MMP-9 in Myocardial Fibrosis and Structural Remodeling in Rheumatic Heart Disease Patients with Atrial Fibrillation: A Single-center Prospective Case-control Study

Abstract Background: Atrial fibrillation (AF) is a common arrhythmia that induces disability or death; however, the underlying pathogenesis is yet unclear. This study aimed to investigate the expression of matrix metalloproteinase-9 (MMP-9) in rheumatic valvular heart disease (RVHD) and its value in predicting AF.Methods: In this single-center, prospective case-control study, 30 patients who received valve replacement for the treatment of RVHD in the Cardiac and Major Vascular Department, Yue Bei People’s Hospital between August 2012 and January 2015 were included in this study. The patients were categorized equally into two groups according to the electrocardiogram characteristics: sinus rhythm (SR) group and chronic atrial fibrillation (AF) group. In patients hospitalized for RVHD, the fasting serum was collected on the following day in the morning, and the tissues of right auricle were collected during the operation. Hematoxylin and eosin staining and Masson staining were performed to assess the pathological structures of myocardial tissues and changes in collagen fibers. Enzyme-linked immunosorbent assay was used to measure the level of MMP-9 in serum, and the distribution of the protein in myocardial tissues was assessed by immunohistochemistry. Echocardiography was performed before the surgery to measure the left atrial diameter and ejection fraction.Results: The MMP-9 expression was significantly higher in the AF group than the SR group (4.2281 ± 0.9165 ng/mg vs. 2.7613 ± 1.2166 ng/mg, p < 0.05). The MMP-9 levels were positively associated with left atrial diameter (LAD) (p < 0.01) and collagen volume fraction (CVF) (p < 0.05).Conclusions: MMP-9 expression is elevated in AF patients and could be one of the major factors involved in the remodeling of atrial structures in AF. MMP-9 influences the metabolism of collagen and promotes the fibrosis of the myocardium, participates in cardiac structural remodeling, and plays a role in the onset and maintenance of AF.

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Association between anxiety symptoms and atrial fibrillation in a community cohort of Chinese older adults: a case-control study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02278-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhu-Xia Shen ◽

Yu-Min Sun ◽

Hui-Hui Gu ◽

Yan Zhang ◽

Zhi-Wen Shen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Older Adults ◽

Heart Disease ◽

Odds Ratio ◽

Case Control Study ◽

Case Control ◽

Anxiety Symptoms ◽

Control Group ◽

Community Based ◽

Control Study

Abstract Background The association between anxiety and atrial fibrillation (AF) remains unclear. Moreover, this association has rarely been studied in Chinese individuals aged 60 years or older. This study investigated the association between anxiety and AF in a community-based case-control study of older adult residents in urban China. Methods The cases and controls were from a community-based study conducted in the Jingansi community in Shanghai, China, between January 2010 and December 2012. A total of 3622 residents aged 60 years or older without severe vision, hearing, or speaking impairments were eligible to participate in the physical examinations and questionnaire survey. AF was assessed based on a previous physician’s diagnosis, electrocardiogram, ambulatory electrocardiogram, or echocardiogram. Anxiety was evaluated using the Zung Self-Rating Anxiety Scale (ZSAS). Using the AF group as a reference, the control group consisted of randomly selected age- and sex-matched individuals in a 1:5 ratio (case:control = 1:5). The association between anxiety and AF in the AF group and the multifactor-matched control group was explored using logistic regression. Results In the AF and control groups, after adjusting for a history of coronary heart disease, valvular heart disease, hypertension, stroke, hyperlipidemia, and diabetes, as well as depression score, ZSAS scores (odds ratio 1.07; 95% confidence interval 1.02–1.12; p = 0.003), and anxiety symptoms (odds ratio 3.94; 95% confidence interval 1.06–14.70; p = 0.041) were associated with AF. Conclusions Anxiety symptoms were associated with AF in a Chinese older population. This suggests that older adults who have anxiety symptoms may need psychological intervention or treatment in daily life and care.

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