简介：BackgroundCircularRNAs(circRNAs)areendogenousnon-codingRNAsthatparticipateinregulatinggeneexpressionindiversebiologicalandpathologicalprocesses.TherolesofcircRNAsinatrialfibrillation(AF)havenotbeenwellelucidated.Inthepresentstudy,circRNAsprofileintheatrialappendagesofpatientswithAFwasexamined.MethodsHematoxylin-eosin(HE)andMassontrichromestainingwasperformedontheatrialappendagesofpatientswithsinusrhythm(SR)orAF.Expressionsoffibrosis,rennin-angiotensin-aldosteronesystem(RAAS)andinflammation-associatedgenesweredeterminedbyquantitativereversetranscriptionPCR(qRT-PCR).CircRNAsexpressionprofileinatrialappendageswasdetectedbycircRNAsmicroarray.qRT-PCRwasalsousedtodeterminetheexpressionof6representativedys-regulatedcircRNAs.PCRproductsofconcernedcircRNAswerefurtheridentifiedbygelelectrophoresisandDNAsequencingassay.ResultsMassontrichromestainingresultshowedthatfibrosiswasincreasedintheatrialappendagesofAFpatients.Thelevelsofcol1a1,Col3a1,fibrinectin-1(FN1),IL1-βandCRPmRNAexpressionweresignificantlyup-regulatedintheatrialappendagesofAFpatients.AcircRNAsarrayrevealedthatcircRNAsweredysregulatedintheatrialappendagesofAFpatients.qRT-PCRresultsdemonstratedthatcircRNA_100395wasup-regulated,circRNA_101270,circRNA_103820,circRNA_104168andcircRNA_100782weredown-regulatedsignificantlyintheatrialappendagesofAFpatientscomparedtoSRpatients.ConclusionsFibrosisandinflammationoccurintheatrialappendagesofAFpatients,whichcouldrelatetocircRNAsdysregulation.

简介：BackgroundAmongpatientsundergoingmitral-valvesurgery,30to50%presentwithatrialfibrillation,whichisassociatedwithreducedsurvivalandincreasedriskofstroke.Surgicalablationofatrialfibrillationhasbeenwidelyadopted,butevidenceregardingitssafetyandeffectivenessislimited.MethodsWerandomlyassigned260patientswithpersistentorlong-standingpersistentatrialfibrillationwhorequiredmitral-valvesurgerytoundergoeithersurgicalablation(ablationgroup)ornoablation(controlgroup)duringthemitral-valveoperation.Patientsintheablationgroupunderwentfurtherrandomizationtopulmonary-veinisolationorabiatrialmazeprocedure.Allpatientsunderwentclosureoftheleftatrialappendage.Theprimaryendpointwasfreedomfromatrialfibrillationatboth6monthsand12months(asassessedbymeansof3-dayHoltermonitoring).ResultsMorepatientsintheablationgroupthaninthecontrolgroupwerefreefromatrialfibrillationatboth6and12months(63.2%vs.29.4%,P<0.001).Therewasnosignificantdifferenceintherateoffreedomfromatrialfibrillationbetweenpatientswhounderwentpulmonary-veinisolationandthosewhounderwentthebiatrialmazeprocedure(61.0%and66.0%,respectively;P=0.60).One-yearmortalitywas6.8%intheablationgroupand8.7%inthecontrolgroup(hazardratiowithablation,0.76;95%confidenceinterval,0.32to1.84;P=0.55).Ablationwasassociatedwithmoreimplantationsofapermanentpacemakerthanwasnoablation(21.5vs.8.1per100patient-years,P=0.01).Therewerenosignificantbetween-groupdifferencesinmajorcardiacorcerebrovascularadverseevents,overallseriousadverseevents,orhospitalreadmissions.ConclusionsTheadditionofatrialfibrillationablationtomitral-valvesurgerysignificantlyincreasedtherateoffreedomfromatrialfibrillationat1yearamongpatientswithpersistentorlong-standingpersistentatrialfibrillation,buttheriskofimplantationofapermanentpacemakerwasalsoincreased