Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major contributor to population mortality and morbidity, particularly stroke-risk. 1 Atrialtissue fibrosis is a central pathophysiological feature and hampers AF-treatment; the underlying molecular mechanisms are poorly understood and present therapies are inadequate. 2 Here, we show that calcitonin (CT), a well-recognized hormone product of the thyroid gland involved in bone metabolism, 3 is produced in significant quantities by atrial cardiomyocytes and acts in a paracrine fashion on neighbouring collagenproducing fibroblasts to control their proliferation and secretion of extracellular matrix proteins. Global disruption of CT-receptor signalling in mice causes atrial fibrosis and increases AF susceptibility. Atrial-specific knockdown (KD) of CT in atrial-targeted liver-kinase B1 (LKB1)-KD mice promotes atrial fibrosis and prolongs/increases the number of spontaneous AF-episodes, while atrial-specific CT overexpression prevents fibrosis and AF in LKB1-KD mice. Patients with persistent AF are characterised by six-

ELTD1 is expressed in endothelial and vascular smooth muscle cells and has a role in angiogenesis. It has been classified as an adhesion GPCR, but as yet, no ligand has been identified and its function remains unknown. To establish its role, ELTD1 was overexpressed in endothelial cells. Expression and consequently ligand independent activation of ELTD1 results in EndMT with a loss of cell-cell contact, formation of stress fibres and mature focal adhesions and an increased expression of smooth muscle actin. The effect was pro-angiogenic, increasing Matrigel network formation and endothelial sprouting. RNA-Seq analysis after the cells had undergone EndMT revealed large increases in chemokines and cytokines involved in regulating immune response. Gene set enrichment analysis of the data identified a number of pathways involved in myofibroblast biology suggesting that the endothelial cells had undergone a type II EMT. This type of EMT is involved in wound repair and is closely associated with inflammation implicating ELTD1 in these processes.

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