RESUMO
Atrial fibrillation (AF) is a common arrhythmia. Better prevention and treatment of AF are needed to reduce AF-associated morbidity and mortality. Several major mechanisms cause AF in patients, including genetic predispositions to AF development. Genome-wide association studies have identified a number of genetic variants in association with AF populations, with the strongest hits clustering on chromosome 4q25, close to the gene for the homeobox transcription PITX2. Because of the inherent complexity of the human heart, experimental and basic research is insufficient for understanding the functional impacts of PITX2 variants on AF. Linking PITX2 properties to ion channels, cells, tissues, atriums and the whole heart, computational models provide a supplementary tool for achieving a quantitative understanding of the functional role of PITX2 in remodelling atrial structure and function to predispose to AF. It is hoped that computational approaches incorporating all we know about PITX2-related structural and electrical remodelling would provide better understanding into its proarrhythmic effects leading to development of improved anti-AF therapies. In the present review, we discuss advances in atrial modelling and focus on the mechanistic links between PITX2 and AF. Challenges in applying models for improving patient health are described, as well as a summary of future perspectives.
Assuntos
Fibrilação Atrial/etiologia , Fibrilação Atrial/genética , Proteínas de Homeodomínio/genética , Modelos Cardiovasculares , Fatores de Transcrição/genética , Animais , Fibrilação Atrial/fisiopatologia , Remodelamento Atrial/genética , Remodelamento Atrial/fisiologia , Padronização Corporal/genética , Simulação por Computador , Genes Homeobox , Predisposição Genética para Doença , Variação Genética , Estudo de Associação Genômica Ampla , Coração/embriologia , Proteínas de Homeodomínio/fisiologia , Humanos , Canais Iônicos/genética , Canais Iônicos/fisiologia , MicroRNAs/genética , MicroRNAs/metabolismo , Mutação , Fatores de Transcrição/fisiologia , Proteína Homeobox PITX2RESUMO
Transcuataneous electrical nerve stimulation (TENS) analgesia as a non-drug method has received people's more and more attention recently. Considering problems of existing products, such as unstable performance and unsatisfied effectiveness, we developed a new analgesia therapy system for delivery based on bio-feedback TENS in our laboratory. We proposed a new idea for stimulation signal design, that is, we modulated a middle frequency signal by a traditional low frequency TENS wave in the new system. We designed different prescription waves for pain relief during a uterine contraction or massage between contractions. In the end, a bio-feedback TENS method was proposed, in which the waveforms of stimulation signals were selected and their parameters were modified automatically based on feedback from uterine pressure, etc. It was proved through quality tests and clinical trials that the system had good performance and satisfied analgesia effectiveness.