Atrial fibrosis in heart surgery patients

Grammer, Joachim B.; Böhm, Joachim; Dufour, Annika; Benz, Matthias; Lange, Rüdiger; Bauernschmitt, Robert

doi:10.1007/s00395-005-0515-x

Cited by 33 publications

(11 citation statements)

References 27 publications

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“…However, excluding 13 patients with an e’/a’ ratio higher than unity or all patients with an E/e’ ratio exceeding 8.5 [6] did not confirm this interpretation. An alternative explanation is that worsening of diastolic LV function leads to collagen deposition in the atria [40] with higher collagen I/III ratio [40], impairment of the atrial reservoir function [41], increase in the left atrial volume [36], deterioration of electromechanical coupling [40], and therefore to lower a’ peak velocity.…”

Section: Discussionmentioning

confidence: 99%

Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population

et al. 2016

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Current knowledge on the pathogenesis of diastolic heart failure predominantly rests on case-control studies involving symptomatic patients with preserved ejection fraction and relying on invasive diagnostic procedures including endomyocardial biopsy. Our objective was to gain insight in serum and urinary biomarkers reflecting collagen turnover and associated with asymptomatic diastolic LV dysfunction. We randomly recruited 782 Flemish (51.3% women; 50.5 years). We assessed diastolic LV function from the early and late diastolic peak velocities of the transmitral blood flow and of the mitral annulus. By sequencing urinary peptides, we identified 70 urinary collagen fragments. In serum, we measured carboxyterminal propeptide of procollagen type 1 (PICP) as marker of collagen I synthesis and tissue inhibitor of matrix metalloproteinase type 1 (TIMP-1), an inhibitor of collagen-degrading enzymes. In multivariable-adjusted analyses with Bonferroni correction, we expressed effect sizes per 1-SD in urinary collagen I (uCI) or collagen III (uCIII) fragments. In relation to uCI fragments, e’ decreased by 0.183 cm/s (95% confidence interval, 0.017 to 0.350; p = 0.025), whereas E/e’ increased by 0.210 (0.067 to 0.353; p = 0.0012). E/e’ decreased with uCIII by 0.168 (0.021 to 0.316; p = 0.018). Based on age-specific echocardiographic criteria, 182 participants (23.3%) had subclinical diastolic LV dysfunction. Partial least squares discriminant analysis contrasting normal vs. diastolic LV dysfunction confirmed the aforementioned associations with the uCI and uCIII fragments. PICP and TIMP-1 increased in relation to uCI (p<0.0001), whereas these serum markers decreased with uCIII (p≤0.0006). Diastolic LV dysfunction was associated with higher levels of TIMP-1 (653 vs. 696 ng/mL; p = 0.013). In a general population, the non-invasively assessed diastolic LV function correlated inversely with uCI and serum markers of collagen I deposition, but positively with uCIII. These observations generalise previous studies in patients to randomly recruited people, in whom diastolic LV function ranged from normal to subclinical impairment, but did not encompass overt diastolic heart failure.

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Section: Discussionmentioning

confidence: 99%

Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population

et al. 2016

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“…24 The findings of differential tissue localization of collagen subtypes observed with this technique have also been confirmed using immunohistochemical and biochemical methods. 25–27 However, as previously demonstrated in wound healing studies, it is possible to overcategorize all newly deposited fibers as collagen type III because many of these newly deposited fibers are initially loose thin fibers in the process of polymerizing into larger fibers. 23 Therefore, in this study, we could most accurately conclude that the collagen remodeling 6 weeks after the introduction of a cut or an intact sling consisted primarily of a shift in the type of collagen from type I-like fibers to type III-like fibers.…”

Section: Commentmentioning

confidence: 98%

Collagen Remodeling and Suburethral Inflammation Might Account for Preserved Anti-incontinence Effects of Cut Polypropylene Sling in Rat Model

Chen

Hijaz

Drazba

et al. 2009

Urology

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OBJECTIVES To determine whether the inflammatory responses or collagen remodeling in suburethral tissue could have contributed to the preserved anti-incontinence effects of a cut polypropylene sling. METHODS Stress urinary incontinence was created in 60 age-matched female Sprague-Dawley rats that were subsequently randomized into 3 equal-size groups according to surgical procedure: placement of a vaginal suburethral sling, placement of a vaginal suburethral sling in which the suburethral portion of the sling was immediately cut, and sham surgery without placement of the sling. In a previous study, the leak point pressure measurements were obtained on these rats 6 weeks after surgery. The rats were then killed, the urethrovaginal tissue was harvested (cross-section of the entire urethra and anterior vagina) from 30 animals (10 from each experimental group), and the tissue was stained with hematoxylin-eosin and Masson’s trichrome for histopathologic studies and picrosirius red for collagen fibers. RESULTS As previously published, the median leak point pressures were similarly and significantly increased in the rats in the intact and cut sling groups compared with those in the sham surgery group. The inflammatory mediators and interstitial edema were similarly increased in the intact and cut sling specimens compared with the sham surgery specimens. Under polarized light, picrosirius red-stained specimens from the sham surgery animals appeared to be composed of collagen that predominately birefringed red to yellow (typical of type I collagen). The picrosirius red-stained cut and intact sling specimens appeared to contain collagen fibers that predominately birefringed green (typical of type III collagen). CONCLUSIONS Histologic changes, including inflammation, localized edema, and differential collagen remodeling, might contribute to the preserved anti-incontinence mechanisms of cut or intact polypropylene slings observed clinically.

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“…Compelling evidence showed that the atrial fibrosis is essential for the onset and maintenance of AF [7]. Atrial fibrosis causes conduction abnormalities which results in an increase in AF vulnerability.…”

Section: Introductionmentioning

confidence: 99%

Association between transforming growth factor β1 polymorphisms and atrial fibrillation in essential hypertensive subjects

Wang

Hou

2010

J Biomed Sci

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BackgroundThe association of TGF β1 polymorphisms and atrial fibrillation (AF) in essential hypertensive (EH) subjects remains unknown. Methods EH subjects with AF (EH+AF+) and sinus rhythm (EH+AF-) were enrolled. The polymorphisms of +869 T → C at codon 10 and + 915 G → C at codon 25, were genotyped. The clinical characteristics including serum TGF β1 levels were detected.ResultsThe GG genotypes of TGF β1 +915 G → C at codon 25 were more prevalent in subjects from EH+AF+ group than those from EH+AF- group (P = 0.009). The subjects with GG genotype from EH+AF+ group had the highest mean serum TGF β1 level, which was significantly higher than that of GG genotype subjects from EH+AF- group (3.18 ± 0.24 ng/dl vs.2.29 ± 0.14 ng/dl, P < 0.05). Multiple analyses revealed that the TGF β1 GG genotype of +915 G → C at codon 25 presented a 3.09 times higher risk in developing AF in the multivariate model after adjusting for age and gender.ConclusionThe polymorphisms of TGF β1 +915 G → C at codon 25 were associated with occurrence of AF and serum TGF β1 level in EH subjects.

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Atrial fibrosis in heart surgery patients

Cited by 33 publications

References 27 publications

Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population

Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population

Collagen Remodeling and Suburethral Inflammation Might Account for Preserved Anti-incontinence Effects of Cut Polypropylene Sling in Rat Model

Association between transforming growth factor β1 polymorphisms and atrial fibrillation in essential hypertensive subjects

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