a First Department of Cardiology , University of Ioannina Medical School , Ioannina , Greece.
b Second Department of Cardiology, Laboratory of Cardiac Electrophysiology , "Evangelismos" General Hospital of Athens , Athens , Greece.
Free Radic Res. 2018 Dec;52(11-12):1199-1209. doi: 10.1080/10715762.2018.1500696. Epub 2018 Sep 10.
Atrial remodelling involves electrophysiological and structural abnormalities that promote the development and perpetuation of atrial fibrillation. Experimental and clinical data indicate that oxidative stress is implicated in the pathophysiology of atrial remodelling. The mechanistic links between atrial remodelling and oxidative stress are complex with several underlying diseases and conditions may affect these pathways. Therefore, the development of antioxidant interventions in this setting remains difficult. Besides classical antioxidant compounds, several agents with pleiotropic effects, including anti-inflammatory and antioxidant, have been tested in experimental and clinical settings with variable results. Strategies applying conventional antioxidants in specific situations such as postoperative atrial fibrillation show beneficial effects, especially the two-step regimen of antioxidants combination. Of note, there are limited data on the development of strategies that target specific sources of reactive oxygen species implicated in atrial remodelling. Lifestyle, diet, and risk factors modification is a complementary promising approach. This updated review provides a concise and critical overview of all available data regarding oxidative stress and its modulation in atrial fibrillation. Future directions on this exciting field are also discussed.
心房重构涉及电生理和结构异常，促进了心房颤动的发生和持续。实验和临床数据表明，氧化应激与心房重构的病理生理学有关。心房重构和氧化应激之间的机制联系很复杂，一些潜在的疾病和情况可能会影响这些途径。因此，在这种情况下开发抗氧化干预措施仍然很困难。除了经典的抗氧化剂化合物外，几种具有多种作用的药物，包括抗炎和抗氧化作用，已在实验和临床环境中进行了测试，但结果各不相同。在特定情况下应用传统抗氧化剂的策略，如术后心房颤动，显示出有益的效果，尤其是抗氧化剂联合的两步方案。值得注意的是，针对在心房重构中涉及的特定活性氧物质来源的策略的发展数据有限。生活方式、饮食和危险因素的改变是一种有前途的补充方法。这篇更新的综述提供了一个关于氧化应激及其在心房颤动中的调节的所有可用数据的简明和批判性概述。还讨论了这个令人兴奋的领域的未来方向。
