| Objective: To investigate the correlation between the levels of plasma galactose-3(galectin-3,Gal-3),soluble carcinogenic factor-2(Soluble suppression of tumorigenicity,sST2)and myocardial fibrosis in rheumatic heart disease,and to provide more evidence for the new research direction and possible therapeutic targets of myocardial fibrosis in patients with rheumatic heart disease.Methods: Collected 38 patients with rheumatic heart disease mainly with mitral stenosis,and received mitral valve replacement in our hospital,age 45~60 years,and heart function II~III,from August 2016 to October 2017.Meanwhile,the control group selected 14 healthy adults in our hospital physical examination center.Exclusion criteria: Exclude the patients who had hypertension,hyperlipidemia,diabetes,myocardial infarction,coronary heart disease,hyperthyroidism,blood disease,liver and kidney insufficiency and malignant tumor before.The experimental group was divided into three groups according to preoperative color Doppler echocardiography: group A(left atrial end diastolic diameter < 55mm),group B(55mm < 65mm),C group(left atrial end diastolic diameter > 65mm),D group(control group).Experimental procedure:(1)Sample extraction: collect the same position of the anterior papillary muscle of the mitral valve in the same position in the operation,and take the tissue samples in 10% formaldehyde for 12 hours to 24 hours,make the wax block.Take the blood samples of the patients before the anesthesia.The blood specimens are anticoagulant with sodium citrate,and then 3000 turn / separate the heart.Then the plasma was taken in EP tube and stored in-80 centigrade ice cabinet in time;(2)Conventional paraffin embedded and sliced;myocardial slices were stained with hematoxylin eosin(Hematoxylin-eosin,HE);(3)After myocardial Masson staining(operating strictly according to the kit instruction manual),the collagen volume ratio(Collagen volume fraction,CVF)was calculated with the IPP 6 image processing software;(4)The degree of fibrinization was evaluated by the ratio of collagen volume ratio and the observation of myocardial morphology;(5)Enzyme immunoadsorption assay was measured the concentration of Galectin-3 and s ST-2(illustrated by ELISA Kit);(6)statistical processing.Result:1.myocardial HE staining results,after the image processing software analysis,cell diameter A group(17.73 + 2.54 mu m),B group(26.61 + 3.87 mu m),C group(31.19 + 4.68 m).The diameter of myocardial cell diameter of group C > B group > A group,the difference of myocardial cell diameter in the three groups was statistically significant(P < 0.01),and there was also a significant difference between every two groups(P < 0.01).2.Myocardial tissue was stained with Masson,and the volume ratio of myocardial collagen fiber was calculated by IPP 6 image analysis software under optical microscope.The group A was(18.61 + 4.04)%,B group was(23.57 + 3.78)% and C group(29.37 + 4.95).C group collagen volume fraction > B group collagen volume fraction > A group collagen volume fraction,the difference of collagen volume fraction between the three groups was statistically significant(P < 0.01),and there was also a significant difference between every two groups(P < 0.01).3.The level of plasma Galectin-3 and sST-2 in the experimental group was higher than that of the control group(P < 0.01).In the experimental group,the plasma Galectin-3 level in group C > B group > A group,the difference of plasma Galectin-3 level in the three groups was statistically significant(P < 0.01),and there was also a significant difference between every two groups(P < 0.01).The plasma sST-2 level in group C > B group > A group,the difference of plasma sST-2 level in the three groups was statistically significant(P < 0.01),and there was significant difference between every two groups(P < 0.01).4.In patients with rheumatic heart disease,plasma Galectin-3 and sST-2 were positively correlated with myocardial collagen volume ratio(P < 0.01).Conclusion: 1)In patients with rheumatic heart disease,the larger the left atrial diameter,the larger the diameter of myocardial cells,the higher the degree of myocardial fibrosis.2)the levels of plasma Galectin-3 and sST-2 in patients with rheumatic heart disease were higher than those of normal adults.In patients with rheumatic heart disease,the larger the left chamber,the higher the level of Galectin-3 and sST-2,suggesting that the size of the left atrium in the patients with rheumatic heart disease was related to the concentration of Galectin-3 and sST-2 in the plasma.3)the level of plasma Galectin-3 and sST-2 in patients with rheumatic heart disease is positively correlated with the ratio of myocardial collagen volume,which suggests that the higher the concentration of Galectin-3 and sST-2,the heavier the myocardial fibrosis,which can indirectly reflect the degree of myocardial fibrosis. |
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