Heijman Jordi, Linz Dominik, Schotten Ulrich
Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, The Netherlands; email:
Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands; email:
Annu Rev Physiol. 2021 Feb 10;83:83-106. doi: 10.1146/annurev-physiol-031720-085307. Epub 2020 Oct 16.
Atrial fibrillation (AF) contributes to morbidity and mortality of millions of individuals. Its molecular, cellular, neurohumoral, and hemodynamic pathophysiological mechanisms are complex, and there is increasing awareness that a wide range of comorbidities can contribute to AF-promoting atrial remodeling. Moreover, recent research has highlighted that AF risk is not constant and that the temporal variation in concomitant conditions contributes to the complexity of AF dynamics. In this review, we provide an overview of fundamental AF mechanisms related to established and emerging comorbidities or risk factors and their role in the AF-promoting effects. We focus on the accumulating evidence for the relevance of temporally dynamic changes in these risk factors and the consequence for AF initiation and maintenance. Finally, we highlight the important implications for future research and clinical practice resulting from the dynamic interaction between AF risk factors and mechanisms.
心房颤动（AF）导致数百万个体发病和死亡。其分子、细胞、神经体液和血流动力学病理生理机制复杂，人们越来越意识到多种合并症可促成促进房颤的心房重构。此外，最近的研究强调房颤风险并非恒定不变，伴随疾病的时间变化导致房颤动态变化的复杂性。在本综述中，我们概述了与既定和新出现的合并症或风险因素相关的房颤基本机制及其在促进房颤效应中的作用。我们关注这些风险因素随时间动态变化的相关性以及对房颤起始和维持的影响的累积证据。最后，我们强调房颤风险因素与机制之间的动态相互作用对未来研究和临床实践的重要意义。
