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Atrial fibrosis

Aleksandra Liżewska-Springer, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Łukasz Drelich, Tomasz Królak, Grzegorz Raczak
BACKGROUND: Catheter ablation (CA) is a well-known treatment option for patients with symptomatic drug-resistant atrial fibrillation (AF). Multiple factors have been identified to determine AF recurrence after CA, however their predictive value is rather small. Identification of novel predictors of CA outcome is therefore of primary importance to reduce health costs and improve long-term results of this intervention. The recurrence of AF following CA is related to the severity of left ventricular (LV) dysfunction, extend of atrial dilatation and fibrosis...
June 20, 2018: Cardiology Journal
David Calvo, David Filgueiras-Rama, José Jalife
Atrial fibrillation is a highly prevalent cardiac arrhythmia and the most important cause of embolic stroke. Although genetic studies have identified an increasing assembly of AF-related genes, the impact of these genetic discoveries is yet to be realized. In addition, despite more than a century of research and speculation, the molecular and cellular mechanisms underlying AF have not been established, and therapy for AF, particularly persistent AF, remains suboptimal. Current antiarrhythmic drugs are associated with a significant rate of adverse events, particularly proarrhythmia, which may explain why many highly symptomatic AF patients are not receiving any rhythm control therapy...
July 2018: Pharmacological Reviews
Li Jin, Simei Sun, Yuhee Ryu, Zhe Hao Piao, Bin Liu, Sin Young Choi, Gwi Ran Kim, Hyung-Seok Kim, Hae Jin Kee, Myung Ho Jeong
Gallic acid is a trihydroxybenzoic acid found in tea leaves and some plants. Here, we report the effect of gallic acid on cardiac dysfunction and fibrosis in a mouse model of pressure overload-induced heart failure and in primary rat cardiac fibroblasts, and compare the effects of gallic acid with those of drugs used in clinics. Gallic acid reduces cardiac hypertrophy, dysfunction, and fibrosis induced by transverse aortic constriction (TAC) stimuli in vivo and transforming growth factor β1 (TGF-β1) in vitro...
June 18, 2018: Scientific Reports
Ichitaro Abe, Yasushi Teshima, Hidekazu Kondo, Haruka Kaku, Shintaro Kira, Yuki Ikebe, Shotaro Saito, Akira Fukui, Tetsuji Shinohara, Kunio Yufu, Mikiko Nakagawa, Naoki Hijiya, Masatsugu Moriyama, Tatsuo Shimada, Shinji Miyamoto, Naohiko Takahashi
BACKGROUND: Epicardial adipose tissue (EAT) is associated with atrial fibrillation (AF), but the underlying mechanisms remain to be fully elucidated. OBJECTIVE: Using human left atrial appendage (LAA) samples, we examined the interactive relationship between the EAT profile and atrial myocardial fibrosis through histological and biochemical analyses. METHODS: LAA samples were obtained from 59 consecutive AF patients during cardiovascular surgery...
June 13, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Carolyn S P Lam, Adriaan A Voors, Rudolf A de Boer, Scott D Solomon, Dirk J van Veldhuisen
This review aims to provide a translational perspective on recent developments in heart failure with preserved ejection fraction (HFpEF), linking mechanistic insights to potential therapies. A key concept in this review is that HFpEF is a haemodynamic condition wherein the heart fails to keep up with the circulatory demands of the body, or does so at the expense of raised left ventricular filling pressures. We, therefore, propose that the 'final common pathway' for development of congestion, i.e. basic haemodynamic mechanisms of increased left ventricular end-diastolic pressure, left atrial hypertension, pulmonary venous congestion, and plasma volume expansion, represents important initial targets for therapy in HFpEF...
June 13, 2018: European Heart Journal
Ewa Pilichowska-Paszkiet, Jakub Baran, Grażyna Sygitowicz, Agnieszka Sikorska, Sebastian Stec, Piotr Kułakowski, Beata Zaborska
AIM: Left atrial (LA) fibrosis promotes atrial fibrillation (AF), may predict poor radiofrequency catheter ablation (RFCA) outcome, and may be assessed invasively using electroanatomical mapping (EAM). Speckle tracking echocardiography (STE) enables quantitative assessment of LA function. The aim was to assess the relationship between LA fibrosis derived from EAM and LA echocardiographic parameters as well as biomarkers of fibrosis in patients with AF. METHODS: Sixty-six patients (64% males, mean age 56 ± 10) with nonvalvular AF treated with first RFCA were prospectively studied...
June 13, 2018: Echocardiography
Yue Zhao, Chunhong Wang, Cong Wang, Xue Hong, Jinhua Miao, Yulin Liao, Lili Zhou, Youhua Liu
Activation of the renin-angiotensin system (RAS) is associated with hypertension and heart disease. However, how RAS activation causes cardiac lesions remains elusive. Here we report the involvement of Wnt/β-catenin signaling in this process. In rats with chronic infusion of angiotensin II (Ang II), eight Wnt ligands were induced and β-catenin activated in both cardiomyocytes and cardiac fibroblasts. Blockade of Wnt/β-catenin signaling by small molecule inhibitor ICG-001 restrained Ang II-induced cardiac hypertrophy by normalizing heart size and inhibiting hypertrophic marker genes...
June 12, 2018: Scientific Reports
Hubert Cochet, Lucas Morlon, Marie-Philippe Vergé, Marjorie Salel, Claudia Camaioni, Amélie Reynaud, Jérôme Peyrou, Philippe Ritter, Pierre Jais, François Laurent, Stéphane Lafitte, Michel Montaudon, Patricia Réant
BACKGROUND: Novel predictors of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) are desirable. AIM: To detect new multimodality imaging variables predictive of de novo AF in HCM. METHODS: Consecutive patients with HCM underwent clinical assessment and 48-hour Holter electrocardiography to detect AF episodes. Left ventricular (LV) morphology, function and fibrosis, and the left atrium (LA) were characterized by cardiac magnetic resonance...
June 5, 2018: Archives of Cardiovascular Diseases
Łukasz Mazurkiewicz, Lidia Ziółkowska, Joanna Petryka, Mateusz Śpiewak, Łukasz Małek, Agata Kubik, Magdalena Marczak, Jolanta Misko, Grażyna Brzezińska-Rajszys
OBJECTIVES: To investigate biatrial mechanics and their relation with left ventricular outflow tract (LVOT) obstruction (LVOTO), the degree of hypertrophy, indices of ventricular diastolic function and fibrosis in children with hypertrophic cardiomyopathy (HCM). METHODS: Fifty-five consecutive, prospectively recruited children with HCM (mean age 12.5 ± 4.6 years, 69.1% male), 19 (34.5%) of whom had LVOTO, underwent cardiac magnetic resonance and echocardiography with quantification of phasic components of biatrial function, biventricular diastolic function and fibrosis...
June 7, 2018: European Radiology
Arne O Melleby, Andreas Romaine, Jan Magnus Aronsen, Ioanni Veras, Lili Zhang, Ivar Sjaastad, Ida G Lunde, Geir Christensen
Aims: Generation of reproducible cardiac disease phenotypes in mice is instrumental for investigating mechanisms leading to heart failure. For decades, suture-based thoracic aortic constriction has been the preferred method for increasing left ventricular (LV) afterload in rodents, but the degree of stenosis resulting from this method is variable. In an effort to improve this methodology, we subjected mice to constriction of the ascending aorta using o-rings with fixed inner diameters (IDs)...
June 5, 2018: Cardiovascular Research
Stewart Spence, Elena Pena, Rebecca E Thornhill, Pablo B Nery, David H Birnie
Presented is the case of a 62-year old male with a history of sarcoidosis and sinus node dysfunction, who underwent late gadolinium enhancement magnetic resonance imaging, which demonstrated left ventricular hyperenhancement and bi-atrial fibrosis.
May 2018: Oxford Medical Case Reports
Eduardo Jorge Godoy, Miguel Lozano, Ignacio García-Fernández, Ana Ferrer-Albero, Rob MacLeod, Javier Saiz, Rafael Sebastian
Introduction: Focal atrial tachycardia is commonly treated by radio frequency ablation with an acceptable long-term success. Although the location of ectopic foci tends to appear in specific hot-spots, they can be located virtually in any atrial region. Multi-electrode surface ECG systems allow acquiring dense body surface potential maps (BSPM) for non-invasive therapy planning of cardiac arrhythmia. However, the activation of the atria could be affected by fibrosis and therefore biomarkers based on BSPM need to take these effects into account...
2018: Frontiers in Physiology
Eva M Benito, Nuno Cabanelas, Marta Nuñez-Garcia, Francisco Alarcón, Rosa M Figueras I Ventura, David Soto-Iglesias, Eduard Guasch, Susanna Prat-Gonzalez, Rosario J Perea, Roger Borràs, Constantine Butakoff, Oscar Camara, Felipe Bisbal, Elena Arbelo, José Maria Tolosana, Josep Brugada, Antonio Berruezo, Lluís Mont
Aims: Left atrial (LA) fibrosis can be identified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) in patients with atrial fibrillation (AF). However, there is limited information about anatomical fibrosis distribution in the left atrium. The aim is to determine whether there is a preferential spatial distribution of fibrosis in the left atrium in patients with AF. Methods and results: A 3-Tesla LGE-CMR was performed in 113 consecutive patients referred for AF ablation...
May 31, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Qifeng Zhou, Carole Maleck, Saskia N I von Ungern-Sternberg, Balram Neupane, David Heinzmann, Jonathan Marquardt, Martin Duckheim, Christian Scheckenbach, Fabian Stimpfle, Meinrad Gawaz, Jürgen Schreieck, Peter Seizer, Michael Gramlich
BACKGROUND: Atrial fibrosis is a hallmark of arrhythmogenic structural remodeling in patients with persistent atrial fibrillation (AF) and is negatively correlated with procedure outcome in patients undergoing ablation. However, noninvasive methods to determine the extent of atrial fibrosis are limited. Here, we used microRNA (miRNA) expression analysis to detect markers of left atrial low-voltage areas (LVAs) in patients with persistent AF undergoing catheter ablation. METHODS: We performed 3-dimensional voltage mapping in 102 patients (average age 62...
June 2018: Circulation. Arrhythmia and Electrophysiology
Erik T Bieging, Alan Morris, Brent D Wilson, Christopher J McGann, Nassir F Marrouche, Joshua Cates
INTRODUCTION: Multiple markers LA remodeling, including LA shape, correlate with outcomes in AF. Catheter ablation is an important treatment of AF, but better tools are needed to determine which patients will benefit. In this study we use particle based modeling to quantitatively assess LA shape, and determine to what degree it predicts AF recurrence after catheter ablation. METHODS AND RESULTS: 254 patients enrolled in the DECAAF study underwent cardiac magnetic resonance imaging of the left atrium prior to AF ablation and were followed for recurrence for up to 475 days...
May 30, 2018: Journal of Cardiovascular Electrophysiology
Takanori Yamaguchi, Takeshi Tsuchiya, Akira Fukui, Yuki Kawano, Toyokazu Otsubo, Yuya Takahashi, Kei Hirota, Kenta Murotani, Kenichi Eshima, Naohiko Takahashi
BACKGROUND: Low-voltage zones (LVZs), as measured by electroanatomic mapping, are thought to be associated with fibrosis. We reported the efficacy of atrial fibrillation (AF) ablation aiming to homogenize left atrial (LA) LVZ. The purpose of this study was to evaluate the impact of LVZ extension outcomes after LVZ homogenization in patients with nonparoxysmal AF. METHODS: This prospective observational cohort study included 172 patients with nonparoxysmal AF undergoing their initial ablation...
May 25, 2018: Journal of Cardiology
Hua Shen, Jing Wang, Jie Min, Wang Xi, Yang Gao, Liang Yin, Yue Yu, Kai Liu, Jian Xiao, Yu-Feng Zhang, Zhi-Nong Wang
BACKGROUND/AIMS: This study aimed to evaluate whether galectin-3 (Gal-3) contributes actively to atrial fibrosis both in patients and experimental atrial fibrillation (AF) models. METHODS: Mouse HL-1 cardiomyocytes were subjected to rapid electrical stimulation (RES) to explore Gal-3 expression and secretion levels by western blotting (WB) and enzyme linked immunosorbent assay (ELISA). Neonatal rat cardiac fibroblasts were treated with conditioned culture medium and recombinant human Gal-3 to evaluate the activation of the transforming growth factor (TGF)-β1/α-smooth muscle actin (SMA)/collagen I (Col I) profibrotic pathway (WB) and fibroblast proliferation with a Cell Counting Kit-8 (CCK-8)...
May 22, 2018: Cellular Physiology and Biochemistry
Martin Manninger, David Zweiker, Arne van Hunnik, Alessio Alogna, Anton J Prassl, Julia Schipke, Stef Zeemering, Birgit Zirngast, Patrick Schönleitner, Michael Schwarzl, Viktoria Herbst, Eva Thon-Gutschi, Stefan Huber, Ursula Rohrer, Jakob Ebner, Helmut Brussee, Burkert M Pieske, Frank R Heinzel, Sander Verheule, Gudrun Antoons, Andreas Lueger, Christian Mühlfeld, Gernot Plank, Ulrich Schotten, Heiner Post, Daniel Scherr
BACKGROUND: Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms. OBJECTIVE: We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP) induced AF combined with desoxycorticosterone acetate (DOCA) induced HT. METHODS: Eighteen pigs were instrumented with right atrial endocardial pacemaker leads and custom-made pacemakers to induce AF by continuous RAP (600bpm)...
May 23, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Christian Jung, Bernhard Wernly, Mikael Bjursell, John Wiseman, Therese Admyre, Johannes Wikström, Malin Palmér, Frank Seeliger, Michael Lichtenauer, Marcus Franz, Charlotte Frick, Ann-Katrin Andersson, Margareta Elg, John Pernow, Per-Ove Sjöquist, Mohammad Bohlooly-Y, Qing-Dong Wang
BACKGROUND: Oxytocin (Oxt) and its receptor (Oxtr) gene system has been implicated in cardiomyogenesis and cardioprotection; however, effects of chronic activation of Oxtr are not known. We generated and investigated transgenic (TG) mice that overexpress Oxtr specifically in the heart. METHODS AND RESULTS: Cardiac-specific overexpression of Oxtr was obtained by having the α-major histocompatibility complex promoter drive the mouse Oxtr gene (α-Mhc-Oxtr). Left ventricular (LV) function and remodeling were assessed by magnetic resonance imaging and echocardiography...
May 23, 2018: Journal of Cardiac Failure
Caroline H Roney, Jason D Bayer, Hubert Cochet, Marianna Meo, Rémi Dubois, Pierre Jaïs, Edward J Vigmond
Success rates for catheter ablation of persistent atrial fibrillation patients are currently low; however, there is a subset of patients for whom electrical isolation of the pulmonary veins alone is a successful treatment strategy. It is difficult to identify these patients because there are a multitude of factors affecting arrhythmia susceptibility and maintenance, and the individual contributions of these factors are difficult to determine clinically. We hypothesised that the combination of pulmonary vein (PV) electrophysiology and atrial body fibrosis determine driver location and effectiveness of pulmonary vein isolation (PVI)...
May 24, 2018: PLoS Computational Biology
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