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atrial fibrillation fibrosis review

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
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
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
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
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
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
Oana Sîrbu, Mariana Floria, Petru Dăscălița, Victorița Şorodoc, Laurențiu Şorodoc
Non-alcoholic fatty liver disease (NAFLD) includes a range of disorders characterized by excess accumulation of triglycerides within the liver. While simple steatosis may be clinically stable, non-alcoholic steatohepatitis (NASH) can be progressive. Inflammation is believed to be the driving force behind NASH and the progression to fibrosis and subsequent cirrhosis. NAFLD is globally considered a significant health concern not only because of its incidence but also because of its economic impact. The fact that NAFLD is associated with cardiovascular disease is widely recognized, as well as the fact that NAFLD patient mortality rises when such an association is present...
July 2016: Anatolian Journal of Cardiology
Karoly Kaszala, Kenneth A Ellenbogen
No abstract text is available yet for this article.
September 2016: Journal of Cardiovascular Electrophysiology
Huang-Jun Liu, Hai-Han Liao, Zheng Yang, Qi-Zhu Tang
Peroxisome proliferator-activated receptor-γ (PPARγ) is a ligand-activated transcription factor belonging to the nuclear receptor superfamily, which plays a central role in regulating lipid and glucose metabolism. However, accumulating evidence demonstrates that PPARγ agonists have potential to reduce inflammation, influence the balance of immune cells, suppress oxidative stress, and improve endothelial function, which are all involved in the cellular and molecular mechanisms of cardiac fibrosis. Thus, in this review we discuss the role of PPARγ in various cardiovascular conditions associated with cardiac fibrosis, including diabetes mellitus, hypertension, myocardial infarction, heart failure, ischemia/reperfusion injury, atrial fibrillation, and several other cardiovascular disease (CVD) conditions, and summarize the developmental status of PPARγ agonists for the clinical management of CVD...
2016: PPAR Research
Konstantinos Vlachos, Konstantinos P Letsas, Panagiotis Korantzopoulos, Tong Liu, Stamatis Georgopoulos, Athanasios Bakalakos, Nikolaos Karamichalakis, Sotirios Xydonas, Michael Efremidis, Antonios Sideris
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic...
March 26, 2016: World Journal of Cardiology
U Schotten, D Dobrev, P G Platonov, H Kottkamp, G Hindricks
Despite considerable basic research into the mechanisms of atrial fibrillation (AF), not much progress has been made in the prognosis of patients with AF. With the exception of anticoagulant therapy, current treatments for AF still do not improve major cardiovascular outcomes. This may be due partly to the diverse aetiology of AF with increasingly more factors found to contribute to the arrhythmia. In addition, a strong increase has been seen in the technological complexity of the methods used to quantify the main pathophysiological alterations underlying the initiation and progression of AF...
May 2016: Journal of Internal Medicine
José Jalife
The mechanisms underlying atrial fibrillation (AF) in humans are poorly understood. In particular, we simply do not understand how atrial AF becomes persistent or permanent. The objective of this brief review is to address the most important factors involved in the mechanism of AF perpetuation, including structural remodeling in the form of fibrosis and electrical remodeling secondary to ion channel expression changes. In addition, I discuss the possibility that both fibrosis and electrical remodeling might be preventable when intervening pharmacologically early enough before the remodeling process reaches a point of no return...
April 2016: Heart Failure Clinics
Erwan Donal, Gregory Y H Lip, Maurizio Galderisi, Andreas Goette, Dipen Shah, Mohamed Marwan, Mathieu Lederlin, Sergio Mondillo, Thor Edvardsen, Marta Sitges, Julia Grapsa, Madalina Garbi, Roxy Senior, Alessia Gimelli, Tatjana S Potpara, Isabelle C Van Gelder, Bulent Gorenek, Philippe Mabo, Patrizio Lancellotti, Karl-Heinz Kuck, Bogdan A Popescu, Gerhard Hindricks, Gilbert Habib, Nuno M Cardim, Bernard Cosyns, Victoria Delgado, Kristina H Haugaa, Denisa Muraru, Koen Nieman, Giuseppe Boriani, Ariel Cohen
Atrial fibrillation (AF) is the commonest cardiac rhythm disorder. Evaluation of patients with AF requires an electrocardiogram, but imaging techniques should be considered for defining management and driving treatment. The present document is an expert consensus from the European Association of Cardiovascular Imaging (EACVI) and the European Heart Rhythm Association. The clinical value of echocardiography, cardiac magnetic resonance (CMR), computed tomography (CT), and nuclear imaging in AF patients are challenged...
April 2016: European Heart Journal Cardiovascular Imaging
Francesco Orso, Gianna Fabbri, Aldo Pietro Maggioni
Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and is associated with an increased risk of fatal and non-fatal events. Antiarrhythmic drugs provide limited protection against AF recurrence and have a poor safety profile. Several mechanisms have been proven to be involved in AF, e.g. inflammation, oxidative stress, fibrosis and ischaemia. Prevention of AF with interventions that target these mechanisms has emerged as a result of experimental studies suggesting the use of upstream therapies...
December 2015: Arrhythmia & Electrophysiology Review
Sebastian Clauss, Moritz F Sinner, Stefan Kääb, Reza Wakili
Atrial fibrillation (AF) is the most common arrhythmia worldwide and has an enormous impact on our healthcare system as it is a major contributor of morbidity and mortality. Although there are several therapeutic options available, treatment of AF still remains challenging. AF pathophysiology is complex and still incompletely understood. In general, our understanding of AF is based on two mechanistic paradigms as functional hallmarks of AF: ectopic activity and reentry. Both ectopic activity and reentry are the result of remodelling processes...
December 2015: Arrhythmia & Electrophysiology Review
Moinuddin Choudhury, Mark R Boyett, Gwilym M Morris
The sinoatrial node (SAN) is the normal pacemaker of the heart and SAN dysfunction (SND) is common, but until recently the pathophysiology was incompletely understood. It was usually attributed to idiopathic age-related fibrosis and cell atrophy or ischaemia. It is now evident that changes in the electrophysiology of the SAN, known as electrical remodelling, is an important process that has been demonstrated in SND associated with heart failure, ageing, diabetes, atrial fibrillation and endurance exercise. Furthermore, familial SND has been identified and mutations have been characterised in key pacemaker genes of the SAN...
May 2015: Arrhythmia & Electrophysiology Review
Rong-Jie Lin, Zi-Zhuo Su, Shu-Min Liang, Yu-Yang Chen, Xiao-Rong Shu, Ru-Qiong Nie, Jing-Feng Wang, Shuang-Lun Xie
OBJECTIVE: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis. DATA SOURCES: This review is based on the data from 1994 to present obtained from PubMed. The search terms were "circulating fibrocytes " and "cardiac fibrosis ". STUDY SELECTION: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected...
February 5, 2016: Chinese Medical Journal
Dragan Opacic, Kelly A van Bragt, Hussein M Nasrallah, Ulrich Schotten, Sander Verheule
Atrial fibrillation (AF) is the most common tachyarrhythmia in clinical practice. Over decades of research, a vast amount of knowledge has been gathered about the causes and consequences of AF related to cellular electrophysiology and features of the tissue structure that influence the propagation of fibrillation waves. Far less is known about the role of myocyte metabolism and tissue perfusion in the pathogenesis of AF. However, the rapid rates of electrical activity and contraction during AF must present an enormous challenge to the energy balance of atrial myocytes...
April 1, 2016: Cardiovascular Research
Teresa Maria Seccia, Brasilina Caroccia, Maria Lorenza Muiesan, Gian Paolo Rossi
Atrial fibrillation (AF) represents the most common sustained cardiac arrhythmia, as it affects 1%-2% of the general population and up to 15% of people over 80 years. High blood pressure, due to its high prevalence in the general population, is by far the most common condition associated with AF, although a variety of diseases, including valvular, coronary heart and metabolic diseases, are held to create the substrate favouring AF. Due to the concomitance of these conditions, it is quite challenging to dissect the precise role of high blood pressure in triggering/causing AF...
March 1, 2016: International Journal of Cardiology
Alejandra Gutierrez, David R Van Wagoner
Atrial fibrillation (AF) is an important cause of stroke and risk factor for heart failure and death. Current pharmacologic treatments for AF have limited efficacy, and treatments that more directly target the underlying causes of AF are needed. Oxidant stress and inflammatory activation are interrelated pathways that promote atrial electrical and structural remodeling, leading to atrial ectopy, interstitial fibrosis, and increased stroke risk. This review evaluates the impact of common stressors on atrial oxidant stress and inflammatory activation and the contribution of these pathways to atrial remodeling...
December 2015: Journal of Cardiovascular Pharmacology
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