emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университетemcardio-210Research ArticleОригинальные научные публикацииOriginal Scientific ResearchАртериальная гипертензия и фибрилляция предсердий: молекулярно-генетические аспекты патогенеза и комплексной терапии, фокус на ренин-ангиотензин-альдостероновую системуArterial hypertension and atrial fibrillation: molecular genetic aspects of pathogenesis and complex therapy, focus on the renin-angiotensin-aldosterone systemБуквальнаяН. В.BukvalnayaN. V.ЯкубоваЛ. В.YakubovaL. V.СнежицкийВ. А.SnezhitskiyV. A.УО «Гродненский государственный медицинский университет»Grodno State Medical University20201011202542986–993Copyright © Буквальная Н.В., Якубова Л.В., Снежицкий В.А., 20252025Буквальная Н.В., Якубова Л.В., Снежицкий В.А.Bukvalnaya N.V., Yakubova L.V., Snezhitskiy V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/210

Обзор посвящен влиянию ренин-ангиотензин-альдостероновой системы на развитие и поддержание фибрилляции предсердий у пациентов с артериальной гипертензией. Отмечено, что неблагоприятные эффекты конечных продуктов ренин-ангиотензин-альдостероновой системы, ангиотензина II и альдостерона, реализуются не только за счет их гиперпродукции, но и через активацию ими трансформирующего фактора роста β1. Данный цитокин инициирует в левом предсердии процесс фиброза, который является субстратом аритмии. Приведены результаты многоцентровых клинических исследований, демонстрирующих эффективность ингибиторов ангиотензин-превращающего фермента, блокаторов рецепторов ангиотензина II и антагонистов минералокортикоидных рецепторов в профилактике фибрилляции предсердий. Проанализировано влияние полиморфных вариантов гена ангиотензин-превращающего фермента ((I/D) ACE), гена рецептора ангиотензина II 1 типа ((A1166C) AGTR1), гена альдостерон-синтазы (C/T (-344) CYP11B2), гена трансформирующего фактора роста β1 (G/C (+915) TGFB1) на развитие артериальной гипертензии и фибрилляции предсердий, а также на эффективность терапии препаратами, блокирующими ренин-ангиотензин-альдостероновую систему.

This article is devoted to the effect of the renin-angiotensin-aldosterone system on the development and maintenance of atrial fibrillation on patients with arterial hypertension. It is noted that the adverse effects of the renin-angiotensin-aldosterone system end products, angiotensin II and aldosterone, can be caused not only by their hyperproduction, but also by the activation of the transforming growth factor β1 initiated by them. This cytokine initiates the process of fibrosis in the left atrium, which is a substrate of arrhythmia. The article features the results of multicenter clinical trial demonstrating the effectiveness of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and mineralocorticoid receptor antagonists in the prevention of atrial fibrillation. The review includes the analysis of the effect of polymorphic variants of the angiotensin-converting enzyme gene ((I/D) ACE), the angiotensin II receptor gene type 1 ((A1166C) AGTR1), the aldosterone synthase gene (C/T (-344) CYP11B2) and the gene of the transforming growth factor β1 (G/C (+915) TGFB1) on the development of arterial hypertension and atrial fibrillation, as well as on the effectiveness of therapy with renin-angiotensin-aldosterone system blocking drugs.

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The authors declare that there are no conflicts of interest present.