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心房颤动是常见而顽固的房性心律失常,心房力学或机械环境改变与房颤发生发展关系密切。机械因素可通过诱导心房电-解剖重构,导致心肌自律性及触发活动增加,传导速度减慢,有效不应期缩短,并最终使房颤易患性增加。其中细胞内钙离子稳态、细胞骨架结构及功能、局部肾素-血管紧张素-醛固酮系统、整合素及丝裂原活化蛋白激酶信号通路等参与上述过程。本文系统地介绍了与心房颤动相关的机械电反馈过程,对该领域内相关研究进行归纳整理,旨在为进一步研究并阐明房颤的力学机制提供理论依据。
Atrial fibrillation is a common and stubborn atrial arrhythmia, atrial mechanics or changes in the mechanical environment and the occurrence and development of atrial fibrillation are closely related. Mechanical factors induce electrical and anatomic remodeling of the atrium, resulting in increased cardiac autonomic activity and triggering activity, slowed conduction, shortened effective refractory period, and ultimately increased atrial fibrillation susceptibility. The intracellular calcium homeostasis, the cytoskeleton structure and function, the local renin-angiotensin-aldosterone system, integrin and mitogen-activated protein kinase signaling pathway involved in the above process. This article systematically introduces the mechanical and electrical feedback process related to atrial fibrillation, and summarizes related research in this field, which is intended to provide a theoretical basis for further study and elucidation of the mechanical mechanism of atrial fibrillation.