Ju Hao, Liu Tao, Yang Manqi, Cheng Mian, Wu Gang
Department of Cardiology, Remin Hospital of Wuhan University, Wuhan, China.
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Pacing Clin Electrophysiol. 2023 Apr;46(4):312-318. doi: 10.1111/pace.14678. Epub 2023 Mar 7.
Atrial fibrillation (AF), one of the most common arrhythmias in clinical practice, is classified into paroxysmal, persistent, and permanent AF according to its duration. The development of AF is associated with increased cardiovascular morbidity and mortality. However, the exact etiology of this disease remains poorly understood. Recent studies found disorders of iron metabolism might be involved in the progression of AF. Abnormal iron metabolism in cardiomyocytes provides arrhythmogenic substrates through a variety of mechanisms, including calcium mishandling, ion channel remodeling, and oxidative stress overaction. Interestingly, in AF patients with iron overload, interventions on iron metabolism, such as iron chelators and ferroptosis inhibitors, has been shown to prevent AF via reducing ferroptosis. Herein, we review the possible mechanisms, consequences, and therapeutic implications of altered atrial iron handling for AF pathophysiology.
心房颤动（AF）是临床实践中最常见的心律失常之一，根据其持续时间可分为阵发性、持续性和永久性房颤。房颤的发生与心血管发病率和死亡率增加有关。然而，这种疾病的确切病因仍知之甚少。最近的研究发现，铁代谢紊乱可能参与房颤的进展。心肌细胞中铁代谢异常通过多种机制提供致心律失常底物，包括钙处理不当、离子通道重塑和氧化应激过度反应。有趣的是，在铁过载的房颤患者中，对铁代谢的干预措施，如铁螯合剂和铁死亡抑制剂，已被证明可通过减少铁死亡来预防房颤。在此，我们综述了心房铁处理改变对房颤病理生理学的可能机制、后果及治疗意义。
