Involvement of Apelin/APJ Axis in Thrombogenesis in Valve Heart Disease Patients with Atrial Fibrillation

• Published in: International Heart Journal Vol. 60; no. 1; pp. 145 - 150
• Main Authors: Cheng, Hai, Chen, Yuhan, Li, Xueling, Chen, Fu, Zhao, Jinxuan, Hu, Jiaxin, Shan, Anqi, Qiao, Shuaihua, Wei, Zilun, He, Guixin, Xu, Biao
• Format: Journal Article
• Language: English
• Published: Japan International Heart Journal Association 31.01.2019; Japan Science and Technology Agency
• Subjects: Aged; Aldosterone; Angiotensin; Angiotensin II; Angiotensin system; Apelin - genetics; Apelin - pharmacology; Apelin Receptors - genetics; Appendages; Atrial Appendage; Atrial Fibrillation - complications; Atrial Fibrillation - pathology; Blood clots; Cardiac arrhythmia; Coronary artery disease; Electrocardiography; Female; Fibrillation; Heart diseases; Heart Valve Diseases - complications; Heart Valve Diseases - pathology; Humans; Male; Middle Aged; Mitral Valve Stenosis - pathology; Mitral Valve Stenosis - surgery; PAI-1; Plasminogen Activator Inhibitor 1 - metabolism; Plasminogen activator inhibitors; RAAS; Receptors, Angiotensin - metabolism; Renin; Renin-Angiotensin System; Rheumatic heart disease; Stenosis; Thrombosis; Thrombosis - metabolism; Thrombosis - physiopathology; Up-Regulation; Valve replacement; PAI-1; Angiotensin system; Valve replacement; RAAS
• ISSN: 1349-2365; 1349-3299
• DOI: 10.1536/ihj.18-166

The mechanism underlying thrombosis in atrial fibrillation (AF) is not yet clearly understood. The apelin/APJ axis parallel and counter-regulate with the angiotensin system. The present study hypothesizes that apelin/APJ axis exert its anti-thrombus effect in normal left atrial tissue and is disrupted by up-regulated renin-angiotensin-aldosterone system (RAAS) signaling during AF. The specimens of left atrial appendages collected from patients with rheumatic mitral stenosis who underwent valve replacement were divided into 3 groups: sinus rhythm, AF+/thrombus−, and AF+/thrombus+. The amounts of angiotensin II receptor subtype 1 (AT1), apelin/APJ and its downstream plasminogen activator inhibitor-1 (PAI-1) were detected by western blot. The expression of apelin/APJ was significantly decreased in the AF+/thrombus+ group compared with the sinus rhythm and AF+/thrombus− groups. Meanwhile the expressions of AT1 and PAI-1 were highest in the AF+/thrombus+ group compared to the other two groups. Taken together, the present study reveals apelin/APJ axis might be correlated with thrombosis in patients with AF mediated by PAI-1.