Upstream Effect for Atrial Fibrillation: Still a Dilemma?

被引：11

作者：

Calo, Leonardo ^{[1
]}

Martino, Annamaria ^{[1
,2
]}

Sciarra, Luigi ^{[1
]}

Ciccaglioni, Antonio ^{[2
]}

De Ruvo, Ermenegildo ^{[1
]}

De Luca, Lucia ^{[1
]}

Sette, Antonella ^{[1
]}

Giunta, Giuseppe ^{[2
]}

Lioy, Ernesto ^{[1
]}

Fedele, Francesco ^{[2
]}

机构：

[1] Policlin Casilino ASL RMB, Div Cardiol, Rome, Italy

[2] Univ Roma La Sapienza, Policlin Umberto I, Rome, Italy

来源：

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2011年 / 34卷 / 01期

关键词：

atrial fibrillation; angiotensin-converting enzyme inhibitors; glucocorticoids; poly-unsaturated fatty acids; statins; upstream therapy; pharmacology; ANGIOTENSIN-CONVERTING-ENZYME; LEFT-VENTRICULAR DYSFUNCTION; POLYUNSATURATED-FATTY-ACIDS; CORONARY-ARTERY-DISEASE; II RECEPTOR BLOCKADE; RANDOMIZED CONTROLLED-TRIALS; PREOPERATIVE STATIN THERAPY; ACUTE MYOCARDIAL-INFARCTION; STERILE PERICARDITIS MODEL; CONGESTIVE-HEART-FAILURE;

D O I：

10.1111/j.1540-8159.2010.02942.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Atrial fibrillation is the most common arrhythmia in clinical practice. Ion channel blocking agents are often characterized by limited long-term efficacy and several side effects. In addition, ablative invasive procedures are neither easily accessible nor always efficacious. The "upstream therapy," which includes angiotensin-converting enzyme inhibitors, aldosterone receptor antagonists, statins, glucocorticoids, and omega-3 poly-unsaturated fatty acids, targets arrhythmia substrate, influencing atrial structural and electrical remodeling that play an essential role in atrial fibrillation induction and maintenance. The mechanisms involved and the most important clinical evidence regarding the upstream therapy influence on atrial fibrillation are presented in this review. Some open questions are also proposed. (PACE 2011; 111-128).

引用

页码：111 / 128

页数：18

共 133 条

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