Значение генетических, эпигенетических факторов и факторов транскрипции в фибрилляции предсердий

Одной из самых распространенных аритмий, возникающих у пациентов с сердечно-сосудистыми заболеваниями, является фибрилляция предсердий (ФП). Врожденные формы ФП достаточно редки. Многие исследования показали, что генетические, эпигенетические факторы и факторы транскрипции могут играть важную роль в возникновении и прогрессировании ФП. В нашем обзоре проведено изучение работ, посвященных выявлению мутаций ионных и не ионных каналов, возможно, связанных с ФП. Эти мутации были обнаружены только в изолированных группах пациентов с ФП, и в целом моногенные формы ФП представляют собой редкий подтип заболевания. Исследования геномных ассоциаций помогли определить потенциальные связи между однонуклеотидными полиморфизмами и ФП. Риск развития ФП в общей популяции, вероятно, определяется взаимодействием между факторами среды и множеством аллелей. В последние годы появление полногеномного ассоциативного сканирования существенно расширило понимание генетических основ наследования ФП и привело к появлению новых доказательств важной роли генетических факторов в развитии ФП, в стратификации риска ФП и рецидиве ФП. Эпигенетические факторы также имеют большое значение при ФП. В настоящее время разрабатывается эпигенетическая терапия, направленная на лечение заболевания посредством воздействия на эпигеном. Недавно возникшая область аблатогеномики включает использование генетических профилей, позволяющих оценить возможность возникновения рецидива ФП после катетерной абляции. Результаты генетических исследований при ФП показывают, что, помимо роли в появлении врожденных патологий сердца, факторы транскрипции играют важную роль в патогенезе ФП.

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