肾素-血管紧张素系统在心房颤动中的作用研究进展

Research progress on the role of renin-angiotensin system in atrial fibrillation

心房颤动(atrial fibrillation,AF)是最常见的心律失常,是导致中风、心脏疾病和死亡的主要原因之一。虽然AF的具体机制尚不清楚,但是心房电重构和结构重构是触发AF的主要机制。多项研究表明,肾素-血管紧张素系统(renin-angiotensin system,RAS)在这种重构中起关键作用。到目前为止,抗心律失常药物和射频消融尚未成功治愈AF。因此,迫切需要一种预防策略来降低AF的发病率、死亡率和医疗费用。RAS阻断剂,包括血管紧张素转换酶抑制剂(angiotensin-converting enzyme inhibitors,ACEIs)和血管紧张素受体阻滞剂(angiotensin-receptor blockers,ARBs)是治疗心脏病的一线治疗方法,ACEIs/ARBs可改善AF患者的心脏重构,能够预防和治疗AF。本综述阐述了RAS在AF发病中的作用以及RAS阻断剂在AF一级和二级预防中的潜力,以期为AF的治疗提供更多的思路。

Atrial fibrillation(AF)is the most common arrhythmia and one of the leading causes of stroke,heart disease and death.Although the specific mechanism of AF is still unclear,atrial electrical remodeling and structural remodeling are the main mechanisms which can trigger AF.Recent studies have shown that the renin-angiotensin system(RAS)plays a key role in this remodeling.So far,antiarrhythmic drugs and radiofrequency ablation have not cured AF successfully.Therefore,a prevention strategy is urgently needed to reduce AF-related morbidity,mortality,and healthcare costs.RAS blockers,including angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin-receptor blockers(ARBs),which are the first-line treatment for heart disease.This study found that ACEIs/ARBs can improve cardiac remodeling in patients with AF and can prevent and treat AF.This review describes the role of RAS in the pathogenesis of AF and the potential of RAS blockers in the primary and secondary prevention of AF,in order to provide more ideas for the treatment of AF.