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冠心病与心房颤动:恶性循环。

Coronary heart disease and atrial fibrillation: a vicious cycle.

机构信息

Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Am J Physiol Heart Circ Physiol. 2021 Jan 1;320(1):H1-H12. doi: 10.1152/ajpheart.00702.2020. Epub 2020 Nov 13.

Abstract

The population suffering from coronary heart disease (CHD) complicated by atrial fibrillation (AF) is rising rapidly. A strong correlation between the two diseases has been reported, and the many common risk factors they share may play prominent roles in their development. In addition, CHD can directly promote the progression of AF by affecting reentry formation, focal ectopic activity, and neural remodeling. At the same time, AF also affects CHD through three aspects: ) atherosclerosis, ) the mismatch of blood supply and oxygen consumption, and ) thrombosis. In conclusion, CHD and AF can aggravate each other and seem to form a vicious cycle. For patients with CHD complicated by AF, principal studies and guidelines have focused on antithrombotic treatment and rhythm control, which are paramount for these patients. Of note, our review sheds light on the strategies to break the cycle of the two diseases, which may be fundamental to treat these patients and optimize the benefit.

摘要

患冠心病(CHD)合并心房颤动(AF)的人群正在迅速增加。这两种疾病之间存在很强的相关性,它们共同的许多常见危险因素可能在其发展中起重要作用。此外,CHD 可通过影响折返形成、局灶性异位活动和神经重构直接促进 AF 的进展。同时,AF 也通过三个方面影响 CHD:)动脉粥样硬化,)血液供应和氧气消耗的不匹配,和)血栓形成。总之,CHD 和 AF 可以相互加重,似乎形成了一个恶性循环。对于 CHD 合并 AF 的患者,主要的研究和指南集中在抗血栓治疗和节律控制上,这对这些患者至关重要。值得注意的是,我们的综述强调了打破这两种疾病循环的策略,这可能是治疗这些患者和优化疗效的基础。

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