自主神经与心房颤动的研究进展

胡润晖; 胡建平; 洪葵

doi:10.13201/j.issn.1001-1439.2020.01.019

自主神经与心房颤动的研究进展

- 1. 南昌大学第二附属医院心内科(南昌, 330006);
- 2. 江西省分子医学重点实验室

详细信息

通讯作者: 洪葵,E-mail:hongkui88@163.com

中图分类号: R541.7

收稿日期: 2019-08-05

Research progress on autonomic nervous and atrial fibrillation

- 1. Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China;
- 2. Jiangxi Provincial Key Laboratory of Molecular Medicine

More Information

Corresponding author: HONG Kui, E-mail: hongkui88@163.com

Received Date: 05 August 2019

摘要

摘要: 异常的自主神经调节与心律失常发生相关。自主神经调节失衡能导致心房肌细胞电触发异常,迷走-交感共激活可能是神经源性房颤发生和发展的主要原因,炎症诱导的自主神经失衡可以作为房颤的促进因素,而自主神经消融可作为房颤治疗策略之一。本文综述了房颤病理生理的神经学证据,阐述了在神经源性房颤发生和发展过程中发挥主要作用的解剖学、病理生理学和治疗学证据。
- 心房颤动 /
- 神经 /
- 机制
Abstract: Abnormal autonomic nerves regulation is associated with arrhythmia.Autonomic nerves system(ANS) imbalance can promote electrical triggers.Sympathovagal co-activation in atrial myocardium is a major contributor to atrial fibrillation initiation and maintenance.Infiammation as one of the AF facilitators also can be attributed to infiammation-induced autonomic imbalance.And autonomic nerve ablation can be used as one of the therapeutic strategies for atrial fibrillation.This article provides anatomical,pathophysiological and therapeutic evidence,supporting a major role for abnormal ANS in atrial fibrillation.
- atrial fibrillation /
- nerves /
- mechanism

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参考文献(32)

[1]	Colilla S,Crow A,Petkun W,et al.Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S.adult population[J].Am J Cardiol,2013,112(8):1142-1147.
[2]	Csepe TA,Zhao J,Hansen BJ,et al.Human sinoatrial node structure:3D microanatomy of sinoatrial conduction pathways[J].Prog Biophys Mol Biol,2016,120(1-3):164-178.
[3]	Lo LW,Scherlag BJ,Chang HY,et al.Paradoxical long-term proarrhythmic effects after ablating the "head station" ganglionated plexi of the vagal innervation to the heart[J].Heart Rhythm,2013,10(5):751-757.
[4]	Maupoil V,Bronquard C,Freslon JL,et al.Ectopic activity in the rat pulmonary vein can arise from simultaneous activation of alpha1- and beta1-adrenoceptors[J].Br J Pharmacol,2007,150(7):899-905.
[5]	Martin RI,Pogoryelova O,Koref MS,et al.Atrial fibrillation associated with ivabradine treatment:meta-analysis of randomised controlled trials[J].Heart,2014,100(19):1506-1510.
[6]	Cammarano C,Silva M,Comee M,et al.Meta-analysis of ivabradine in patients with stable coronary artery disease with and without left ventricular dysfunction[J].Clin Ther,2016,38(2):387-395.
[7]	Voigt N,Heijman J,Wang Q,et al.Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation[J].Circulation,2014,129(2):145-156.
[8]	Christ T,Kovacs P P,Acsai K,et al.Block of Na(+)/Ca(2+) exchanger by SEA0400 in human right atrial preparations from patients in sinus rhythm and in atrial fibrillation[J].Eur J Pharmacol,2016,788:286-293.
[9]	Burashnikov A,Antzelevitch C.Late-phase 3 EAD.A unique mechanism contributing to initiation of atrial fibrillation[J].Pacing Clin Electrophysiol,2006,29(3):290-295.
[10]	Heijman J,Kirchner D,Kunze F,et al.Muscarinic type-1 receptors contribute to IK,ACh in human atrial cardiomyocytes and are upregulated in patients with chronic atrial fibrillation[J].Int J Cardiol,2018,255:61-68.
[11]	Scridon A,Serban RC,Chevalier P.Atrial fibrillation:Neurogenic or myogenic?[J].Arch Cardiovasc Dis,2018,111(1):59-69.
[12]	Pokushalov E,Kozlov B,Romanov A,et al.Long-term suppression of atrial fibrillation by botulinum toxin injection into epicardial fat pads in patients undergoing cardiac surgery:one-year follow-up of a randomized pilot study[J].Circ Arrhythm Electrophysiol,2015,8(6):1334-1341.
[13]	Sposato LA,Fridman S,Whitehead SN,et al.Linking stroke-induced heart injury and neurogenic atrial fibrillation:a hypothesis to be proven[J].J Electrocardiol,2018,Feb 20.doi:10.1016/j.jelectrocard.2018.02.006.
[14]	Sposato LA,Lopes RD.Disentangling the risk of atrial fibrillation detected after ischemic stroke (AFDAS):A real challenge in clinical practice[J].Int J Cardiol,2018,261:99-100.
[15]	Shen MJ,Choi EK,Tan AY,et al.Neural mechanisms of atrial arrhythmias[J].Nat Rev Cardiol,2011,9(1):30-39.
[16]	Sharifov OF,Fedorov VV,Beloshapko GG,et al.Roles of adrenergic and cholinergic stimulation in spontaneous atrial fibrillation in dogs[J].J Am Coll Cardiol,2004,43(3):483-490.
[17]	Cerasuolo JO,Cipriano LE,Sposato LA.The complexity of atrial fibrillation newly diagnosed after ischemic stroke and transient ischemic attack:advances and uncertainties[J].Curr Opin Neurol,2017,30(1):28-37.
[18]	候绪娟,段文昌,郑少华.持续性快速右心房起搏犬肺静脉一左心房连接处自主神经重构的研究[J].山东大学学报(医学版),2014,51(12):7-10.
[19]	Katritsis DG,Pokushalov E,Romanov A,et al.Autonomic denervation added to pulmonary vein isolation for paroxysmal atrial fibrillation:a randomized clinical trial[J].J Am Coll Cardiol,2013,62(24):2318-2325.
[20]	Driessen A,Berger WR,Krul S,et al.Ganglion plexus ablation in advanced atrial fibrillation:The AFACT Study[J].J Am Coll Cardiol,2016,68(11):1155-1165.
[21]	Scherlag MA,Scherlag BJ.A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension[J].J Am Coll Cardiol,2013,62(12):1129-1130.
[22]	Yu X,He W,Qin Z,et al.Selective ablation of the ligament of Marshall attenuates atrial electrical remodeling in a short-term rapid atrial pacing canine model[J].J Cardiovasc Electrophysiol,2018,29(9):1299-1307.
[23]	Chen M,Zhou X,Liu Q,et al.Left-sided noninvasive vagus nerve stimulation suppresses atrial fibrillation by upregulating atrial gap junctions in Canines[J].J Cardiovasc Pharmacol,2015,66(6):593-599.
[24]	Sha Y,Scherlag BJ,Yu L,et al.Low-level right vagal stimulation:anticholinergic and antiadrenergic effects[J].J Cardiovasc Electrophysiol,2011,22(10):1147-1153.
[25]	Leftheriotis D,Flevari P,Kossyvakis C,et al.Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility[J].Heart Rhythm,2016,13(11):2111-2117.
[26]	Bernstein SA,Wong B,Vasquez C,et al.Spinal cord stimulation protects against atrial fibrillation induced by tachypacing[J].Heart Rhythm,2012,9(9):1426-1433.
[27]	Wang S,Zhou X,Huang B,et al.Spinal cord stimulation suppresses atrial fibrillation by inhibiting autonomic remodeling[J].Heart Rhythm,2016,13(1):274-281.
[28]	Goldberger JJ,Arora R,Buckley U,et al.Autonomic nervous system dysfunction:JACC Focus Seminar[J].J Am Coll Cardiol,2019,73(10):1189-1206.
[29]	Juhasz V,Hornyik T,Benak A,et al.Comparison of the effects of IK,ACh,IKr,and INa block in conscious dogs with atrial fibrillation and on action potentials in remodeled atrial trabeculae[J].Can J Physiol Pharmacol,2018,96(1):18-25.
[30]	Zhou X,Wang Z,Huang B,et al.Regulation of the NRG1/ErbB4 pathway in the intrinsic cardiac nervous system is a potential treatment for atrial fibrillation[J].Front Physiol,2018,9:1082.
[31]	Yu L,Li X,Huang B,et al.Atrial fibrillation in acute obstructive sleep apnea:autonomic nervous mechanism and modulation[J].J Am Heart Assoc,2017,6(9):pii:e006264.
[32]	Paquet M,Cerasuolo JO,Thorburn V,et al.Pathophysiology and Risk of Atrial Fibrillation Detected after Ischemic Stroke (PARADISE):A Translational,Integrated,and Transdisciplinary Approach[J].J Stroke Cerebrovasc Dis,2018,27(3):606-619.