心房和肺静脉机械牵张在慢性心力衰竭合并心房颤动中的作用与相关治疗的研究进展

The Role and Related Treatment of Atrial and Pulmonary Vein Mechanical Stretch in Chronic Heart Failure Complicated with Atrial Fibrillation

心房颤动是心力衰竭患者最常见的心律失常之一。心力衰竭引发心房颤动的机制主要涉及炎症反应、血流动力学引起的机械牵张及离子通道的变化导致的电生理重塑等,其中机械牵张被认为是诱发心房颤动的关键因素之一。目前研究已证明,心力衰竭合并心房颤动的治疗往往存在复发率高和预后不佳等问题,因此,深入探究病因并寻找新的防治策略尤为重要。现主要综述心房和肺静脉机械牵张在慢性心力衰竭合并心房颤动患者病情发生、发展过程中的病理生理机制,探讨减少心房和肺静脉机械牵张在治疗及预后判断中的潜在作用。

Atrial fibrillation is one of the most prevalent arrhythmias in patients with heart failure.The mechanism of atrial fibrillation induced by heart failure mainly involves inflammatory reaction,hemodynamically induced mechanical stretch and electrophysiological remodeling caused by ion channel changes,among which mechanical stretch is considered to be one of the key factors inducing atrial fibrillation.Current studies have proved that the treatment of heart failure combined with atrial fibrillation often has high recurrence rate and poor prognosis,so it is particularly important to explore the etiology and find new prevention and treatment strategies.This article mainly reviews the pathophysiological mechanism of atrial and pulmonary vein mechanical stretch in the occurrence and development of heart failure patients with atrial fibrillation,and discusses the potential role of reducing atrial and pulmonary vein mechanical stretch in treatment and prognosis.