Heat shock proteins in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery

• Published in: Cell stress & chaperones Vol. 16; no. 5; pp. 517 - 528
• Main Authors: Cao, Hailong, Xue, Lei, Xu, Xiaohan, Wu, Yanhu, Zhu, Jinfu, Chen, Liang, Chen, Duan, Chen, Yijiang
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.09.2011; Springer Netherlands; Springer Nature B.V
• Subjects: Adult; Apoptosis; Atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Fibrillation - prevention & control; Atrial Fibrillation - surgery; Biochemistry; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cell Biology; Female; Fibrosis; Heart; Heart Atria - metabolism; Heart Atria - pathology; Heart Atria - physiopathology; Heart Atria - surgery; Heart Rate - physiology; Heart valves; Heat shock proteins; Heat-Shock Proteins - metabolism; Humans; Immunology; Inflammation; Male; Middle Aged; Mitral Valve - physiopathology; Mitral Valve - surgery; Neurosciences; Original Paper; Postoperative Complications; Recurrence; Shock heating; Sinuses; Surgical specialties; Heat shock proteins; Mitral valve surgery; Sinus rhythm; Stabilization; Atrial fibrillation
• ISSN: 1355-8145; 1466-1268
• DOI: 10.1007/s12192-011-0263-9

A spontaneously restored sinus rhythm in permanent atrial fibrillation patients has been often observed after mitral valve (MV) surgery, but persisting duration in sinus rhythm varies from patient to patient. Heat shock proteins (Hsps) may be involved in pathogenesis of atrial fibrillation. We hypothesized that stabilization of restored sinus rhythm is associated with expression of Hsps in the atria. To test this hypothesis, clinical data, biopsies of right atrial appendage, and blood samples were collected from 135 atrial fibrillation patients who spontaneously restored sinus rhythm after conventional isolated MV replacement.Comparison was made between patients who had recurrence of atrial fibrillation within 7 days (AF) vs. patients with persisted sinus rhythm for more than 7 days (SR).Results showed that SR patients had higher activity of heat shock transcription factor 1 (HSF1) as well as upregulated expressions of heat shock cognate 70, Hsp70, and Hsp27 in the tissues. The activation of HSFl-Hsps pathway was associated with less-aggressive pathogenesis as reflected by lower rates of myolysis, apoptosis, interstitial fibrosis, and inflammation in SR patients. However, Hsp60 was lower in both tissue and plasma in SR patients, and was positively correlated with apoptosis, interstitial fibrosis, and inflam-mation. These findings suggest that the Hsps play important roles in stabilization of restored sinus rhythm after MV surgery by inhibiting AF-related atrial remodeling and arrhythmogenic substrates in atrial fibrillation patients. Low circulating Hsp60 levels preoperatively might predict a stable spontaneously restored sinus rhythm postoperatively.