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常见基因变异在心房颤动中的作用。

The role of common genetic variants in atrial fibrillation.

作者信息

Paludan-Müller Christian, Svendsen Jesper H, Olesen Morten S

机构信息

Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Electrocardiol. 2016 Nov-Dec;49(6):864-870. doi: 10.1016/j.jelectrocard.2016.08.012. Epub 2016 Aug 26.

Abstract

This review focuses on the genetic basis of atrial fibrillation (AF) and the role of variants in the susceptibility of developing the disease. AF is the most common cardiac arrhythmia affecting 1-2% of the general population. Studies in the last decade have demonstrated that AF, and in particular lone AF, has a substantial genetic component. A number of genome-wide association studies (GWAS) have indicated that common genetic variants, more precisely the so called single-nucleotide polymorphisms (SNPs) are associated with AF. Presently more than 10 genomic regions have been identified using this approach. Highly penetrant variants in lone AF have also been described in a number of cases. Furthermore, familial AF, although rare, have been recognized for many years. Variants associated with AF have been identified in more than 40 genes, including cardiac gap junction proteins, ion channels and beta subunits. The evidence for some of these findings is not as strong as the evidence for the common variants. All in all, it is a complex picture, as both gain- and loss of function variants have been identified in a number of the genes. This review will focus on the common variants associated with AF. The pathophysiological mechanisms responsible for AF are still far from completely understood, and it is assumed that this arrhythmia represents a complex interplay of genetic predispositions, arrhythmogenic contributors such as electrolytes and inflammatory stimuli as well as contributions from concomitant cardiac and non-cardiac diseases.

摘要

本综述聚焦于心房颤动(AF)的遗传基础以及基因变异在该疾病易感性中的作用。AF是最常见的心律失常,影响着1%至2%的普通人群。过去十年的研究表明,AF,尤其是孤立性AF,具有显著的遗传成分。多项全基因组关联研究(GWAS)表明,常见的基因变异,更确切地说是所谓的单核苷酸多态性(SNP)与AF相关。目前,使用这种方法已鉴定出超过10个基因组区域。在许多病例中也描述了孤立性AF中的高 penetrant 变异。此外,家族性AF虽然罕见,但多年来已被认识到。与AF相关的变异已在40多个基因中被鉴定出来,包括心脏间隙连接蛋白、离子通道和β亚基。其中一些发现的证据不如常见变异的证据有力。总而言之,情况很复杂,因为在许多基因中都发现了功能获得性和功能丧失性变异。本综述将聚焦于与AF相关的常见变异。导致AF的病理生理机制仍远未完全了解,据推测,这种心律失常代表了遗传易感性、心律失常促成因素(如电解质和炎症刺激)以及伴随的心脏和非心脏疾病的综合作用之间的复杂相互作用。

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