Rac1 and connective tissue growth factor. The missing link between atrial remodeling and the pathogenesis of atrial fibrillation?
Rac1 and connective tissue growth factor. The missing link between atrial remodeling and the pathogenesis of atrial fibrillation?
复制标题
Rac1 和结缔组织生长因子。
DOI：
10.1016/j.jacc.2009.07.071
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发表时间：
2010
影响因子：
24
通讯作者：
Liao,JamesK
中科院分区：
文献类型：
--
作者：
Liao,JamesK
心房颤动 (AF) 是最常见的心律失常类型，也是发病率和死亡率的主要原因 (1)。 AF 通常发生在心脏手术后或患有高血压或缺血性、瓣膜性、结构性或代谢性心脏病的患者中 (2)。在某些情况下，房颤没有明确的病因，通常称为孤立性或特发性房颤。尽管如此，大多数 AF 患者左心房尺寸增大 (3)，且左心房增大的 AF 患者与左心房尺寸正常的患者相比，心血管预后较差 (4)。然而，左心房扩大也可能是 AF 的结果 (5)。对孤立性 AF 患者的组织学活检研究显示心房炎症和纤维化增加 (6)。事实上，纤维化和细胞外基质重塑是左心房扩大的重要组成部分 (7, 8)，而左心房容量的增加是术后 AF 的有力预测因素 (9)。这些发现表明左心房纤维化可能导致房颤的发病机制。然而，介导左心房这些变化的精确信号通路尚不清楚。
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major cause of morbidity and mortality (1). AF typically occurs after cardiac surgery or in patients with hypertension or ischemic, valvular, structural, or metabolic heart disease (2). In some cases, AF has no clear etiology, which is often referred to as lone or idiopathic AF. Nevertheless, most patients with AF have increased left atrial size (3), and AF patients with left atrial enlargement have poorer cardiovascular prognosis compared with patients who have normal left atrial dimensions (4). However, left atrium enlargement could also be a consequence of AF (5). Histological biopsy studies in patients with lone AF revealed increased atrial inflammation and fibrosis (6). Indeed, fibrosis and extracellular matrix remodeling are important components of left atrial enlargement (7, 8), and increased left atrial volume is a strong predictor of postoperative AF (9). These findings suggest that left atrial fibrosis could contribute to the pathogenesis of AF. However, the precise signaling pathways that mediate these changes in the left atrium are not known.