Department of Experimental Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands.
Cardiovasc Res. 2011 Mar 1;89(4):754-65. doi: 10.1093/cvr/cvq357. Epub 2010 Nov 11.
Structural remodelling occurring before, due to the underlying heart disease, and during atrial fibrillation (AF) sets the stage for permanent AF. Current therapy in AF aims to maintain sinus rhythm in symptomatic patients, but outcome is unfortunately poor. Stretch of the atria is a main contributor to atrial remodelling. In this review, we describe different aspects of structural remodelling as seen in animal models and in patients with AF, including atrial enlargement, cellular hypertrophy, dedifferentiation, fibrosis, apoptosis, and loss of contractile elements. In the second part, we describe downstream signals of mechanical stretch and their contribution to AF and structural remodelling. Ultimately, knowledge of mechanisms underlying structural remodelling may help to identify new pharmacological targets for AF prevention.
结构重构发生在心房颤动 (AF) 之前、期间和由于潜在的心脏病，为永久性 AF 奠定了基础。目前 AF 的治疗旨在维持有症状患者的窦性节律，但结果并不理想。心房的拉伸是心房重构的主要原因之一。在这篇综述中，我们描述了在动物模型和 AF 患者中观察到的结构重构的不同方面，包括心房扩张、细胞肥大、去分化、纤维化、细胞凋亡和收缩元件丢失。在第二部分，我们描述了机械拉伸的下游信号及其对 AF 和结构重构的贡献。最终，对结构重构潜在机制的认识可能有助于确定 AF 预防的新的药理学靶点。
