心律失常是心血管疾病常见的临床表现形式,尤其是室性心动过速、心室颤动等恶性心律失常,不但加重原有心脏疾病,还可诱发心源性猝死。目前抗心律失常药物的疗效并不十分理想,总有效率只有30%~60%。人们对心律失常作用机制的认识仍有限,因此,揭示心律失常发生的深层机制,寻找新的作用靶点是抗心律失常研究领域的重点、难点。近年人们发现心房特异性钾离子通道电流IKur、IKAch等参与了心房颤动,这使心房颤动治疗的研究向前推进一步。钙渗漏、缝隙连接蛋白及钙通道自身抗体在心律失常发生中发挥重要作用。这些发现为开发更有效的抗心律失常药物提供了理论基础。近年研究发现,一类调控基因的小分子RNA(microRNA,miRNA)在心血管疾病的发生、发展中起重要作用,特别是对心律失常及其引起的猝死起关键作用。miR-1、miR-133、miR-590等对心肌缺血、心肌梗死伴随的心律失常表现出明显调控作用。miRNA的生物学特性是同时对多个靶点具有调控作用,这使其具有成为理想抗心律失常靶点的潜力,为心律失常及猝死的防治带来希望。
Arrhythmia is a common complication of cardiovascular diseases and a risk factor for human health.Especially,ventricular tachycardia and ventricular fibrillation may not only exacerbate original heart diseases,but also cause cardiac sudden death which has been an important death reason in China.However,anti-arrhythmic drugs nowadays cannot effectively treat these arrhythmias,with an efficiency of only 30%-60% ,which indicates that our knowledge about arrhythmias is limited.Hence,to explore the potential mechanism,look for novel targets,and develop drugs with multiple-channel action are the focus of the research direction.Recent studies displayed that the atrial-specific potassium channels such as IKur and IKAch were involved in atrial fibrillation,which provided a prospective target for atrial fibrillation treatment.Calcium leak,gap junction protein and autoantibody against ICaL channel were shown to participate in arrhythmogenesis.These findings provided a theoretical basis for the development of more effective anti-arrhythmic drugs.Remarkably,as a kind of important RNA regulating gene expression,microRNA(miRNA) was shown to possess anti-arrhythmic activities which may prevent cardiac sudden death.miR-1,miR-133 and miR-590 regulated the arrhythmia in various types of animal models.Because of the multiple-gene regulation actions of miRNA,it has the potential to be developed as novel anti-arrhythmic target.