Atrial fibrillation (AF) is the most common sustained arrhythmia, characterized by rapid, irregular and uncoordinated activation of the atria. It is often triggered by ectopic foci and it eventually leads to atrial electric and structural remodelling, which only further facilitates its persistence. Neurotrophins are a family of neurotrophic factors, that regulate survival and differentiation of neurons during developement and maintain their specific connections and function in adulthood. Their role is becoming increasingly important in cardiovascular system, where they participate in cardiac myocyte survival, angiogenesis and hypertrophy.Since neurotrophin actions in both cardiovascular and nervous system point to the involvement of neurotrophic system in AF occurence, our aim was to determine the levels of synthesis and gene expression of neurotrophins and their receptors in the presence of this arrhythmia. For this purpose, we obtained serum and left and right atrial tissue samples from 34 patients with valvular disease. Among them, 19 suffered from AF and 15 of them had regular heart rhythm. We quantified nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) levels using enzyme-linked immunosorbent assay. Gene expression of neurotrophins NGF and NT-3 and neurotrophic receptors p75NTR, TrkA and TrkB was determined by real-time PCR. As shown by the results of these measurements, serum neurotrophin levels remained unchanged in the presence of AF. Basal protein levels of the three studied neurotrophins were comparable between left and right control atrium, yet NGF and p75NTR gene expression levels were significantly lower in left atrial tissue. When the arrhythmia group was compared to the control, no significant differences in atrial NGF, BDNF and NT-3 protein levels were observed. Also we found no changes in NGF and NT-3 gene expression. However, in the presence of AF p75NTR gene expression highly increased in the left atrium and TrkA gene expression in the right atrium decreased. No difference in TrkB gene expression was found.
In conclusion, neurotrophin gene expression and synthesis are not influenced by atrial fibrillation. Nevertheless, the pattern of neurotrophin receptor gene expression is altered in its presence. This could notably alter the function of the nervous system and influence the structural remodelling of atrial tissue in human heart.
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