Role of inflammation in atrial fibrillation pathophysiology and management.
Role of inflammation in atrial fibrillation pathophysiology and management.
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DOI：
10.1253/circj.cj-15-0138
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Nattel S
中科院分区：
文献类型：
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作者：
Harada M;Van Wagoner DR;Nattel S
心房颤动（AF）是最常见的临床相关心律失常，但可用于治疗AF及其并发症（其中最重要的是血栓形成）以及评估AF风险和潜在病理生理学的方法在很大程度上是有限的。新出现的证据表明，炎症在AF的发病机制中起着重要作用。这些证据包括AF受试者血清中炎症生物标志物水平升高，AF患者和AF动物模型心脏组织中炎症标志物的表达，以及抗炎药物在实验性AF范例中的有益作用。炎症被认为与促进AF底物形成的各种病理过程有关，如氧化应激、细胞凋亡和纤维化。炎症还与内皮功能障碍、血小板活化和凝血级联活化相关，导致血栓形成。因此，炎症可能导致AF及其血栓栓塞并发症的发生/维持。在这里，我们回顾了炎症和炎症生物标志物在房颤风险管理和治疗中的作用的证据。我们还总结了房颤病理生理学中炎症依赖性细胞和分子机制的现有知识及其作为治疗靶点的潜力。
Atrial fibrillation (AF) is the most common clinically relevant arrhythmia, but the methods available for treating AF and its complications (of which the most important is thrombogenesis), as well as for assessing AF risk and underlying pathophysiology, are largely limited. Emerging evidence suggests a significant role of inflammation in the pathogenesis of AF. That evidence includes elevated serum levels of inflammatory biomarkers in AF subjects, the expression of inflammatory markers in cardiac tissues of AF patients and animal models of AF, and beneficial effects of anti-inflammatory drugs in experimental AF paradigms. Inflammation is suggested to be linked to various pathological processes, such as oxidative stress, apoptosis, and fibrosis, that promote AF substrate formation. Inflammation has also been associated with endothelial dysfunction, platelet activation, and coagulation cascade activation, leading to thrombogenesis. Thus, inflammation may contribute to both the occurrence/maintenance of AF and its thromboembolic complications. Here, we review the evidence for a role of inflammation and inflammatory biomarkers in the risk management and treatment of AF. We also summarize the current knowledge of inflammation-dependent cellular and molecular mechanisms in AF pathophysiology and their potential as therapeutic targets.