Rafaqat Saira, Rafaqat Sana, Rafaqat Simon
Department of Zoology, Lahore College for Women University, Lahore, Punjab, Pakistan.
Department of Biotechnology, Lahore College for Women University, Lahore, Punjab, Pakistan.
J Innov Card Rhythm Manag. 2023 Feb 15;14(2):5355-5364. doi: 10.19102/icrm.2023.14025. eCollection 2023 Feb.
Numerous studies have reported that physical or emotional stress can provoke atrial fibrillation (AF) or vice versa, which suggests a potential link between exposure to external stressors and AF. This review article sought to describe in detail the relationship between major stress biomarkers and the pathogenesis of AF and presents up-to-date knowledge on the role of physiological and psychological stress in AF patients. For this purpose, this review article contends that plasma cortisol is linked to a greater risk of AF. A previous study has investigated the association between increased copeptin levels and paroxysmal AF (PAF) in rheumatic mitral stenosis and reported that copeptin concentration was not independently associated with AF duration. Reduced levels of chromogranin were measured in patients with AF. Furthermore, the dynamic activity of antioxidant enzymes, including catalase as well as superoxide dismutase, was examined in PAF patients during a period of <48 h. Malondialdehyde activity, serum high-sensitivity C-reactive protein, and high mobility group box 1 protein concentrations were significantly greater in patients with persistent AF or PAF compared to controls. Pooled data from 13 studies confirmed a significant reduction in the risk of AF related to the administration of vasopressin. Other studies have revealed the mechanism of action of heat shock proteins (HSPs) in preventing AF and also discussed the therapeutic potential of HSP-inducing compounds in clinical AF. More research is required to detect other biomarkers of stress, which have not been reported in the pathogenesis of AF. Further studies are required to identify their mechanism of action and drugs to manage these biomarkers of stress in AF patients, which might help to reduce the prevalence of AF globally.
众多研究报告称，身体或情绪压力可引发房颤（AF），反之亦然，这表明暴露于外部应激源与房颤之间存在潜在联系。这篇综述文章旨在详细描述主要应激生物标志物与房颤发病机制之间的关系，并介绍有关生理和心理压力在房颤患者中作用的最新知识。为此，这篇综述文章认为血浆皮质醇与房颤风险增加有关。此前一项研究调查了风湿性二尖瓣狭窄患者中 copeptin 水平升高与阵发性房颤（PAF）之间的关联，并报告 copeptin 浓度与房颤持续时间无独立关联。在房颤患者中检测到嗜铬粒蛋白水平降低。此外，在PAF患者中，在<48小时的时间段内检测了包括过氧化氢酶和超氧化物歧化酶在内的抗氧化酶的动态活性。与对照组相比，持续性房颤或PAF患者的丙二醛活性、血清高敏C反应蛋白和高迁移率族蛋白B1浓度显著更高。13项研究的汇总数据证实，使用加压素可显著降低房颤风险。其他研究揭示了热休克蛋白（HSPs）预防房颤的作用机制，并讨论了HSP诱导化合物在临床房颤中的治疗潜力。需要更多研究来检测应激的其他生物标志物，这些标志物在房颤发病机制中尚未见报道。还需要进一步研究来确定它们的作用机制以及用于管理房颤患者这些应激生物标志物的药物，这可能有助于降低全球房颤的患病率。
