Effects of atorvastatin on atrial remodeling in a rabbit model of atrial fibrillation produced by rapid atrial pacing

Yang, Qian; Qi, Xiaoyong; Dang, Yi‐Wu; Li, Yingxiao; Hao, Xiao‐Jiang

doi:10.1186/s12872-016-0301-8

Cited by 25 publications

(16 citation statements)

References 44 publications

(72 reference statements)

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“…At the cellular level, Atorvastatin inhibits angiotensin-mediated cell injury by suppressing ROS production in neonatal rat ventricular myocytes [ 111 ]. More importantly, Atorvastatin treatment prevents atrial electrical remodeling, including effective refractory period shortening and reduction of the L-type calcium current in a rabbit model of tachycardia-pacing induced AF [ 112 ]. Clinically, statins confer their greatest benefit in the prevention of post-operative AF [ 94 , 113 , 114 ].…”

Section: Therapies Targeting Oxidative Stress and Inflammation For Trmentioning

confidence: 99%

Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes

Karam

Chavez-Moreno

Koh

et al. 2017

Cardiovasc Diabetol

356

244

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans. Several risk factors promote AF, among which diabetes mellitus has emerged as one of the most important. The growing recognition that obesity, diabetes and AF are closely intertwined disorders has spurred major interest in uncovering their mechanistic links. In this article we provide an update on the growing evidence linking oxidative stress and inflammation to adverse atrial structural and electrical remodeling that leads to the onset and maintenance of AF in the diabetic heart. We then discuss several therapeutic strategies to improve atrial excitability by targeting pathways that control oxidative stress and inflammation.

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Section: Therapies Targeting Oxidative Stress and Inflammation For Trmentioning

confidence: 99%

Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes

Karam

Chavez-Moreno

Koh

et al. 2017

Cardiovasc Diabetol

356

244

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“…Statins are commonly used in patients with obesity and type 2 diabetes to prevent atherosclerotic events, but they have striking effects in lessening epicardial adipocyte mass and inflammation, and thereby preventing fibrosis in the underlying myocardium . This anti‐inflammatory action may explain why statins ameliorate the development of an atrial myopathy in experimentally induced cardiac stress and in patients with AF . In randomized controlled trials (RCTs), statins reduced the incidence of new‐onset as well as recurrent AF; their use is also associated with a decrease in AF‐related thromboembolic events .…”

Section: Therapeutic Challenges In Patients With a Metabolic Disordermentioning

confidence: 99%

“…102,103 This anti-inflammatory action may explain why statins ameliorate the development of an atrial myopathy in experimentally induced cardiac stress and in patients with AF. [104][105][106] In randomized controlled trials (RCTs), statins reduced the incidence of new-onset as well as recurrent AF; 107-109 their use is also associated with a decrease in AF-related thromboembolic events. 110,111 At the same time, the use of statins is followed by an improvement in abnormal diastolic filling dynamics [112][113][114] as well as by reduced risk for new-onset HF with the features of HFpEF.…”

Section: Statinsmentioning

confidence: 99%

Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment

Packer

2019

European J of Heart Fail

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Obesity and diabetes can lead to heart failure with preserved ejection fraction (HFpEF), potentially because they both cause expansion and inflammation of epicardial adipose tissue and thus lead to microvascular dysfunction and fibrosis of the underlying left ventricle. The same process also causes an atrial myopathy, which is clinically evident as atrial fibrillation (AF); thus, AF may be the first manifestation of HFpEF. Many patients with apparently isolated AF have latent HFpEF or subsequently develop HFpEF. Most patients with obesity or diabetes who have AF and exercise intolerance have increased left atrial pressures at rest or during exercise, even in the absence of diagnosed HFpEF. Among patients with AF, those who also have latent HFpEF have increased risk for systemic thromboembolism and death. The identification of HFpEF in patients with obesity or diabetes alters the risk‐to‐benefit relationship of commonly prescribed treatments. Bariatric surgery and statins can ameliorate AF and reduce the risk for HFpEF. Conversely, antihyperglycaemic drugs that promote adipogenesis or cause sodium retention (insulin and thiazolidinediones) may increase the risk for heart failure in patients with an underlying ventricular myopathy. Patients with obesity and diabetes who undergo catheter ablation for AF are at increased risk for AF recurrence and for post‐ablation increases in pulmonary venous pressures and worsening heart failure, especially if HFpEF coexists. Therefore, AF may be the earliest indicator of HFpEF in patients with obesity or type 2 diabetes, and recognition of HFpEF alters the management of these patients.

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“…endothelin-1 and matrix metalloproteinase) [ 75 – 77 ] could be useful for identifying additional targets for the timely initiation of preventive strategies aimed at avoiding AFDAS perpetuation and stroke recurrence that could be tested in experimental studies (Fig. 3 ) [ 78 – 86 ]. Patients with acute neurogenic AFDAS may evolve to recurrent paroxysmal or even chronic or permanent AFDAS mediated by atrial remodeling, possibly representing a group at particularly high risk of recurrent stroke.…”

Section: Markers Of Atrial Fibrillation Detected After Stroke and Tramentioning

confidence: 99%

The complexity of atrial fibrillation newly diagnosed after ischemic stroke and transient ischemic attack: advances and uncertainties

Cerasuolo¹,

Cipriano²,

Sposato

2017

Current Opinion in Neurology

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Purpose of reviewAtrial fibrillation is being increasingly diagnosed after ischemic stroke and transient ischemic attack (TIA). Patient characteristics, frequency and duration of paroxysms, and the risk of recurrent ischemic stroke associated with atrial fibrillation detected after stroke and TIA (AFDAS) may differ from atrial fibrillation already known before stroke occurrence. We aim to summarize major recent advances in the field, in the context of prior evidence, and to identify areas of uncertainty to be addressed in future research.Recent findingsHalf of all atrial fibrillations in ischemic stroke and TIA patients are AFDAS, and most of them are asymptomatic. Over 50% of AFDAS paroxysms last less than 30 s. The rapid initiation of cardiac monitoring and its duration are crucial for its timely and effective detection. AFDAS comprises a heterogeneous mix of atrial fibrillation, possibly including cardiogenic and neurogenic types, and a mix of both. Over 25 single markers and at least 10 scores have been proposed as predictors of AFDAS. However, there are considerable inconsistencies across studies. The role of AFDAS burden and its associated risk of stroke recurrence have not yet been investigated.SummaryAFDAS may differ from atrial fibrillation known before stroke in several clinical dimensions, which are important for optimal patient care strategies. Many questions remain unanswered. Neurogenic and cardiogenic AFDAS need to be characterized, as it may be possible to avoid some neurogenic cases by initiating timely preventive treatments. AFDAS burden may differ in ischemic stroke and TIA patients, with distinctive diagnostic and treatment implications. The prognosis of AFDAS and its risk of recurrent stroke are still unknown; therefore, it is uncertain whether AFDAS patients should be treated with oral anticoagulants.

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Effects of atorvastatin on atrial remodeling in a rabbit model of atrial fibrillation produced by rapid atrial pacing

Cited by 25 publications

References 44 publications

Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes

Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes

Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment

The complexity of atrial fibrillation newly diagnosed after ischemic stroke and transient ischemic attack: advances and uncertainties

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