First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Curr Med Chem. 2019;26(5):780-802. doi: 10.2174/0929867324666170918122502.
Atrial fibrillation is the most common rhythm disturbance encountered in clinical practice. Although often considered as solely arrhythmic in nature, current evidence has established that atrial myopathy constitutes both the substrate and the outcome of atrial fibrillation, thus initiating a vicious, self-perpetuating cycle. This myopathy is triggered by stress-induced (including pressure/volume overload, inflammation, oxidative stress) responses of atrial tissue, which in the long term become maladaptive, and combine elements of both structural, especially fibrosis, and electrical remodeling, with contemporary approaches yielding potentially useful biomarkers of these processes. Biomarker value becomes greater given the fact that they can both predict atrial fibrillation occurrence and treatment outcome. This mini-review will focus on the biomarkers of atrial remodeling (both electrical and structural) and fibrosis that have been validated in human studies, including biochemical, histological and imaging approaches.
心房颤动是临床实践中最常见的节律紊乱。尽管通常被认为仅具有心律失常的性质，但现有证据已确立，心房心肌病既是心房颤动的基质又是其结果，从而引发了一个恶性的、自我维持的循环。这种心肌病是由心房组织的应激诱导（包括压力/容积超负荷、炎症、氧化应激）反应引发的，从长远来看，这些反应变得适应不良，并结合了结构重塑（特别是纤维化）和电重构的元素，目前的方法为这些过程提供了潜在有用的生物标志物。鉴于这些生物标志物既可以预测心房颤动的发生，又可以预测治疗效果，因此其价值更大。这篇迷你综述将重点介绍在人类研究中得到验证的心房重构（电重构和结构重构）和纤维化的生物标志物，包括生化、组织学和影像学方法。
