Atrial fibrillation-induced atrial contractile dysfunction: a tachycardiomyopathy of a different sort

Schotten, Ulrich

doi:10.1016/s0008-6363(01)00453-9

Cited by 150 publications

(114 citation statements)

References 34 publications

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“…In both groups, stimulation of PLB-Ser-16 by 5-HT was less pronounced than stimulation by NE, EPI, or FSK. Our results are consistent with an early report indicating that ISO-evoked relaxation and AC stimulation do not differ between patients with SR and patients with AF (18).…”

Section: Resultssupporting

confidence: 93%

Arrhythmias, elicited by catecholamines and serotonin, vanish in human chronic atrial fibrillation

Christ

Rozmaritsa²,

Engel³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Fig. 1. Bone cells express Avprs. Immunofluorescence micrographs (A) and Western immunoblotting (B)show the expression of Avpr1α in osteoblasts and osteoclasts, and as a function of osteoblast (mineralization) and osteoclast (with Rankl) differentiation. The expression of Avp (ligand) and Avpr1α (receptor) in osteoblasts is regulated by 17β-estradiol, as determined by quantitative PCR (C) and Western immunoblotting (D). (Magnification: A, 63×.) Because Avp is a small peptide, its precursor neurophysin II is measured. Statistics: Student t test, P values shown compared with 0 h. Stimulation of Erk phosphorylation (p-Erk) as a function of total Erk (t-Erk) by Avp (10 −8 M) in osteoclast precursors (preosteoclasts), osteoclasts (OC), and osteoblasts establishes functionality of the Avpr1α in the presence or absence of the receptor inhibitor SR49059 (10 −8 M) (E). Western immunoblotting showing the expression of Avpr2 in preosteoclasts, OCs (F), and osteoblasts (G) isolated from Avpr1α −/− mice, as well as in MC3T3.E1 osteoblast precursors (G). Functionality of Avpr2 was confirmed by the demonstration that cells from Avpr1α −/− mice remained responsive to AVP in reducing the expression of osteoblast differentiation genes, namely Runx2, Osx, Bsp, Atf4, Opn, and Osteocalcin (quantitative PCR, P values shown) (H). Only relevant bands from Western blots are shown, with gaps introduced where empty lanes are excised to conserve space.

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Section: Resultssupporting

confidence: 93%

Arrhythmias, elicited by catecholamines and serotonin, vanish in human chronic atrial fibrillation

Christ

Rozmaritsa²,

Engel³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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“…14 We have demonstrated significant postpacing-pause potentiation of LAAEV in the mechanically stunned intact atrium, providing evidence for the presence of a functional sarcoplasmic reticulum. These findings are consistent with the observations of Schotten et al 11,21 in isolated atrial myocardial fibers and extend their findings to the whole atrium, suggesting that atrial mechanical stunning is not caused by the disruption of the contractile apparatus itself.…”

Section: Implications For the Mechanism Of Atrial Mechanical Remodelisupporting

confidence: 92%

“…However, evidence suggests that homeostatic mechanisms act to reduce the accumulating intracellular calcium by a decrease of the L-type calcium current. 11,24 Schotten and Allessie 21 have also demonstrated an upregulation of the sodium-calcium exchanger, which removes calcium from the cell. We speculate, therefore, that extrusion of calcium from the cell with chronic AFL results in relative cellular calcium depletion, which becomes clinically apparent as atrial mechanical stunning on slowing of the rate of atrial stimulation by termination of arrhythmia.…”

Section: Implications For the Mechanism Of Atrial Mechanical Remodelimentioning

confidence: 99%

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

et al. 2002

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Background-Atrial mechanical stunning develops on termination of chronic atrial arrhythmias and is implicated in the genesis of thromboembolic complications after cardioversion. The mechanisms responsible for atrial mechanical stunning are unknown. The effects of atrial rate, isoproterenol, and calcium on atrial mechanical function in patients with atrial stunning have not been evaluated, and it is not known if atrial stunning can be reversed. Methods and Results-Thirty-five patients with chronic atrial flutter (AFL) undergoing radiofrequency ablation were studied. Fifteen patients in sinus rhythm undergoing ablation for paroxysmal AFL were studied as control for effects of the procedure. Left atrial appendage emptying velocities (LAAEVs) and spontaneous echocardiographic contrast (LASEC) were assessed by transesophageal echocardiography during AFL, after reversion to sinus rhythm, during atrial pacing at cycle lengths of 750 to 250 ms, after a postpacing pause, and with isoproterenol or calcium. PϽ0.0001). No change in LAAEV was observed in the paroxysmal AFL group. Conclusion-Atrial mechanical stunning can be reversed by pacing at increased rates and through the administration of isoproterenol or calcium. These findings suggest a functional contractile apparatus in the mechanically remodeled atrium as a result of chronic atrial flutter.

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“…20 Contractile remodeling likely arises in response to both electrical abnormalities (reduced release of systolic calcium) and structural atrial changes (myolysis). 12,21 The resulting reduced contractility may lead to thrombus formation and atrial dilation. It also may facilitate disease progression by allowing the coexistence of multiple wavelets.…”

Section: Mechanisms Of Af Development and Progressionmentioning

confidence: 99%

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

Saliba

Wazni

2011

Clinical Cardiology

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Atrial fibrillation (AF) is a common supraventricular tachyarrhythmia with substantial morbidity and mortality. This review briefly describes the mechanisms of AF development and progression, including electrical, structural, and contractile remodeling. In addition, the potential benefits of achieving and maintaining sinus rhythm are discussed. For example, rhythm control has been associated with improvements in left ventricular function, AF symptoms, exercise tolerance, the ability to perform activities of daily living, and quality of life. More recently, dronedarone, a noniodinated benzofuran derivative approved for use in the treatment of AF, was shown to significantly improve clinical outcomes including cardiovascular hospitalizations and death from any cause in A Placebo‐Controlled, Double‐Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter (ATHENA). The review concludes with an examination of AF treatment options and expectations. Evidence suggests that the complete absence of AF recurrence is not always achievable; however, complete restoration of sinus rhythm may not be necessary for patients to achieve clinically meaningful benefits. Copyright © 2011 Wiley Periodicals, Inc.The editorial assistance provided for this manuscript was funded by Sanofi‐Aventis. The authors were fully responsible for all content and editorial decision, and received no financial support or other form of compensation related to the development of the paper. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Atrial fibrillation-induced atrial contractile dysfunction: a tachycardiomyopathy of a different sort

Cited by 150 publications

References 34 publications

Arrhythmias, elicited by catecholamines and serotonin, vanish in human chronic atrial fibrillation

Arrhythmias, elicited by catecholamines and serotonin, vanish in human chronic atrial fibrillation

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

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