Atrial fibrillation and rapid acute pacing regulate adipocyte/adipositas-related gene expression in the atria

Chilukoti, Ravi Kumar; Giese, Anne‐Katrin; Malenke, Wiebke; Homuth, Georg; Bukowska, Alicja; Goette, Andreas; Felix, Stephan B.; Kanaan, Jennifer; Wollert, Hans-Georg; Evert, Katja; Verheule, Sander; Jaı̈s, Pierre; Hatem, Stéphane N.; Lendeckel, Uwe; Wolke, Carmen

doi:10.1016/j.ijcard.2015.03.072

Cited by 64 publications

(45 citation statements)

References 82 publications

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“…Obesity not only creates atrial fibrosis 84 , but also increases epicardial fat 84,85 . Furthermore, obesity leads to the infiltration of fat cells into the atrial tissue and to the activation of atrial fat cells, thus modifying atrial electrical function 22,86 , providing a possible mech anism linking obesity and pericardial fat to AF. Therefore, epicardial adipose tissue could be an important health modifier for AF.…”

Section: Fat-cell Infiltration and Activationmentioning

confidence: 99%

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

et al. 2015

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Despite the important advances that have enabled better stroke prevention in atrial fibrillation (AF) and more effective maintenance of sinus rhythm over the past decades, a large unmet need to improve the prevention and treatment of AF remains. Mortality for AF remains at 3.5% per year, and death is often experienced as sudden death or as a result of heart failure 1,2 . Each year, approximately 20% of patients with AF need to be hospitalized 3,4 , and stroke occurs in 1.5% of patients with AF who are receiving anticoagulant drugs 5 . Furthermore, more than half of the patients with AF are symptomatic despite adequate anticoagulation and rate control 4,6 . In view of the projected increase in the incidence and prevalence of AF 7-9 , as well as the substantial burden of death and dis ability that is still associated with this condition 10 , the status quo is unacceptable.Current management of patients with AF comprises treatment of the accompanying cardiovascular conditions, oral anticoagulation, rate control -with medications that slow atrioventricular nodal recovery or, rarely, with atrioventricular nodal ablation -and rhythm-control therapy with antiarrhythmic drugs, electrical cardioversion, catheter ablation or, at times, AF surgery 11,12 . Unfortunately, most of these current approaches are disconnected from our understanding of the major mechanisms that cause AF 1,13,14 1,2,7,19,20 Abstract | Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.230 | APRIL 2016 | VOLUME 13 www.nature.com/nrcardio CONSENSUS STATEMENT © 2 0 1 6 M a c m i l l a n P u b l i s h e r s L i m i t e d . A l l r i g h t s r e s e r v e d .

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Section: Fat-cell Infiltration and Activationmentioning

confidence: 99%

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

et al. 2015

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“…A previous study assessed inflammation of EAT that was harvested from patients undergoing cardiac surgery, and showed that it represented an important local source of the inflammatory mediators tumor necrosis factor-a and interleukin-6 [21,22], which might have direct arrhythmogenic effects on atrial tissue and be associated with AF pathogenesis [23]. Moreover, lone AF and rapid acute pacing were recently reported to provoke significant changes in atrial adipogenesis and to promote adipocyte differentiation and adipose tissue expansion [24]. These mechanisms might play an important role in the formation of the AF substrate during the pathogenesis of AF.…”

Section: Inflammation Of Eat and Afmentioning

confidence: 99%

Inflammation of left atrial epicardial adipose tissue is associated with paroxysmal atrial fibrillation

Kusayama

Furusho

Kashiwagi

et al. 2016

Journal of Cardiology

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“…Genes involved in metabolism are among the most strongly regulated genes in pAF patients compared to sinus rhythm patients [5]. Moreover, there is increasing evidence for a role of epicardial adipose tissue and changes in atrial adipocyte-related gene expression in atrial tachycardia-induced remodeling [6]. The work by Lenski et al, for the first time, links irregular pacing, calcium-handling abnormalities and alterations in atrial metabolism.…”

mentioning

confidence: 99%

Irregular rhythm and atrial metabolism are key for the evolution of proarrhythmic atrial remodeling in atrial fibrillation

Heijman

Dobrev

2015

Basic Res Cardiol

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Atrial fibrillation and rapid acute pacing regulate adipocyte/adipositas-related gene expression in the atria

Cited by 64 publications

References 82 publications

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Inflammation of left atrial epicardial adipose tissue is associated with paroxysmal atrial fibrillation

Irregular rhythm and atrial metabolism are key for the evolution of proarrhythmic atrial remodeling in atrial fibrillation

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