Impact of aldosterone antagonists on the substrate for atrial fibrillation: aldosterone promotes oxidative stress and atrial structural/electrical remodeling.

Impact of aldosterone antagonists on the substrate for atrial fibrillation: aldosterone promotes oxidative stress and atrial structural/electrical remodeling.
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DOI:
10.1016/j.ijcard.2013.08.022
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发表时间:
2013-10-15
影响因子:
3.5
通讯作者:
Van Wagoner, David R.
Van Wagoner, David R.
中科院分区:
医学2区
文献类型:
--
作者:
Mayyas, Fadia;Alzoubi, Karem H.;Van Wagoner, David R.

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心房颤动(AF)是最常见的心律失常,是一种具有多种复杂潜在机制的心电图描述。氧化应激是结构重构的重要驱动力,其产生AF的底物。氧化自由基可促进心房氧化损伤、电重构和结构重构以及心房炎症的增加。AF和其他心血管疾病激活血管紧张素(Ang-II)依赖性和非依赖性级联。肾素-血管紧张素-醛固酮系统(RAAS)的关键成分是盐皮质激素醛固酮。最近的研究提供了心肌醛固酮合成的证据。醛固酮通过多种机制促进心脏氧化应激、炎症和结构/电重构。在HF患者中,醛固酮产生增强。在患者和实验性HF和AF模型中,醛固酮受体拮抗剂对心脏重塑和氧化应激具有有利影响。寻求通过调节醛固酮系统来减轻AF负担的治疗方法可能是有益的,但未得到充分利用。
Atrial fibrillation (AF), the most common cardiac arrhythmia, is an electrocardiographic description of a condition with multiple and complex underlying mechanisms. Oxidative stress is an important driver of structural remodeling that creates a substrate for AF. Oxidant radicals may promote increase of atrial oxidative damage, electrical and structural remodeling, and atrial inflammation. AF and other cardiovascular morbidities activate angiotensin (Ang-II)-dependent and independent cascades. A key component of the renin–angiotensin-aldosterone system (RAAS) is the mineralocorticoid aldosterone. Recent studies provide evidence of myocardial aldosterone synthesis. Aldosterone promotes cardiac oxidative stress, inflammation and structural/electrical remodeling via multiple mechanisms. In HF patients, aldosterone production is enhanced. In patients and in experimental HF and AF models, aldosterone receptor antagonists have favorable influences on cardiac remodeling and oxidative stress. Therapeutic approaches that seek to reduce AF burden by modulating the aldosterone system are likely beneficial but underutilized.
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