肾素-血管紧张素-醛固酮系统与心律失常关系的研究进展

Relationship Between Renin-Angiotensin-Aldosterone System and Arrhythmias

肾素-血管紧张素-醛固酮系统(Renin-Angiotensin-Aldosterone System,RAAS)是人体内一个重要的内分泌/旁分泌系统,参与如高血压、心肌肥厚、动脉粥样硬化等多种心血管疾病的病理过程。大量数据表明,RAAS也参与心律失常的疾病过程,可引起心房颤动、室性心动过速、心室颤动等快速型心律失常的发生。目前已知,RAAS主要通过增加心肌肥厚、纤维化和心肌组织的异质性导致上述心律失常的发生。最新研究发现,RAAS还通过多种电生理效应参与心律失常的发生,血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors,ACEIs)、血管紧张素受体拮抗剂(angiotensin receptor blockers,ARBs)和醛固酮受体阻滞剂(mineralocorticoid receptor blockers,MRBs)可减少这些心律失常的发生。本文重点探讨RAAS在心律失常发生中的作用及可能的分子机制,为临床预防以及治疗以上心律失常提供新的方向。

The Renin-Angiotensin-Aldosterone System(RAAS)is an important endocrine/paracrine system in the human body,which is involved in the pathophysiological processes of various cardiovascular diseases,such as hypertension,cardiac hypertrophy,and atherosclerosis.A large number of datas show that RAAS is also involved in the disease process of arrhythmia,which can cause the occurrence of tachyarrhythmias,such as atrial fibrillation,ventricular tachycardia and ventricular fibrillation.It is currently known that RAAS leads to tachyarrhythmias mainly by the ways of cardiac hypertrophy,fibrosis and heterogeneity of myocardial tissue.The latest study has found RAAS having multiple electrophysiological effects involved in the arrhythmia occurrence.Angiotensin-converting enzyme inhibitors(ACEIs),angiotensin receptor antagonists(ARBs)and aldosterone receptor blockers(MRBs)can reduce the occurrence of tachyarrhythmias.We will summarize the role and possible molecular mechanism of RAAS in tachyarrhythmia,and provide a new direction for the clinical prevention and treatment of the above arrhythmia.