Zou Fengwei, Levine Hannah, Mohanty Sanghamitra, Natale Andrea, Di Biase Luigi
Department of Medicine/Cardiology, Montefiore-Einstein Center for Heart & Vascular Care, Bronx, NY 10467, USA.
Department of Clinical Cardiac Electrophysiology, Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX 78705, USA.
Card Electrophysiol Clin. 2025 Mar;17(1):13-18. doi: 10.1016/j.ccep.2024.10.001. Epub 2024 Nov 16.
Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias in the world. Patients with AF also suffer from heart failure (HF). The relationship between AF and HF is often considered bidirectional and both share very similar risk factors. The mechanism of AF-induced cardiomyopathy lies in 3 distinct components: tachycardia-related cardiac dysfunction, heart rhythm irregularity, and AF-induced atrial myopathy. These components are mediated by calcium mishandling, neurohormonal activation, oxidative stress, myocardial supply-demand mismatch, and irreversible fibrosis and remodeling. Managing AF-induced cardiomyopathy should focus on early rhythm control to mitigate the development of irreversible remodeling and atrial myopathy.
心房颤动（AF）是全球最常见的心律失常之一。房颤患者也会并发心力衰竭（HF）。房颤与心力衰竭之间的关系通常被认为是双向的，且两者具有非常相似的危险因素。房颤诱发心肌病的机制有三个不同的组成部分：心动过速相关的心脏功能障碍、心律不齐以及房颤诱发的心房肌病。这些组成部分由钙处理不当、神经激素激活、氧化应激、心肌供需不匹配以及不可逆的纤维化和重塑介导。治疗房颤诱发的心肌病应侧重于早期节律控制，以减轻不可逆重塑和心房肌病的发展。
