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Authors
Advisor(s)
Abstract(s)
Contexto
A FA constitui actualmente a arritmia cardíaca mais frequente na pratica clínica, com
maior prevalência na população idosa, assumindo proporções de uma verdadeira epidemia do
séc. XXI, com graves consequências na saúde publica a nível mundial. A FA caracteriza-se por
uma activação auricular desorganizada, acelerada e irregular, o que se traduz numa contracção
auricular deficiente e consequente estase sanguínea, potenciadora de eventos cardioembólicos.
De acordo com o padrão clínico pode classificar-se em paroxística, persistente,
persistente de longa duração e permanente. Tem vindo a ser desenvolvida intensa investigação
no domínio do conhecimento dos mecanismos fisiopatológicos desta arritmia, o que poderá
impulsionar uma melhoria da prevenção no sentido de contrariar a alta incidência e prevalência
de FA.
São múltiplos os factores de risco que se encontram associados ao desenvolvimento de FA
e cerca de 56% dos pacientes com FA apresentam pelo menos um factor de risco associado.
Assim, a diminuição da incidência e prevalência da FA pode ser em parte conseguida pela
prevenção dos factores de risco reversíveis como por exemplo a pressão arterial e obesidade.
Objectivos
Com este trabalho pretende-se elaborar revisão bibliografica abordando os avanços na
investigação dos mecanismos fisiopatológicos e factores de risco associados ao desenvolvimento
de FA.
Métodos
Foram pesquisados vários artigos cientificos em motores de busca médicos com as
palavras-chave “atrial fibrillation”, “atrial fibrillation pathophysiology”, “atrial fibrillation
etiology” e “atrial fibrillation risk factors”, em várias ocasiões no intervalo temporal de Janeiro
a Abril de 2014.
Conclusões
Os mecanismos responsáveis pela génese e manutenção da FA englobam elementos de
iniciação focais, “triggers”, localizados habitualmente nas veias pulmonares, responsáveis pela
iniciação da arritmia, bem como um complexo substrato anatómico e electrofisiológico que
contribuem para a perpetuação da arritmia. A investigação recente tem identificado como
factores de risco para FA a idade, a hipertensão, a diabetes, obesidade, apneia do sono, o
exercício físico, o tabagismo, consumo de alcool, o hipertiroidismo, a estatura, o factor étnico e
o factor genético.
Context AF is now the most common cardiac arrhythmia in clinical practice, with higher prevalence in the elderly population, assuming proportions of an epidemic of the 21st century, with serious consequences on public health worldwide. Atrial fibrillation is characterized by disorganized, rapid and irregular atrial activation, which results in a deficient atrial contraction and subsequent blood stasis, potentiating cardioembolic events. According to the clinical pattern AF can be classified as paroxysmal, persistent, persistent long-lasting and permanent. Intensive research has been developed in the field of knowledge of the pathophysiologic mechanisms of this arrhythmia, which can boost improving prevention to counteract the high incidence and prevalence of AF. Multiple risk factors are associated with the development of AF, and about 56 % of patients with AF have at least a risk factor involved. Thus, reducing the incidence and prevalence of AF may be partly achieved by prevention of reversible risk factors such as blood pressure and obesity. Objectives With this paper we intend to elaborate a literature review addressing advances in research into the pathophysiological mechanisms and risk factors associated with the development of AF. Methods In various scientific medical search engines the keywords “atrial fibrillation”, “atrial fibrillation pathophysiology”, “atrial fibrillation etiology” and “atrial fibrillation risk factors” were surveyed on several occasions in the time interval from January to April 2014. Conclusions The mechanisms responsible for the genesis and maintenance of AF comprise focal initiation elements, “triggers”, usually located in the pulmonary veins, responsible for the initiation of the arrhythmia, as well as complex anatomical and electrophysiological substrate that contribute to the perpetuation of the arrhythmia. Recent research has identified as risk factors for AF the age, hypertension, diabetes, obesity, sleep apnea, exercise, smoking, alcohol consumption, hyperthyroidism, height, ethnic factor and genetic factor.
Context AF is now the most common cardiac arrhythmia in clinical practice, with higher prevalence in the elderly population, assuming proportions of an epidemic of the 21st century, with serious consequences on public health worldwide. Atrial fibrillation is characterized by disorganized, rapid and irregular atrial activation, which results in a deficient atrial contraction and subsequent blood stasis, potentiating cardioembolic events. According to the clinical pattern AF can be classified as paroxysmal, persistent, persistent long-lasting and permanent. Intensive research has been developed in the field of knowledge of the pathophysiologic mechanisms of this arrhythmia, which can boost improving prevention to counteract the high incidence and prevalence of AF. Multiple risk factors are associated with the development of AF, and about 56 % of patients with AF have at least a risk factor involved. Thus, reducing the incidence and prevalence of AF may be partly achieved by prevention of reversible risk factors such as blood pressure and obesity. Objectives With this paper we intend to elaborate a literature review addressing advances in research into the pathophysiological mechanisms and risk factors associated with the development of AF. Methods In various scientific medical search engines the keywords “atrial fibrillation”, “atrial fibrillation pathophysiology”, “atrial fibrillation etiology” and “atrial fibrillation risk factors” were surveyed on several occasions in the time interval from January to April 2014. Conclusions The mechanisms responsible for the genesis and maintenance of AF comprise focal initiation elements, “triggers”, usually located in the pulmonary veins, responsible for the initiation of the arrhythmia, as well as complex anatomical and electrophysiological substrate that contribute to the perpetuation of the arrhythmia. Recent research has identified as risk factors for AF the age, hypertension, diabetes, obesity, sleep apnea, exercise, smoking, alcohol consumption, hyperthyroidism, height, ethnic factor and genetic factor.
Description
Keywords
Etiologia da Fibrilhação Auricular Factores de Risco da Fibrilhação Auricular Fibrilhação Auricular Fisiopatologia da Fibrilhação Auricular