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atrial fibrillation fibrosis review

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https://www.readbyqxmd.com/read/28382425/characteristics-of-pr-interval-as-predictor-for-atrial-fibrillation-association-with-biomarkers-and-outcomes
#1
REVIEW
Katja Schumacher, Nikolaos Dagres, Gerhard Hindricks, Daniela Husser, Andreas Bollmann, Jelena Kornej
The PR interval may be considered as a simple and easily obtainable predictor for adverse events, including atrial fibrillation (AF), pacemaker implantation, and mortality. Interestingly, both high and low extremes of the PR duration are associated with AF risk. However, the results regarding PR prolongation as a risk factor for AF are inconsistent. Some studies have analyzed the impact of P duration (as a part of the PR interval) and demonstrated that the P-duration contributes to the length of PR interval and adverse outcomes...
April 5, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28315199/hiv-infection-and-risk-of-cardiovascular-diseases-beyond-coronary-artery-disease
#2
REVIEW
Revery P Barnes, John Charles A Lacson, Hossein Bahrami
PURPOSE OF REVIEW: Cardiovascular disease (CVD) increasingly afflicts people living with HIV (PLWH) in the contemporary era of antiretroviral therapy (ART). Coronary artery disease (CAD) is the most widely studied cardiovascular problem in PLWH; however, less is known about other clinically relevant subtypes of CVD such as heart failure (HF), cerebrovascular disease, sudden cardiac death, pericardial diseases, and pulmonary hypertension. This paper reviews evidence of other subtypes of CVD as emerging issues in the post-ART era...
May 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28274110/the-role-of-myocardial-fibrosis-in-determining-the-success-rate-of-ablation-for-the-treatment-of-atrial-fibrillation
#3
Subothini Selvendran, Nikhil Aggarwal, Justin Li, Gary Tse, Vassilios S Vassiliou
Atrial fibrillation is the most common sustained cardiac arrhythmia and with an aging population its prevalence will increase. In addition to appropriate anticoagulation to reduce the thromboembolic risk, there has been an increasing need for a personalised approach in identifying which patients are likely to benefit more from atrial fibrillation ablation procedures. This review will discuss the role of myocardial fibrosis in patients with atrial fibrillation, its mechanistic role, association with biomarkers and how this could potentially be of use in the development of a risk score identifying the success of maintaining sinus rhythm following an electrophysiological ablation...
March 7, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28271726/molecular-mechanisms-of-atrial-fibrosis-implications-for-the-clinic
#4
REVIEW
Shivshankar Thanigaimani, Dennis H Lau, Thomas Agbaedeng, Adrian D Elliott, Rajiv Mahajan, Prashanthan Sanders
Recent research has unravelled an increasing list of cardiac conditions and risk factors that may be responsible for the abnormal underlying atrial substrate that predisposes to atrial fibrillation (AF). Atrial fibrosis has been demonstrated as the pivotal structural abnormality underpinning conduction disturbances that promote AF in different disease models. Despite the advancement in our discoveries of the molecular mechanisms involved in the profibrotic milieu, targeted therapeutics against atrial fibrosis remain lacking...
April 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28215065/application-of-computer-models-on-atrial-fibrillation-research
#5
Michela Masè
Atrial fibrillation (AF) is a multifactorial and multiscale disease, where electrical, structural, anatomical and genetic factors contribute to the emergence of a complex and dynamic macroscopic phenotype. The incomplete understanding of AF mechanisms and the diversity and multiplicity of factors promoting the arrhythmia in humans have hampered the development of effective therapeutic approaches. Computer models and simulation of atrial arrhythmias may represent an unique allied to investigate AF mechanisms and direct therapeutic strategies, being able to merge and provide interpretation for multiscale data from cellular to entire organ scale levels...
February 17, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28169950/update-about-atrial-fibrillation-genetics
#6
Alexandra Pérez-Serra, Oscar Campuzano, Ramon Brugada
PURPOSE OF REVIEW: Atrial fibrillation is an important cause of morbidity in the aging population. The mechanisms responsible for the triggering and maintenance of the chaotic atrial rhythm are still poorly understood. In this review, we will focus on the genetic aspects of atrial fibrillation, to understand causality, with special emphasis on recent studies published in the field. RECENT FINDINGS: Diseases such as hypertension, valvular heart disease, and heart failure may induce atrial fibrillation, which increases the risk of stroke and sudden cardiac death...
February 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28155995/sinus-node-dysfunction-and-atrial-fibrillation-a-reversible-phenomenon
#7
REVIEW
Larry R Jackson, Bharath Rathakrishnan, Kristen Campbell, Kevin L Thomas, Jonathan P Piccini, Tristram Bahnson, Jonathan A Stiber, James P Daubert
BACKGROUND: Symptomatic sinus node dysfunction (SND) consists of a variety of manifestations, including tachycardia-bradycardia syndrome. Atrial fibrillation (AF) is commonly associated with SND, which complicates the management of both conditions. This paper reviews the epidemiology, pathophysiology, and clinical trial data investigating therapeutic approaches for treatment of patients with both SND and AF. METHODS: The authors reviewed articles published in English describing the epidemiology, pathophysiology, and therapeutic approaches for patients with SND and AF...
February 3, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28109316/adenosine-induced-ventricular-fibrillation-in-a-structurally-normal-heart-a-case-report
#8
Christopher A Rajkumar, Norman Qureshi, Fu Siong Ng, Vasileios F Panoulas, Phang Boon Lim
BACKGROUND: Adenosine is the first-line pharmacotherapy for termination of supraventricular tachycardia through its action on the atrioventricular node. However, pro-arrhythmic effects of adenosine are also recognised, most notably in the presence of pre-excited atrial fibrillation. In this case report, we describe the induction of ventricular fibrillation in a patient with no demonstrable accessory pathway, nor any other structural heart disease. This rare, idiosyncratic reaction has never previously been reported and is of relevance given the widespread and routine use of adenosine in clinical practice...
January 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28062142/aldosterone-pathway-blockade-to-prevent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#9
J Neefs, N W E van den Berg, J Limpens, W R Berger, S M Boekholdt, P Sanders, J R de Groot
BACKGROUND: Despite advances in therapeutic interventions AF remains a progressive and symptomatic disease. Therefore, novel therapeutic interventions targeting the underlying arrhythmogenic substrate for AF is needed. Atrial fibrosis is an important component of the arrhythmogenic substrate of AF and may be initiated by aldosterone binding to the mineralocorticoid receptor. We hypothesized that aldosterone pathway blockade with mineralocorticoid receptor antagonists (MRA) reduces atrial fibrosis, and thus AF...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28057790/novel-risk-markers-and-risk-assessments-for-cardiovascular-disease
#10
REVIEW
Mark R Thomas, Gregory Y H Lip
The use of risk markers has transformed cardiovascular medicine, exemplified by the routine assessment of troponin, for both diagnosis and assessment of prognosis in patients with chest pain. Clinical risk factors form the basis for risk assessment of cardiovascular disease and the addition of biochemical, cellular, and imaging parameters offers further refinement. Identifying novel risk factors may allow greater risk stratification and a steady, but gradual progression toward precision medicine. Indeed, the generation of data in this area of research is explosive and when combined with new technologies and techniques provides the potential for more refined, targeted approaches to cardiovascular medicine...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28054377/left-atrial-substrate-modification-targeting-low-voltage-areas-for-catheter-ablation-of-atrial-fibrillation-a-systematic-review-and-meta-analysis
#11
REVIEW
Alessandro Blandino, Francesca Bianchi, Stefano Grossi, Giuseppe Biondi-Zoccai, Maria Rosa Conte, Luca Gaido, Fiorenzo Gaita, Marco Scaglione, Francesco Rametta
BACKGROUND: This meta-analysis aims to assess the impact of a voltage-guided substrate modification by targeting low-voltage area (LVA) in addition to pulmonary vein isolation (PVI) in patients undergoing catheter ablation for atrial fibrillation (AF). METHODS: MEDLINE/PubMed, Cochrane Library, and references reporting AF ablation and "voltage* OR substrate* OR fibrosis OR fibrotic area*" were screened and studies included if matching inclusion and exclusion criteria...
February 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27875475/scar-based-catheter-ablation-for-persistent-atrial-fibrillation
#12
Pablo B Nery, Rebecca Thornhill, Girish M Nair, Elena Pena, Calum J Redpath
PURPOSE OF REVIEW: Percutaneous catheter ablation can be an effective treatment for paroxysmal atrial fibrillation. However, catheter ablation for the treatment of persistent atrial fibrillation or long-standing persistent atrial fibrillation is associated with success rates of 45-50% at 1 year. To address the challenge of ablating patients with persistent atrial fibrillation, several approaches have been proposed. Atrial scar-based catheter ablation is a promising strategy for ablation of persistent atrial fibrillation...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27830772/diagnosis-pathophysiology-and-management-of-exercise-induced-arrhythmias
#13
REVIEW
Eduard Guasch, Lluís Mont
The cardiovascular benefits of physical activity are indisputable. Nevertheless, growing evidence suggests that both atrial fibrillation and right ventricular arrhythmia can be caused by intense exercise in some individuals. Exercise-induced atrial fibrillation is most commonly diagnosed in middle-aged, otherwise healthy men who have been engaged in endurance training for >10 years, and is mediated by atrial dilatation, parasympathetic enhancement, and possibly atrial fibrosis. Cardiac ablation is evolving as a first-line tool for athletes with exercise-induced arrhythmia who are eager to remain active...
February 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27780555/relation-of-left-atrial-size-to-atrial-fibrillation-in-patients-aged-%C3%A2-22%C3%A2-years
#14
Douglas Y Mah, Divya Shakti, Kimberlee Gauvreau, Steven D Colan, Mark E Alexander, Dominic J Abrams, David W Brown
Left atrial (LA) dilation has been shown to be associated with atrial fibrillation (AF) in the adult population, with some studies indicating that larger LAs are more prone to AF recurrence. The relation of LA size to AF in the pediatric and young adult population has not been investigated. In this study, all pediatric patients (aged ≤22 years) who presented to Boston Children's Hospital from January 2002 to December 2012 with AF were reviewed. Patients with significant congenital heart disease, cardiomyopathies, proven channelopathies, previous cardiac surgery, end-stage renal disease, or severe lung disease/cystic fibrosis were excluded...
January 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27729358/multimodality-cardiac-imaging-for-the-assessment-of-left-atrial-function-and-the-association-with-atrial-arrhythmias
#15
Flemming Javier Olsen, Litten Bertelsen, Martina Chantal de Knegt, Thomas Emil Christensen, Niels Vejlstrup, Jesper Hastrup Svendsen, Jan Skov Jensen, Tor Biering-Sørensen
Several cardiac imaging modalities are able to visualize the left atrium (LA) and, therefore, allow for quantification of both structural and functional properties of this cardiac chamber. In echocardiography, only the maximal LA volume is included in the assessment of diastolic function at the current moment. Numerous studies, however, have shown that functional measures may be superior to the maximal LA volume in several aspects and to possess clinical value even in the absence of structural abnormalities...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27707827/improved-exercise-tolerance-in-patients-with-preserved-ejection-fraction-by-spironolactone-on-myocardial-fibrosis-in-atrial-fibrillation-rationale-and-design-of-the-impress-af-randomised-controlled-trial
#16
Eduard Shantsila, Ronnie Haynes, Melanie Calvert, James Fisher, Paulus Kirchhof, Paramjit S Gill, Gregory Y H Lip
INTRODUCTION: Patients with atrial fibrillation frequently suffer from heart failure with preserved ejection fraction. At present there is no proven therapy to improve physical capacity and quality of life in participants with permanent atrial fibrillation with preserved left ventricular contractility. OBJECTIVE: The single-centre IMproved exercise tolerance In heart failure With PReserved Ejection fraction by Spironolactone On myocardial fibrosiS In Atrial Fibrillation (IMPRESS-AF) trial aims to establish whether treatment with spironolactone as compared with placebo improves exercise tolerance (cardiopulmonary exercise testing), quality of life and diastolic function in patients with permanent atrial fibrillation...
October 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27486329/biomarkers-and-the-prediction-of-atrial-fibrillation-state-of-the-art
#17
REVIEW
Wesley T O'Neal, Sanjay Venkatesh, Stephen T Broughton, William F Griffin, Elsayed Z Soliman
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice, and it places a substantial burden on the health care system. Despite improvements in our understanding of AF pathophysiology, we have yet to develop targeted preventive therapies. Recently, numerous biological markers have been identified to aid in the prediction of future AF events. Subclinical markers of atrial stress, inflammation, endothelial dysfunction, kidney dysfunction, and atherosclerosis have been linked to AF...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27451095/endothelial-small-and-intermediate-conductance-k-channels-and-endothelium-dependent-hyperpolarization-as-drug-targets-in-cardiovascular-disease
#18
R Köhler, A Oliván-Viguera, H Wulff
Endothelial calcium/calmodulin-gated K channels of small (KCa2.3) and intermediate conductance (KCa3.1) produce membrane hyperpolarization and endothelium-dependent hyperpolarization (EDH)-mediated vasodilation. Dysfunctions of the two channels and ensuing EDH impairments are found in several cardiovascular pathologies such as diabetes, atherosclerosis, postangioplastic neointima formation, but also inflammatory disease, cancer, and organ fibrosis. Moreover, KCa3.1 plays an important role in endothelial barrier dysfunction, edema formation in cardiac and pulmonary disease, and in ischemic stroke...
2016: Advances in Pharmacology
https://www.readbyqxmd.com/read/27389443/left-atrial-strain-a-useful-index-in-atrial-fibrillation
#19
REVIEW
Matteo Cameli, Giulia Elena Mandoli, Ferdinando Loiacono, Stefania Sparla, Elisabetta Iardino, Sergio Mondillo
Left atrial (LA) strain is a speckle tracking echocardiography (STE)-derived parameter applied to the analysis of chamber function that provides highly reproducible measures of LA deformation by a non-Doppler, angle-independent quantification. In recent years, data regarding accuracy and clinical application of LA strain are rapidly increasing. This review describes the main features of LA strain and examines the role of STE in the evaluation of various aspects of AF, as the risk of developing the arrhythmia in general population, the evaluation of LA fibrosis and LA impairment, the quantification of cardioembolic risk and of recurrence after cardioversion or ablation therapies...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27389440/assessment-of-atrial-fibrosis-for-the-rhythm-control-of-atrial-fibrillation
#20
REVIEW
Gordon A Begg, Arun V Holden, Gregory Y H Lip, Sven Plein, Muzahir H Tayebjee
Rhythm control of atrial fibrillation (AF) remains challenging, with modest long-term success rates. Atrial fibrosis has been associated with AF, but the clinical utility of assessment of this fibrosis has yet to be fully elucidated. In this paper we review the current state of understanding of the pathophysiology of atrial fibrosis in AF, and its impact upon the instigation and propagation of the arrhythmia. Fibrosis causes an increase in volume of dysfunctional extracellular matrix, and is associated with cellular alterations such as hypertrophy, apoptosis and membrane dysfunction within the atrial myocardium...
October 1, 2016: International Journal of Cardiology
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