Profibrotic pathways and atrial cardiomyopathy in persistent atrial fibrillation

Canpolat, Uğur

doi:10.6061/clinics/2016(10)12

Cited by 1 publication

(2 citation statements)

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“…Closely related to atrial contractile dysfunction in AC is the occurrence of atrial fibrosis, which is an integral part of atrial remodeling in AF. The majority of patients with AF and without known structural heart disease have atrial fibrosis as a substrate (47). Fibrosis is also a prominent histopathologic and mechanistic feature of early persistent AF (48).…”

Section: Fibrosis and Structural Atrial Remodelingmentioning

confidence: 99%

“…Given that aging is associated with oxidative stress, Ca 2+ dysregulation, and apoptosis, it is not surprising that age is directly associated with the extent of both atrial fibrosis and apopotosis (49). Matrix metalloproteins are highly expressed in AF and positively correlate to extent of atrial fibrosis in AF; in particular matrix metalloprotein 9 (MMP-9) has been described as a circulating serum biomarker suggestive of atrial fibrosis (47). Additionally, alcohol consumption is associated with progressive fibrosis of the atria.…”

Section: Fibrosis and Structural Atrial Remodelingmentioning

confidence: 99%

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Atrial Cardiomyopathy: An Unexplored Limb of Virchow's Triad for AF Stroke Prophylaxis

Darlington

McCauley

2020

Front. Cardiovasc. Med.

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The most dreaded complication of atrial fibrillation is stroke, and 70-80% of patients with AF-related stroke die or become disabled. The mechanisms of thromboembolism in AF are multifactorial, with evidence demonstrating that all three criteria of Virchow's triad are satisfied in AF: abnormal stasis of blood, endothelial damage, and hypercoagulability. Mechanistic insights into the latter two limbs have resulted in effective stroke prophylactic therapies (left atrial appendage occlusion and oral anticoagulants); however, despite these advances, there remains an excess of stroke in the AF population that may be due, in part, to a lack of mechanistic understanding of atrial hypocontractility resulting in abnormal stasis of blood within the atrium. These observations support the emerging concept of atrial cardiomyopathy as a cause of stroke. In this Review, we evaluate molecular, translational, and clinical evidence for atrial cardiomyopathy as a cause for stroke from AF, and present a rationale for further investigation of this largely unaddressed limb of Virchow's triad in AF.

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Section: Fibrosis and Structural Atrial Remodelingmentioning

confidence: 99%

Section: Fibrosis and Structural Atrial Remodelingmentioning

confidence: 99%