Balouch Muhammad A, Kolek Matthew J, Darbar Dawood
Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Glob Cardiol Sci Pract. 2014 Jan 29;2014(1):24-36. doi: 10.5339/gcsp.2014.5. eCollection 2014.
Atrial fibrillation (AF) is a common disorder with a complex and incompletely understood pathophysiology. Genetic approaches to understanding the pathophysiology of AF have led to the identification of several biological pathways important in the pathogenesis of the arrhythmia. These include pathways important for cardiac development, generation and propagation of atrial electrical impulses, and atrial remodeling and fibrosis. While common and rare genetic variants in these pathways are associated with increased susceptibility to AF, they differ substantially among patients with lone versus typical AF. Furthermore, how these pathways converge to a final common clinical phenotype of AF is unclear and might also vary among different patient populations. Here, we review the contemporary knowledge of AF pathogenesis and discuss how derangement in cardiac development, ion channel dysfunction, and promotion of atrial fibrosis may contribute to this common and important clinical disorder.
心房颤动(AF)是一种常见疾病,其病理生理学复杂且尚未完全被理解。通过遗传学方法来理解AF的病理生理学,已促使人们识别出在该心律失常发病机制中重要的几种生物学途径。这些途径包括对心脏发育、心房电冲动的产生与传导以及心房重塑和纤维化至关重要的途径。虽然这些途径中的常见和罕见基因变异与AF易感性增加相关,但在孤立性AF与典型AF患者之间存在很大差异。此外,这些途径如何汇聚成AF最终的共同临床表型尚不清楚,并且在不同患者群体中可能也有所不同。在此,我们综述了AF发病机制的当代知识,并讨论心脏发育紊乱、离子通道功能障碍以及心房纤维化的促进如何可能导致这种常见且重要的临床疾病。