and epicardial electrical potential in atrial fibrillation in order to verify and explore whether MFBs participate in the occurrence or maintenance of atrial fibrillation.Methods: The first part,the left atrial appendage of patients were collected(Approved by the Ethics Committee of the First Affiliated Hospital of China Medical University,batch number: Coron trial [2017] 2017-69-3),selecting due to valvular disease with atrial fibrillation valve replacement or angioplasty and RFA patients for the experimental group,selecting mitral valve disease with huge left atrium(> 55mm)required mitral valve replacement and left atrial fold patients as the control group,to compare the left atrial appendage α-SMA protein expression level and distribution density;The second part,based on the first part,the experimental canines(hybrid canines)as the object,through implantation of wireless implanted pacemaker to establish atrial canine fast atrial pacing model of left atrial appendage,the empty surgery group as a control group,to compare the left atrial appendage α-SMA protein expression level and distribution density;The third part,before excuted,using the CARTO electrophysiological mapping system,marking low potential and non-low-potential areas of tissue,to study the relationship between the low voltage area and the distribution of MFBs in the epicardial center of atrial fibrillation,to provide a theoretical basis for exploring the mechanism of atrial fibrillation.Results: The α-SMA protein in left atrial appendage was significantly higher in patients with atrial fibrillation than in non-atrial fibrillation patients(P <0.05).The α-SMA protein in left atrial appendage was significantly higher than that in non-atrial fibrillation dogs(P <0.05).Atrial fibrillation canine self-control test,the epicardium mark low voltage area α-SMA protein expression and distribution density than non-non-low-voltage regional organizations,with statistical significance(P <0.05).Conclusion: MFBs in patients with atrial fibrillation were significantly higher than those in patients without atrial fibrillation,and MFBs were higher in low-voltage area.It is strongly suggested that the occurrence of atrial fibrillation may be related to the differentiation of myofibroblasts.With myocardial injuried(including muscle tone,inflammatory,hypoxia,etc.)and repair,MFBs appear physiological/reactive expression,when a certain critical state,MFBs expression imbalance of activation-apoptosis,and then continue to express to a certain extent,from the basic structural reconstruction Into structural restructuring as the basis of electrophysiological reconstruction,eventually leading to the occurrence of atrial fibrillation.Therefore,the results of this experiment tend to "focal theory",the relevant conclusions need to be further carried out a large number of animal and clinical trials,in order to verify.