Chen Pao-Huan, Kao Yu-Hsun, Chen Yi-Jen
Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 11031 Taipei, Taiwan.
Department of Psychiatry, Taipei Medical University Hospital, 11031 Taipei, Taiwan.
Rev Cardiovasc Med. 2024 Sep 24;25(9):343. doi: 10.31083/j.rcm2509343. eCollection 2024 Sep.
Atrial fibrillation (AF) is a common phenomenon of sustained arrhythmia leading to heart failure or stroke. Patients with mental disorders (MD), particularly schizophrenia and bipolar disorder, are at a high risk of AF triggered by the dysregulation of the autonomic nervous system, atrial stretch, oxidative stress, inflammation, and electrical or structural remodeling. Moreover, pathophysiological mechanisms underlying MD may also contribute to the genesis of AF. An overactivated hypothalamic-pituitary-adrenal axis, aberrant renin-angiotensin-aldosterone system, abnormal serotonin signaling, disturbed sleep, and genetic/epigenetic factors can adversely alter atrial electrophysiology and structural substrates, leading to the development of AF. In this review, we provide an update of our collective knowledge of the pathophysiological and molecular mechanisms that link MD and AF. Targeting the pathogenic mechanisms of MD-specific AF may facilitate the development of therapeutics that mitigate AF and cardiovascular mortality in this patient population.
心房颤动（AF）是导致心力衰竭或中风的持续性心律失常的常见现象。患有精神障碍（MD）的患者，尤其是精神分裂症和双相情感障碍患者，由于自主神经系统失调、心房牵张、氧化应激、炎症以及电或结构重塑而引发房颤的风险很高。此外，MD潜在的病理生理机制也可能导致房颤的发生。下丘脑-垂体-肾上腺轴过度激活、肾素-血管紧张素-醛固酮系统异常、血清素信号异常、睡眠障碍以及遗传/表观遗传因素会对心房电生理和结构基质产生不利影响，从而导致房颤的发生。在本综述中，我们提供了关于连接MD和AF的病理生理和分子机制的最新综合知识。针对MD特异性房颤的致病机制可能有助于开发减轻该患者群体房颤和心血管死亡率的治疗方法。
