Do age-associated changes of voltage-gated sodium channel isoforms expressed in the mammalian heart predispose the elderly to atrial fibrillation?  

作　　者：Emmanuel Isaac Stephanie M Cooper Sandra A Jones Mahmoud Loubani 

机构地区：[1]Department of Cardiothoracic Surgery,Hull University Teaching Hospitals,Cottingham HU165JQ,United Kingdom [2]Department of Biomedical Sciences,University of Hull,Hull HU67RX,United Kingdom

出　　处：《World Journal of Cardiology》2020年第4期123-135,共13页世界心脏病学杂志（英文版）（电子版）

摘　　要：Atrial fibrillation(AF)is the most common cardiac arrhythmia worldwide.The prevalence of the disease increases with age,strongly implying an age-related process underlying the pathology.At a time when people are living longer than ever before,an exponential increase in disease prevalence is predicted worldwide.Hence unraveling the underlying mechanics of the disease is paramount for the development of innovative treatment and prevention strategies.The role of voltage-gated sodium channels is fundamental in cardiac electrophysiology and may provide novel insights into the arrhythmogenesis of AF.Na_v1.5 is the predominant cardiac isoform,responsible for the action potential upstroke.Recent studies have demonstrated that Na_v1.8(an isoform predominantly expressed within the peripheral nervous system)is responsible for cellular arrhythmogenesis through the enhancement of pro-arrhythmogenic currents.Animal studies have shown a decline in Na_v1.5 leading to a diminished action potential upstroke during phase 0.Furthermore,the study of human tissue demonstrates an inverse expression of sodium channel isoforms;reduction of Na_v1.5 and increase of Na_v1.8 in both heart failure and ventricular hypertrophy.This strongly suggests that the expression of voltage-gated sodium channels play a crucial role in the development of arrhythmias in the diseased heart.Targeting aberrant sodium currents has led to novel therapeutic approaches in tackling AF and continues to be an area of emerging research.This review will explore how voltage-gated sodium channels may predispose the elderly heart to AF through the examination of laboratory and clinical based evidence.

关 键 词：VOLTAGE-GATED SODIUM channels Ageing Atrial FIBRILLATION NAV1.5 NAV1.8 Late SODIUM current Cardiac electrophysiology 

分 类 号：R541.75[医药卫生—心血管疾病]