Atrial Fibrillation Pathophysiology and Prognosis

Siontis, Konstantinos C.; Gersh, Bernard J.

doi:10.1161/circimaging.115.003020

Cited by 13 publications

(13 citation statements)

References 112 publications

(103 reference statements)

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“…9,10 Chronic RA pressure overload and stretching, along with chronic hypoxia, may alter the atrial substrate by promoting fibrosis and local tissue heterogeneities, which in turn predispose to a risk for AF. 19 This is consistent with emerging data demonstrating a key role of atrial fibrosis in the pathogenesis of AF as documented by delayed enhancement on MRI. 20,21 Figure 2 with those from 16 age-matched controls without PH undergoing EPS for supraventricular tachycardia.…”

Section: Pathophysiology Of Atrial Arrhythmias In the Setting Of Elevsupporting

confidence: 90%

Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

Wanamaker

Cascino

McLaughlin

et al. 2018

Arrhythmia &Amp; Electrophysiology Review

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Atrial arrhythmias, including atrial fibrillation and atrial flutter, are common in patients with pulmonary hypertension and are closely associated with clinical decompensation and poor clinical outcomes. The mechanisms of arrhythmogenesis and subsequent clinical decompensation are reviewed. Practical implications and current evidence for the management of atrial arrhythmias in patients with pulmonary hypertension are summarised.

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Section: Pathophysiology Of Atrial Arrhythmias In the Setting Of Elevsupporting

confidence: 90%

Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

Wanamaker

Cascino

McLaughlin

et al. 2018

Arrhythmia &Amp; Electrophysiology Review

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“…[15][16][17][18] Studies in nononcology patients have further shown that echocardiographic measures of left atrial (LA) dysfunction (eg, low LA ejection fraction [EF] and abnormal reservoir strain) may provide incremental value in determining future AF risk. 19,20 There is a paucity of information on the incidence and risk factors of de novo AF in HCT patients, especially in those undergoing allogeneic HCT, and there have been no studies to examine the association between pre-HCT echocardiographic parameters and future AF risk. In these patients, it is especially important to understand outcomes following the onset of AF, given the increasing indications for HCT and greater numbers of older (.…”

Section: Introductionmentioning

confidence: 99%

Atrial Fibrillation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

Chang

Chanson

Teh

et al. 2021

JCO

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PURPOSE To examine the incidence and risk factors for de novo atrial fibrillation (AF) after allogeneic hematopoietic cell transplantation (HCT) and to describe the impact of AF on HCT-related outcomes. METHODS A retrospective cohort study design was used to examine AF and associated outcomes in 487 patients who underwent allogeneic HCT from 2014 to 2016 and to characterize patient- and HCT-related risk factors. A nested case-control study design was used to describe the association between pre-HCT echocardiographic measures and future AF events. RESULTS The median age at HCT was 52.4 years (18.1-78.6); the median time to AF was 117.5 days (4.0-1,405.0). The 5-year cumulative incidence of AF was 10.6%. Older (≥ 50 years) age (hazard ratio [HR], 2.76; 95% CI, 1.37 to 5.58), HLA-unrelated donor (HR, 2.20; 95% CI, 1.18 to 4.12), dyslipidemia (HR, 2.40; 95% CI, 1.23 to 4.68), and pre-HCT prolonged QTc interval (HR, 2.55; 95% CI, 1.38 to 4.72) were independent risk factors for AF. Despite having comparable left ventricular systolic function, patients who developed AF were significantly more likely to have lower left atrial ejection fraction, left atrial reservoir function, and elevated tricuspid regurgitant jet velocity prior to HCT, compared with patients who did not. The incidence rate of stroke after AF was 143 per 1,000 person-years. In adjusted analyses, AF was associated with a 12.8-fold (HR, 12.76; 95% CI, 8.76 to 18.57) risk of all-cause mortality and 15.8-fold (HR, 15.78; 95% CI, 8.70 to 28.62) risk of nonrelapse mortality. CONCLUSION The burden of AF after allogeneic HCT population is substantial, and the development of AF is associated with poor survival. We identified important associations between patient demographics, pre-HCT cardiac parameters, HCT-related exposures, and risk of AF, setting the stage for targeted prevention strategies during and after HCT.

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“…During AF, the ineffective contraction of the left atrium promotes vascular stasis, which, along with the pro coagulating state, produces an increase in the formation of thrombi at the level of the left atrial appendix, a remnant of sac-shaped embryonic development that would contribute to the cardiovascular risk of AF (36,37). Other prothrombotic abnormalities in patients with AF include alterations in the D-dimer, platelet factor-4, thrombin-antithrombin complexes, and plasminogen activator inhibitor (PAI-1).…”

Section: Atrial Fibrillation and Cardiovascular Riskmentioning

confidence: 99%

News on angiotensin II and atrial fibrillation : from the molecular to the pathophysiological.

et al. 2021

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Introducción: la fibrilación auricular es la arritmia más prevalente en el mundo y acarrea elevadas cifras de morbilidad y mortalidad. Numerosos estudios han demostrado la participación del sistema renina angiotensina en la patogenia de la fibrilación auricular, y en varios de estos, se especula el mecanismo subyacente que involucra un proceso de remodelación del tejido auricular. Objetivo: exponer literatura relacionada con los mecanismos fisiopatológicos de la Fibrilación Auricular, su impacto en el riesgo cardiovascular, y aspectos relacionados entre angiotensina II y fibrilación auricular. Métodos: se llevó a cabo una revisión no sistemática de la literatura utilizando términos clave tales como “Atrial Fibrillation” y “Angiotensin II”, además de sinónimos, los cuales fueron combinados con los conectores “AND” y “OR”, tanto en inglés como en español, en las bases de datos PubMed, ScienceDirect, Embase, EBSCO, y MEDLINE. Resultados: la fibrosis atrial constituye una alteración estructural que propicia el mantenimiento de la Fibrilación Auricular, y la Angiotensina II contribuye en este proceso ampliamente mediante la estimulación de procesos inflamatorios, disminución en la actividad de colagenasa, aumento en la expresión de MAPK, y cambios en las propiedades electrofisiológicas cardíacas a través de la unión al receptor AT1. Conclusiones: conocer la fisiopatología de la fibrilación auricular a nivel molecular, permite dilucidar aún más el contexto y las posibles complicaciones de los pacientes afectados, facilitando la generación de hipótesis que contribuyan al diagnóstico oportuno, preciso y efectivo, el desarrollo de nuevas dianas terapéuticas, así como un mejor enfoque en el área clínica.

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Atrial Fibrillation Pathophysiology and Prognosis

Cited by 13 publications

References 112 publications

Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

Atrial Fibrillation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

News on angiotensin II and atrial fibrillation : from the molecular to the pathophysiological.

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