"Sinus node dysfunction and atrial fibrillation-Relationships, clinical phenotypes, new mechanisms, and treatment approaches"

作者全名："Duan, Suhang; Du, Jianlin"

作者地址："[Duan, Suhang; Du, Jianlin] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, 74 Lin Jiang Rd, Chongqing 400010, Peoples R China"

通信作者："Du, JL (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, 74 Lin Jiang Rd, Chongqing 400010, Peoples R China."

来源：AGEING RESEARCH REVIEWS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000967414200001

JCR分区：Q1

影响因子：12.5

年份：2023

卷号：86

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：Sinus node dysfunction; Atrial fibrillation; HCN4; Ganglionated plexus; Neuromodulation

摘要："Although the anatomical basis of the pathogenesis of sinus node dysfunction (SND) and atrial fibrillation (AF) is located primarily in the left and right atria, increasing evidence suggests a strong correlation between SND and AF, in terms of both clinical presentation and formation mechanisms. However, the exact mechanisms underlying this association are unclear. The relationship between SND and AF may not be causal, but is likely to involve common factors and mechanisms, including ion channel remodeling, gap junction abnormalities, structural remodeling, genetic mutations, neuromodulation abnormalities, the effects of adenosine on cardiomyocytes, oxidative stress, and viral infections. Ion channel remodeling manifests primarily as alterations in the ""funny"" current (I-f) and Ca2+ clock associated with cardiomyocyte autoregulation, and gap junction abnormalities are manifested primarily as decreased expression of connexins (Cxs) mediating electrical impulse propagation in cardiomyocytes. Structural remodeling refers primarily to fibrosis and cardiac amyloidosis (CA). Some genetic mutations can also cause arrhythmias, such as SCN5A, HCN4, EMD, and PITX2. The intrinsic cardiac autonomic nervous system (ICANS), a regulator of the heart's physiological functions, triggers arrhythmias.In addition, we discuss arrhythmias caused by viral infections, notably Coronavirus Disease 2019 (COVID-19). Similarly to upstream treatments for atrial cardiomyopathy such as alleviating CA, ganglionated plexus (GP) ablation acts on the common mechanisms between SND and AF, thus achieving a dual therapeutic effect."

基金机构：National Natural Science Foundation of China (NSFC) [82270281]; Natural Science Foundation of Chongqing Science and Technology Commission [cstc2020jcyj-msxmX0210]; Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2020FYYX047]; Future Medicine Youth Innovation Team Development Support Program of Chongqing Medical University [W0133]; Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University

基金资助正文："This work was supported by grants from the National Natural Science Foundation of China (NSFC) (82270281), Natural Science Foundation of Chongqing Science and Technology Commission (cstc2020jcyj-msxmX0210), Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau; 2020FYYX047), Future Medicine Youth Innovation Team Development Support Program of Chongqing Medical University (W0133), and Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University."