University of Tennessee Erlanger Cardiology, UT College of Medicine, Chattanooga, TN, USA.
Am Heart J. 2011 Jul;162(1):31-7. doi: 10.1016/j.ahj.2011.03.030.
Despite some common risk factors for atrial fibrillation (AF) being more prevalent among blacks, African Americans are increasingly being reported with lower prevalence and incidence of AF compared with whites. Contemporary studies have not provided a complete explanation for this apparent AF paradox in African Americans. Although many traditional and novel risk factors for AF have been identified, the role of ethnic-specific risk factors has not been examined. Whereas hypertension has been the most common risk factor associated with AF, coronary artery disease also plays an important role in AF pathophysiology in whites. Thereby, elucidating the role of ethnic-specific risk factors for AF may provide important insight into why African Americans are protected from AF or why whites are more prone to develop the arrhythmia. The link between AF susceptibility and genetic processes has only been recently uncovered. Polymorphisms in renin-angiotensin system genes have been characterized as predisposing to AF under certain environmental conditions. Several ion channel genes, signaling molecules, and several genetic loci have been linked with AF. Thereby, studies investigating genetic variants contributing to the differential AF risk in individuals of African American versus European ancestry may also provide important insight into the etiology of the AF paradox in blacks.
尽管心房颤动 (AF) 的一些共同危险因素在黑人群体中更为普遍，但与白种人相比，非裔美国人的 AF 患病率和发病率却越来越低。目前的研究尚未完全解释非裔美国人中这种明显的 AF 悖论。尽管已经确定了许多 AF 的传统和新型危险因素，但尚未研究种族特异性危险因素的作用。虽然高血压是与 AF 最常见的危险因素，但冠状动脉疾病在白种人中的 AF 病理生理学中也起着重要作用。因此，阐明 AF 的种族特异性危险因素的作用可能为非裔美国人免受 AF 影响或白种人更易发生心律失常的原因提供重要的见解。AF 易感性与遗传过程之间的联系直到最近才被揭示。肾素-血管紧张素系统基因中的多态性在某些环境条件下被认为是导致 AF 的易感性因素。几个离子通道基因、信号分子和几个遗传位点与 AF 有关。因此，研究导致非裔美国人和欧洲裔个体 AF 风险差异的遗传变异也可能为黑人中 AF 悖论的病因学提供重要的见解。
