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Atrial fibrillation and remodeling

Georgeta D Vaidean, Marta Manczuk, Jared W Magnani
OBJECTIVE: Obesity and hypertension often coexist and represent risk factors for atrial fibrillation. This study hypothesized that their single and joint effects on atrial remodeling would be reflected in the PR interval and P-wave durations on electrocardiogram (ECG). METHODS: This cross-sectional analysis of a community-based study included 11,308 men and women age 45-64. Atrial indices were obtained from digital standard 12-lead resting ECG. Analyses were adjusted for traditional cardiovascular risk factors...
October 18, 2016: Obesity
Sotirios Nedios, Emmanuel Koutalas, Philipp Sommer, Arash Arya, Sascha Rolf, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Ole-Alexander Breithardt
AIMS: The association between anatomical left atrial (LA) remodelling and ventricular diastolic dysfunction (DD) in atrial fibrillation (AF) patients is not well studied. We aimed to examine the effect of DD on anatomic LA remodelling and their relation with ablation outcomes. METHODS AND RESULTS: In 104 patients (58 ± 10 years, 69% male) referred for AF ablation, LA volume (LAV) was determined by computed tomography. A cutting plane, between the pulmonary vein (PV) ostia and the appendage and parallel to the posterior wall, divided LAV into anterior- (LA-A) and posterior-LA parts...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tomos E Walters, Jonathan M Kalman, Sheila K Patel, Megan Mearns, Elena Velkoska, Louise M Burrell
AIM: Angiotensin converting enzyme 2 (ACE2) is an integral membrane protein whose main action is to degrade angiotensin II. Plasma ACE2 activity is increased in various cardiovascular diseases. We aimed to determine the relationship between plasma ACE2 activity and human atrial fibrillation (AF), and in particular its relationship to left atrial (LA) structural remodelling. METHODS AND RESULTS: One hundred and three participants from a tertiary arrhythmia centre, including 58 with paroxysmal AF (PAF), 20 with persistent AF (PersAF), and 25 controls, underwent clinical evaluation, echocardiographic analysis, and measurement of plasma ACE2 activity...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jonathan H Kim, Aaron L Baggish
Although moderate levels of exercise reduce cardiovascular morbidity and mortality in the general population, recent data have questioned whether higher doses of physical activity are associated with diminished health benefits and adverse outcomes. This review focuses on several issues at the center of this controversy including epidemiologic data describing mortality trends in those who engage in high levels of physical activity and recent observational data suggesting adverse cardiovascular outcomes among long-term endurance athletes...
November 2016: Current Treatment Options in Cardiovascular Medicine
Bharath Ambale-Venkatesh, Kihei Yoneyama, Ravi K Sharma, Yoshiaki Ohyama, Colin O Wu, Gregory L Burke, Steven Shea, Antoinette S Gomes, Alistair A Young, David A Bluemke, João Ac Lima
OBJECTIVE: To investigate whether sphericity volume index (SVI), an indicator of left ventricular (LV) remodelling, predicts incident cardiovascular events (coronary heart disease, CHD; all cardiovascular disease, CVD; heart failure, HF; atrial fibrillation, AF) over 10 years of follow-up in a multiethnic population (Multi-Ethnic Study of Atherosclerosis). METHODS: 5004 participants free of known CVD had magnetic resonance imaging (MRI) in 2000-2002. Cine images were analysed to compute, [Formula: see text] equivalent to LV volume/volume of sphere with length of LV as the diameter...
September 30, 2016: Heart: Official Journal of the British Cardiac Society
Anna M May, David R Van Wagoner, Reena Mehra
A surge of data has reproducibly identified strong associations of obstructive sleep apnea (OSA) with cardiac arrhythmias. As an extension of epidemiologic and clinic-based findings, experimental investigations have made strides in advancing our understanding of the putative OSA and cardiac arrhythmogenesis mechanistic underpinnings. While most studies have focused on the links between OSA and atrial fibrillation (AF), relationships with ventricular arrhythmias have also been characterized. Key findings implicate OSA-related autonomic nervous system fluctuations typified by enhanced parasympathetic activation during and sympathetic surges subsequent to respiratory events which contribute to augmented arrhythmic propensity...
September 29, 2016: Chest
Adrian D Elliott, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders
Exercise training has considerable health benefits. However, recent research has demonstrated a greater risk of atrial arrhythmias in endurance athletes. The mechanisms promoting atrial fibrillation in athletes are unclear but there seems to be a central role for atrial remodeling, accompanied by autonomic alterations and inflammation. Animal studies have provided unique insights, yet prospective human data are lacking. Treatment options seem to yield similar efficacy to that seen in a nonathletic population and may be justified as an early rhythm control strategy...
November 2016: Cardiology Clinics
Liselotte C R Hensen, Victoria Delgado, Suzanne E van Wijngaarden, Melissa Leung, Mihaly K de Bie, Maurits S Buiten, Martin J Schalij, Jos J Van de Kerkhof, Ton J Rabelink, Joris I Rotmans, J Wouter Jukema, Jeroen J Bax
BACKGROUND: The prevalence of atrial fibrillation (AF) in end-stage renal disease (ESRD) patients is relatively high. The present study evaluated the association between left atrial (LA) remodelling, including an increased size and myocardial fibrosis, and slow LA conduction and the occurrence of AF. METHODS: In 171 ESRD patients enrolled in the Implantable Cardioverter Defibrillators in Dialysis patients (ICD2) trial, the LA dimensions, LA conduction delay [as reflected by the time difference between P-wave onset on surface electrocardiogram and A'-wave on tissue Doppler imaging (PA-TDI)] and LA function were compared between patients who exhibited AF versus patients without AF...
September 29, 2016: Nephrology, Dialysis, Transplantation
Nicolas Clementy, Nazih Benhenda, Eric Piver, Bertrand Pierre, Anne Bernard, Laurent Fauchier, Jean-Christophe Pages, Dominique Babuty
Galectin-3 is a biomarker of fibrosis and atrial remodeling, involved in the mechanisms of initiation and maintenance of atrial fibrillation (AF). We sought to study the accuracy of galectin-3 level in predicting recurrences of AF after ablation. Serum concentrations of galectin-3 were determined in a consecutive series of patients addressed for AF ablation in our center. After a 3-month blanking period, recurrences of atrial arrhythmias were collected during the first year in all patients, using Holter monitoring at 3, 6 months and 12 months...
September 28, 2016: Scientific Reports
Zewei Sun, Dongchen Zhou, Xudong Xie, Shuai Wang, Zhen Wang, Wenting Zhao, Hongfei Xu, Liangrong Zheng
Increased macrophage accumulation occurs in the atria of patients with atrial fibrillation (AF). However, the phenotype and functions of the macrophages in AF remain unclear. We investigated the macrophage-atrial myocyte interaction in AF patients and found that the increased macrophages were mainly pro-inflammatory macrophages (iNOS(+), Arg1(-)). Tachypacing of HL-1 atrial myocytes also led to pro-inflammatory macrophage polarization. In addition, lipopolysaccharide (LPS)-stimulated pro-inflammatory macrophages-induced atrial electrical remodeling, evidenced by increased AF incidence and decreased atrial effective refractory period and L-type calcium currents (I Ca-L) in both canine and mouse AF models...
November 2016: Basic Research in Cardiology
Yuichi Hori, Shiro Nakahara, Naofumi Anjo, Ayako Nakagawa, Naoki Nishiyama, Kouta Yamada, Akiko Hayashi, Takaaki Komatsu, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
PURPOSE: The atrial conduction time measured by echocardiography using tissue Doppler imaging (TDI) has been reported as a predictive factor of left atrial (LA) remodeling. We investigated the P wave to LA appendage (LAA) conduction time defined by transthoracic echocardiography using TDI (P-LAA TDI), and directly compared the actual LA electrical conduction time determined by the electrophysiological data. Additionally, we confirmed the clinical utility of the P-LAA TDI by examining the relationship to the electroanatomical LA remodeling data...
September 22, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Céline Jumeau, Alain Rupin, Pauline Chieng-Yane, Nathalie Mougenot, Noël Zahr, Monique David-Dufilho, Stéphane N Hatem
The present study tested the hypothesis that thrombin participates in formation of left atrial remodeling and that direct oral anticoagulants, such as direct thrombin inhibitors (DTIs), can prevent its progression. In a rat model of heart failure associated with left atrial dilation, we found that chronic treatment with DTIs reduces the atrial remodeling and the duration of atrial fibrillation (AF) episodes induced by burst pacing by inhibiting myocardial hypertrophy and fibrosis. In addition to the prevention of thromboembolism complicating AF, DTIs may be of interest to slow down the progression of the arrhythmogenic substrate...
August 2016: JACC. Basic to Translational Science
Yu Wang, Yi-Li Wang, Xia Huang, Yang Yang, Ya-Jun Zhao, Cheng-Xi Wei, Ming Zhao
Atrial fibrillation (AF) is a complex disease with multiple inter-relating causes culminating in rapid atrial activation and atrial structural remodeling. The contribution of endoplasmic reticulum and mitochondria stress to AF has been highlighted. As the class III antiarrhythmic agent, ibutilide are widely used to AF. This study was designed to explore whether ibutilide could treat AF by inhibiting endoplasmic reticulum stress pathways and mitochondria stress. The neonatal rat cardiomyocytes were isolated and exposed to H2O2, ibutilide was add to the culture medium 12 h...
September 17, 2016: Heart and Vessels
Chung-Lieh Hung, Alexandra Gonçalves, Yu-Jun Lai, Yau-Huei Lai, Kuo-Tzu Sung, Chi-In Lo, Chuan-Chuan Liu, Jen-Yuan Kuo, Charles Jia-Yin Hou, Tze-Fan Chao, Bernard E Bulwer, Shing-Jong Lin, Hung-I Yeh, Carolyn S P Lam
BACKGROUND: The effects of light to moderate alcohol consumption on cardiac mechanics remain poorly understood. The aim of this study was to investigate the dose-response relationship between alcohol consumption and left ventricular (LV) and left atrial (LA) function using myocardial deformation. METHODS: In total 3,946 asymptomatic participants (mean age, 49.7 ± 10.7 years; 65% men) were consecutively studied using comprehensive echocardiography and two-dimensional speckle-tracking in a cross-sectional, retrospective manner...
September 14, 2016: Journal of the American Society of Echocardiography
Erick B Ríos-Pérez, Maricela García-Castañeda, Adrián Monsalvo-Villegas, Guillermo Avila
It is widely accepted that aldosterone induces atrial fibrillation (AF) by promoting structural changes, but its effects on the function of primary atrial myocytes remain unknown. We have investigated this point in adult rat atrial myocytes, chronically exposed to the hormone. This treatment produced larger amplitude of Ca(2+) transients, longer action potential (AP) duration, and higher incidence of unsynchronized Ca(2+) oscillations. Moreover, it also gave rise to increases in both cell membrane capacitance (Cm, 30 %) and activity of L-type Ca(2+) channels (LTCCs, 100 %)...
September 15, 2016: Pflügers Archiv: European Journal of Physiology
Li-Juan Liu, Feng-Juan Yao, Gui-Hua Lu, Cheng-Gui Xu, Zhe Xu, Kai Tang, Yun-Jiu Cheng, Xiu-Ren Gao, Su-Hua Wu
OBJECTIVES: To study the role of the Rho/ROCK pathway in Ang II and TGF-β1-induced atrial remodeling. METHODS AND RESULTS: A canine atrial fibrillation (AF) model was established by rapid atrial pacing (RAP) of the left atrium. The roles of TGF-β1, the RhoA/ROCK signaling pathway and connective tissue growth factor (CTGF) in atrial remodeling were studied via both in vitro and in vivo experiments. Each of the dogs that received RAP developed persistent AF within 4 weeks...
2016: PloS One
Wei Wang, Yun Zhu, Jianguang Yi, Wei Cheng
Remodeling of atrial electrophysiology and structure is the primary feature of atrial fibrillation (AF). Evidence suggests that abnormalities in the expression levels of embryological cardiovascular development‑associated transcription factors, including Nkx2.5, are crucial for the development of AF. Rat atrial myocardial cells (AMCs) in culture dishes were placed in an electric field and stimulated. Transmission electron microscopy was used to observe the ultrastucture prior to and following rapid pacing...
October 2016: Molecular Medicine Reports
Alejandro Liberos, Alfonso Bueno-Orovio, Miguel Rodrigo, Ursula Ravens, Ismael Hernandez-Romero, Francisco Fernandez-Aviles, Maria S Guillem, Blanca Rodriguez, Andreu M Climent
BACKGROUND: Atrial remodeling as a result of long-standing persistent atrial fibrillation (AF) induces substrate modifications that lead to different perpetuation mechanisms than in paroxysmal AF and a reduction in the efficacy of antiarrhythmic treatments. OBJECTIVE: The purpose of this study was to identify the ionic current modifications that could destabilize reentries during chronic AF and serve to personalize antiarrhythmic strategies. METHODS: A population of 173 mathematical models of remodeled human atrial tissue with realistic intersubject variability was developed based on action potential recordings of 149 patients diagnosed with AF...
August 26, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yung-Hsin Yeh, Lung-An Hsu, Ying-Hwa Chen, Chi-Tai Kuo, Gwo-Jyh Chang, Wei-Jan Chen
Structural and electrical remodeling in the atrium constitutes the main feature of atrial fibrillation (AF), which is characterized by increased oxidative stress. Heme oxygenase-1 (HO-1) is a potent anti-oxidant system that may provide protection against various oxidative stress-related diseases. The aim of this study is to investigate whether HO-1 has a protective effect on AF-related remodeling. Cultured atrium-derived myocytes (HL-1 cell line) were used to evaluate tachypacing-induced oxidative stress, structural, and electrical remodeling...
September 2016: Basic Research in Cardiology
Susana Cañón, Ricardo Caballero, Adela Herraiz-Martínez, Marta Pérez-Hernández, Begoña López, Felipe Atienza, José Jalife, Leif Hove-Madsen, Eva Delpón, Antonio Bernad
microRNAs (miR) have considerable potential as therapeutic tools in cardiac diseases. Alterations in atrial miR are involved in the development of atrial fibrillation (AF), but the molecular mechanism underlying their contribution to atrial remodeling in chronic atrial fibrillation (CAF) is only partially understood. Here we used miR array to analyze the miR profile of atrial biopsies from sinus rhythm (SR) and CAF patients. qRT-PCR identified a distinctive CAF-miR signature and described conserved miR-208b upregulation in human and ovine AF atrial tissue...
August 18, 2016: Journal of Molecular and Cellular Cardiology
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