Triggers for Atrial Fibrillation: The Role of Anxiety

Severino, Paolo; Mariani, Marco Valerio; Maraone, Annalisa; Piro, Agostino; Ceccacci, Andrea; Tarsitani, Lorenzo; Maestrini, Viviana; Mancone, Massimo; Pasquini, Massimo; Fedele, Francesco

doi:10.1155/2019/1208505

Cited by 61 publications

(68 citation statements)

References 46 publications

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“…Many studies have been performed in regard to the mechanism and therapeutic strategies of AF. Multiple factors, including advancing age, male sex, obesity, heart failure, obstructive sleep apnea, anxiety, systemic arterial hypertension, and biomarkers such as N-terminal pro-Btype natriuretic peptide (NT-proBNP), have been identified as factors correlated with AF development [12][13][14][15]. Our study showed that the level of plasma Neu5Ac was significantly higher in the AF group than in the control group, indicating that Neu5Ac was significantly correlated with AF.…”

Section: Discussionmentioning

confidence: 63%

Serum N-Acetylneuraminic Acid Is Associated with Atrial Fibrillation and Left Atrial Enlargement

Xie

Zhu

et al. 2020

Cardiology Research and Practice

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Purpose. Recent studies have indicated that N-acetylneuraminic acid (Neu5Ac) plays a key role in severe coronary artery diseases, involving RhoA signaling pathway activation, which is critically involved in cardiac fibrosis. There is convincing evidence from many studies that left atrium fibrosis is involved in the pathophysiology of AF. Therefore, we speculated that Neu5Ac may be associated with atrial fibrillation (AF) and involved in the development of AF. This study aims to investigate the clinical relationship between Neu5Ac and AF and left atrial enlargement. Methods. Forty-five patients with AF (AF group) and forty-five patients with non-AF (control group) matched for age, sex, and hospitalization date were recruited for our study. Plasma concentrations of Neu5Ac from peripheral venous blood were analyzed using enzyme-linked immunosorbent assay (ELISA). The baseline characteristics, plasma level of Neu5Ac, and echocardiographic characteristics were evaluated. Results. The plasma level of Neu5Ac was significantly higher in the AF group than in the control group (107.66 ± 47.50 vs 77.87 ± 39.09 ng/ml; P<0.05); the left atrial diameters were positively correlated with the plasma Neu5Ac level (R = 0.255; P<0.05). The plasma Neu5Ac level (R = 0.368; P<0.05) and the left atrial diameters (R = 0.402; P<0.05) were positively correlated with AF history times. Neu5Ac (odds ratio 1.018, 95% CI 1.003–1.032; P<0.05) and the left atrial diameter (odds ratio 1.142, 95% CI 1.020–1.280; P<0.05) were independent risk factors for AF in multivariate regression analysis. Conclusions. Serum Neu5Ac is associated with atrial fibrillation, and the mechanism may involve left atrial enlargement.

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Section: Discussionmentioning

confidence: 63%

Serum N-Acetylneuraminic Acid Is Associated with Atrial Fibrillation and Left Atrial Enlargement

Xie

Zhu

et al. 2020

Cardiology Research and Practice

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“…Therefore, it is important to decipher pathophysiological mechanisms that underlie the heart damage [69][70][71]; also, it is fundamental to identify any involvement of systemic organs [72][73][74][75]. In the management of patients with HF, instead of utilizing the new ESC classification of preserved, mid-range, and reduced LVEF to identify HF patients, we propose an alternate approach by HLM classification and multimodality imaging.…”

Section: Heart Failure Classification Beyond Ejection Fractionmentioning

confidence: 99%

Structural and myocardial dysfunction in heart failure beyond ejection fraction

et al. 2019

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Heart failure is a multifaceted syndrome addressing for a high rate of death among the general population. The common approach to this disease has been always based on the evaluation of the left ventricular ejection fraction by two-dimensional echocardiography with Simpson's method. Mounting evidences have demonstrated the pitfalls of this method and have suggested that the management of heart failure requires a deep knowledge of the pathophysiological insights of the disease and cannot rely only on the evaluation of the left ventricular ejection fraction. Several advanced imaging technologies overwhelm the evaluation of ejection fraction and could provide a better understanding of the myocardial abnormalities underlying heart failure. Considering the limitation of left ventricular ejection fraction and the systemic involvement of heart failure, classifications of heart failure based on ejection fraction should be substituted with a comprehensive "staging" of multiorgan damage, not only considering the heart but also the lungs, kidneys, and liver, such as the HLM staging system. Such a holistic approach based on the HLM staging system and multimodality imaging can provide a global assessment of patient features allowing for targeted therapies and better heart failure management.

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“…AdHF is considered an unstable condition where standard treatment is, by definition, insufficient, and additional interventions must be considered [35][36][37]. Certainly, severe symptoms, such as dyspnea and/or fatigue at rest or with minimal exertion, are keys for identifying AdHF [33].…”

Section: Adhf and End-stage Hf: Difference In Clinical And Functionalmentioning

confidence: 99%

Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist

et al. 2019

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Advanced heart failure (AdHF) represents a challenging aspect of heart failure patients. Because of worsening clinical symptoms, high rates of re-hospitalization and mortality, AdHF represents an unstable condition where standard treatments are inadequate and additional interventions must be applied. A heart transplant is considered the optimal therapy for AdHF, but the great problem linked to the scarcity of organs and long waiting lists have led to the use of mechanical circulatory support with ventricular-assist device (VAD) as a destination therapy. VAD placement improves the prognosis, functional status, and quality of life of AdHF patients, with high rates of survival at 1 year, similar to transplant. However, the key element is to select the right patient at the right moment. The complete assessment must include a careful clinical evaluation, but also take into account psychosocial factors that are of crucial importance in the out-of-hospital management. It is important to distinguish between AdHF and end-stage HF, for which advanced therapy interventions would be unreasonable due to severe and irreversible organ damage and, instead, palliative care should be preferred to improve quality of life and relief of suffering. The correct selection of patients represents a great issue to solve, both ethically and economically.

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Triggers for Atrial Fibrillation: The Role of Anxiety

Cited by 61 publications

References 46 publications

Serum N-Acetylneuraminic Acid Is Associated with Atrial Fibrillation and Left Atrial Enlargement

Serum N-Acetylneuraminic Acid Is Associated with Atrial Fibrillation and Left Atrial Enlargement

Structural and myocardial dysfunction in heart failure beyond ejection fraction

Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist

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