Clinical Significance of Peripheral Endothelial Function for Left Atrial Blood Stagnation in Nonvalvular Atrial Fibrillation Patients With Low-to-Intermediate Stroke Risk

Fujii, Akiko; Inoue, Kentaro; Nagai, Takayuki; Uetani, Teruyoshi; Nishimura, Kazuhisa; Suzuki, Jun; Funada, Junichi; Okura, Takafumi; Higaki, Jitsuo; Ogimoto, Akiyoshi

doi:10.1253/circj.cj-16-0176

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…This in turn causes a loss of atrial contraction resulting in static blood flow and clot formation within the left atrial appendage. Fujii et al 79 demonstrated that endothelial dysfunction, as assessed by reduced reactive hyperemia peripheral arterial tonometry (RH-PAT) index (Figure 3B), was independently associated with static atrial blood flow, as determined by spontaneous echo contrast on transoesophageal echocardiography. 79 In addition, AF is strongly associated with a procoagulant state; increased levels of clotting factors (factor VIII, fibrinogen), markers of platelet activation (platelet factor 4, β-thrombomodulin, P-selectin), and markers of fibrinolysis (D-dimer, tissue plasminogen activator, plasminogen activator inhibitor-1) have all been described.…”

Section: Endothelial Dysfunction and Thromboembolismmentioning

confidence: 99%

“…Fujii et al 79 demonstrated that endothelial dysfunction, as assessed by reduced reactive hyperemia peripheral arterial tonometry (RH-PAT) index (Figure 3B), was independently associated with static atrial blood flow, as determined by spontaneous echo contrast on transoesophageal echocardiography. 79 In addition, AF is strongly associated with a procoagulant state; increased levels of clotting factors (factor VIII, fibrinogen), markers of platelet activation (platelet factor 4, β-thrombomodulin, P-selectin), and markers of fibrinolysis (D-dimer, tissue plasminogen activator, plasminogen activator inhibitor-1) have all been described. 78 Endothelial dysfunction induces the release of procoagulant factors (VWF, tissue factor) and reduces the secretion of antithrombotic factors (NO), thereby augmenting this procoagulant state.…”

Section: Endothelial Dysfunction and Thromboembolismmentioning

confidence: 99%

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Endothelial function and atrial fibrillation: A missing piece of the puzzle?

Black

Mohammad

Saraf

et al. 2021

Cardiovasc electrophysiol

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Endothelial dysfunction, a term used to describe both the physical damage and dysregulated physiology of this endothelial lining, is an increasingly recognized pathophysiological state shared by many cardiovascular diseases. Historically, the role of endothelial dysfunction in atrial fibrillation (AF) was thought to be limited to mediating atrial thromboembolism. However, there is emerging evidence that endothelial dysfunction both promotes and maintains atrial arrhythmic substrate, predicts adverse outcomes, and identifies patients at high risk of recurrence following cardioversion and ablation therapy. Treatments targeted at improving endothelial function also represent a promising new therapeutic paradigm in AF. This review summarizes the current understanding of endothelial function in AF.

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Section: Endothelial Dysfunction and Thromboembolismmentioning

confidence: 99%

Section: Endothelial Dysfunction and Thromboembolismmentioning

confidence: 99%

Endothelial function and atrial fibrillation: A missing piece of the puzzle?

Black

Mohammad

Saraf

et al. 2021

Cardiovasc electrophysiol

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“…In addition, smoking in AF patients can increase rouleaux formation of erythrocytes, platelet aggregation, and blood coagulability, and may play an important role in the genesis of LASEC. Although the pathophysiologic mechanisms of LAA abnormalities caused by smoking remain unclear, LA endothelial damage via nicotine‐induced inflammation, oxidative stress, or impaired nitric oxide bioavailability [20], may be related to LA abnormalities in current smokers [26].…”

Section: Discussionmentioning

confidence: 99%

Transesophageal echocardiographic thromboembolic risk is associated with smoking status in patients with atrial fibrillation

Inao

Hirai

Nakagawa

et al. 2017

Journal of Arrhythmia

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BackgroundSmoking is a risk factor for cardiovascular diseases, but it is unclear whether smoking status, including environmental tobacco smoke, increases stroke risk in patients with atrial fibrillation (AF). Abnormalities of the left atrium (LA) and aortic atherosclerosis, as detected by transesophageal echocardiography (TEE), are risk factors for stroke and thromboembolism in AF patients. We investigated the impact of smoking status on thromboembolic risk by TEE in patients with nonvalvular AF.MethodsIn 122 patients with AF (mean age, 63 years; chronic AF 50%) who underwent TEE before catheter ablation of AF or for detection of the potential cardioembolic source, urinary concentrations of cotinine and clinical variables including smoking status and the CHA2DS2-VASc score were determined.ResultsSevere aortic atherosclerosis and increased aortic wall thickness were more frequently detected by TEE in current smokers than in non-smokers (p<0.05), though these findings did not significantly differ between non-smokers and environmental smokers. Patients in AF rhythm during TEE, who were environmental smokers and at relatively low risk, as stratified by their CHA2DS2-VASc score (≤ 2), showed lower LA appendage flow velocity than those without environmental smoking (47±22 vs. 34±13 cm/sec, p<0.05).ConclusionsTEE findings indicated that smoking status could be associated with thromboembolic risk in patients with AF.

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“…However, TEAM literature held a point of view that blood stasis can arise because of predisposing factors, such as body constitution type,25 or a syndrome-like state with impaired blood circulation 26. On the other hand, Western medicine studies regarded blood stasis as an impairment of circulatory function caused by anatomical characteristics27; surgical operations28; weakened endothelium and blood vessels29; and certain diseases, such as atrial fibrillation 30. We will use this working definition when we chart our data in the study.…”

Section: Methodsmentioning

confidence: 99%

“…26 On the other hand, Western medicine studies regarded blood stasis as an impairment of circulatory function caused by anatomical characteristics 27 ; surgical operations 28 ; weakened endothelium and blood vessels 29 ; and certain diseases, such as atrial fibrillation. 30 We will use this working definition when we chart our data in the study. The conceptual diagram of blood stasis is shown in Figure 1.…”

Section: Search Strategymentioning

confidence: 99%

Modern concepts and biomarkers of blood stasis in cardio- and cerebrovascular diseases from the perspectives of Eastern and Western medicine: a scoping review protocol

Park

Kim

et al. 2022

JBI Evidence Synthesis

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The objective of this review is to provide a modern definition and identify potential biomarkers of blood stasis in cardio-and cerebrovascular diseases by mapping, comparing, and combining Eastern and Western concepts.Introduction: Blood stasis is a pathological concept found in both Eastern and Western medical literature. In traditional East Asian medicine, blood stasis is a differential syndrome characterized by stagnant blood flow in various parts of the body. Similarly, in Western medicine, various diseases, especially cardio-and cerebrovascular diseases, are known to be accompanied by blood stasis. Numerous scientific studies on blood stasis have been conducted over the last decade, and there is a need to synthesize those results.Inclusion criteria: We will use the keywords "blood stasis," "blood stagnation," "blood stagnant," and "blood congestion" in 3 electronic databases: PubMed, Cochrane CENTRAL, and Google Scholar. In addition, we will use the keywords "어혈" and "혈어" in 4 Korean electronic databases (ie, NDSL, OASIS, KISS, and DBpia). Peer-reviewed articles published from 2010 to the present that focus on blood stasis in cardio-and cerebrovascular diseases in human subjects according to the International Classification of Diseases 11 th revision categories BA00-BE2Z, 8B00-8B2Z, 8E64, and 8E65 will be included. Reviews, opinion articles, in vivo, in vitro, and in silico preclinical studies will be excluded. Methods:We will follow the frameworks by Arksey and O'Malley and Levac et al. as well as JBI guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Two reviewers will independently search and screen titles and abstracts followed by full-text screening of eligible studies. If there are discrepancies between the 2 reviewers, a third reviewer will be consulted to make the final decision. We will use descriptive narrative, tabular, and graphical displays, and content analysis to present the results.Scoping review registration: Open Science Framework https://osf.io/gv4ym

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Clinical Significance of Peripheral Endothelial Function for Left Atrial Blood Stagnation in Nonvalvular Atrial Fibrillation Patients With Low-to-Intermediate Stroke Risk

Cited by 5 publications

References 34 publications

Endothelial function and atrial fibrillation: A missing piece of the puzzle?

Endothelial function and atrial fibrillation: A missing piece of the puzzle?

Transesophageal echocardiographic thromboembolic risk is associated with smoking status in patients with atrial fibrillation

Modern concepts and biomarkers of blood stasis in cardio- and cerebrovascular diseases from the perspectives of Eastern and Western medicine: a scoping review protocol

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