Atrial Fibrillation Clinical Trial
Official title:
Comparative Gene Expression Profiles in Patients With Permanent Atrial Fibrillation and Normal Sinus Rhythm
The aim of this project is to determine the morphological criteria of apoptosis in atrial tissues of patients with AF versus SR at transcriptome and genomic size.
Mitral valve regurgitation (MR) is the second most common valvular heart disease encountered
in adults. Furthermore, atrial fibrillation (AF) is the most common cardiac arrhythmia seen
in clinical practice. Overall, 70% of the patients with severe MR are associated with AF
independent from etiopathogenesis of MR. AF is clinically divided into three subgroups; 1)
paroxysmal AF, occurs as episodes and ends spontaneously, 2) persistent AF, episodes
terminate only with medical or electrical cardioversion, and 3) permanent AF, current
medical treatments and electrical cardioversion does not restore a normal sinus rhythm.
Despite intensive electrophysiological studies, the molecular mechanisms and pathways of AF
are still not fully elucidated.
Apoptosis which has distinctive morphological and biochemical characteristics is genetically
regulated, active programmed cell death process. It is known that cardiac morphogenesis
restore from apoptosis. In addition, apoptosis has an important role in several
cardiovascular system pathologies. It has been shown that atrial apoptosis causes numerous
arrhythmias including AF. Likewise, in the pilot study which has been performed by our study
group, AF is associated with apoptosis by immunohistochemical and DNA fragmentation analysis
methods.
The aim of this project is to determine the morphological criteria of apoptosis in atrial
tissues of patients with AF by using electron microscopy and immunohistochemistry. Moreover,
we will investigate the transcriptional profile of AF associated genes by oligonucleotide
microarray method. The gene expression profiles of patients with AF and degenerative MR will
be compared with the atrial tissue samples from the patients with degenerative MR who
preserve normal sinus rhythm which will serve as controls. In summary the apoptotic pathways
would be analyzed at transcriptomic and genomic level. Besides, the pathways that may
interfere AF pathophysiology would also be evaluated. The expression profiles of the genes
primarily verified by quantitative real time RT-PCR will be further confirmed by translation
of end-result proteins determined with Western blot technique. Thus, brand-new clues about
physiology of fibrillating atrial cells would be achieved.
Keywords: Atrial fibrillation, apoptosis, oligonucleotide microarray
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