scholarly journals Atrial Cardiomyopathy and Atrial Fibrillation in Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mengdi Ren ◽  
Yu Yao ◽  
Xin Yue ◽  
Yuye Ning ◽  
Yan Yang
Keyword(s):  
Atrial Fibrillation ◽  
Current Literature ◽  
Atrial Remodeling ◽  
Number Of Patients ◽  
Anticancer Treatment ◽  
Underlying Mechanisms

The number of patients with oncologic and cardiologic comorbidities is increasing. A growing number of evidence shows an inextricable link between cancer, atrial fibrillation, and atrial cardiomyopathy. Cancer itself and resultant inflammation, anticancer treatment, and other comorbidities lead to atrial remodeling and fibrosis, which increases the tendency to develop atrial cardiomyopathy and atrial fibrillation. The scarcity of current literature and ambiguous results make its relationship difficult to fully understand. In this review, we will summarize existing evidence of the relationships and interactions among cancer, atrial cardiomyopathy, and atrial fibrillation and discuss the underlying mechanisms, and provide better information for the management of these patients.

Ion Channel Remodelling in Atrial Fibrillation

2011 ◽  
Vol 7 (2) ◽  
pp. 97 ◽  
Author(s):  
Niels Voigt ◽  
Dobromir Dobrev ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Ion Channel ◽  
Antiarrhythmic Drugs ◽  
Current Knowledge ◽  
Bleeding Complications ◽  
Large Size ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
Life Threatening ◽  
Underlying Mechanisms

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.

Biomarkers of Atrial Fibrillation in Hypertension

2019 ◽  
Vol 26 (5) ◽  
pp. 888-897 ◽  
Author(s):  
Costas Tsioufis ◽  
Dimitris Konstantinidis ◽  
Ilias Nikolakopoulos ◽  
Evi Vemmou ◽  
Theodoros Kalos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Ventricular ◽  
P Wave ◽  
Diagnostic Tools ◽  
Atrial Remodeling ◽  
Hypertensive Patients ◽  
Risk Patients ◽  
Underlying Mechanisms ◽  
Prompt Diagnosis ◽  
The Ideal

Background: Atrial fibrillation (AF) is the most frequently encountered cardiac arrhythmia globally and substantially increases the risk for thromboembolic disease. Albeit, 20% of all cases of AF remain undiagnosed. On the other hand, hypertension amplifies the risk for both AF occurrences through hemodynamic and non-hemodynamic mechanisms and cerebrovascular ischemia. Under this prism, prompt diagnosis of undetected AF in hypertensive patients is of pivotal importance. Method: We conducted a review of the literature for studies with biomarkers that could be used in AF diagnosis as well as in predicting the transition of paroxysmal AF to sustained AF, especially in hypertensive patients. Results: Potential biomarkers for AF can be broadly categorized into electrophysiological, morphological and molecular markers that reflect the underlying mechanisms of adverse atrial remodeling. We focused on P-wave duration and dispersion as electrophysiological markers, and left atrial (LA) and LA appendage size, atrial fibrosis, left ventricular hypertrophy and aortic stiffness as structural biomarkers, respectively. The heterogeneous group of molecular biomarkers of AF encompasses products of the neurohormonal cascade, including NT-pro BNP, BNP, MR-pro ANP, polymorphisms of the ACE and convertases such as corin and furin. In addition, soluble biomarkers of inflammation (i.e. CRP, IL-6) and fibrosis (i.e. TGF-1 and matrix metalloproteinases) were assessed for predicting AF. Conclusion: The reviewed individual biomarkers might be a valuable addition to current diagnostic tools but the ideal candidate is expected to combine multiple indices of atrial remodeling in order to effectively detect both AF and adverse characteristics of high risk patients with hypertension.

scholarly journals Atrial Fibrillation Progression Is Associated with Cell Senescence Burden as Determined by p53 and p16 Expression

2019 ◽  
Vol 9 (1) ◽  
pp. 36
Author(s):  
Laurence Jesel ◽  
Malak Abbas ◽  
Sin-Hee Park ◽  
Kensuke Matsushita ◽  
Michel Kindo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Right Atrial ◽  
Atrial Remodeling ◽  
Inflammatory Proteins ◽  
Underlying Mechanisms ◽  
The Right ◽  
New Evidence

Background: Whilst the link between aging and thrombogenicity in atrial fibrillation (AF) is well established, the cellular underlying mechanisms are unknown. In AF, the role of senescence in tissue remodeling and prothrombotic state remains unclear. Aims: We investigated the link between AF and senescence by comparing the expression of senescence markers (p53 and p16), with prothrombotic and inflammatory proteins in right atrial appendages from patients in AF and sinus rhythm (SR). Methods: The right atrial appendages of 147 patients undergoing open-heart surgery were harvested. Twenty-one non-valvular AF patients, including paroxysmal (PAF) or permanent AF (PmAF), were matched with 21 SR patients according to CHA2DS2-VASc score and treatment. Protein expression was assessed by tissue lysates Western blot analysis. Results: The expression of p53, p16, and tissue factor (TF) was significantly increased in AF compared to SR (0.91 ± 0.31 vs. 0.58 ± 0.31, p = 0.001; 0.76 ± 0.32 vs. 0.35 ± 0.18, p = 0.0001; 0.88 ± 0.32 vs. 0.68 ± 0.29, p = 0.045, respectively). Expression of endothelial NO synthase (eNOS) was lower in AF (0.25 ± 0.15 vs. 0.35 ± 0.12, p = 0.023). There was a stepwise increase of p53, p16, TF, matrix metalloproteinase-9, and an eNOS progressive decrease between SR, PAF, and PmAF. AF was the only predictive factor of p53 and p16 elevation in multivariate analysis. Conclusions: The study brought new evidence indicating that AF progression is strongly related to human atrial senescence burden and points at a link between senescence, thrombogenicity, endothelial dysfunction and atrial remodeling.

scholarly journals Atrial Remodeling in Atrial Fibrillation. Comorbidities and Markers of Disease Progression Predict Catheter Ablation Outcome

2020 ◽  
Vol 16 ◽  
Author(s):  
Judit Szilágyi ◽  
László Sághy
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Disease Progression ◽  
Patient Selection ◽  
Atrial Remodeling ◽  
Supraventricular Arrhythmia ◽  
Improve Patient Selection ◽  
Number Of Patients ◽  
Improve Patient

: Atrial fibrillation is the most common supraventricular arrhythmia affecting an increasing proportion of the population in which the mainstream therapy, catheter ablation provides freedom from arrhythmia for only a limited number of patients. Understanding the mechanism is key in order to find more effective therapies and to improve patient selection. In this review, we will detail the structural and electrophysiological changes of the atrial musculature that constitute atrial remodeling in atrial fibrillaton and how risk factors and markers of disease progression can predict catheter ablation outcome.

scholarly journals Electroanatomic substrate of atrial fibrillation in patients after COVID-19

2021 ◽  
Vol 26 (7) ◽  
pp. 4526
Author(s):  
An. M. Osadchy ◽  
V. V. Semenyuta ◽  
A. V. Kamenev ◽  
S. G. Shcherbak ◽  
D. S. Lebedev
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Fibrous Tissue ◽  
Left Atrial Volume ◽  
Diffuse Fibrosis ◽  
Control Group ◽  
Atrial Remodeling ◽  
Number Of Patients ◽  
First Time

Aim. To determine the features of left atrial electroanatomic structure and the arrhythmia substrate in patients with atrial fibrillation (AF) after coronavirus disease 2019 (COVID-19).Material and methods. The pilot study included 20 patients with AF who underwent catheter radiofrequency ablation. Ten patients had COVID-19 and 10 patients were included as a control group. AF substrate was identified using anatomic and bipolar mapping. Zones with following amplitudes were analyzed: <0,25 mV, <0,5 mV, from 0,5 to 0,75 mV inclusive, and >0,75 mV. Left atrial volume was determined based on anatomic map.Results. The groups were homogeneous in AF type, number of patients after prior pulmonary vein isolation, and heart rate during mapping. In the COVID-19 group, there was a higher area of fibrous zones with an amplitude of <0,25 mV (51,5±16,6% vs 29,1±16,1% in the control group, p=0,007), <0,5 mV (76,7±11,5% vs 45,6±22,7% in the control group, p=0,001) and a lower area of intact myocardium with an amplitude >0,75 mV (11,6±8,0% vs 45,0±25,0% in the control group, p=0,001). In 7 COVID-19 patients, the posterior wall was isolated due to low-amplitude zones. Of these, three patients underwent surgery for the first time. According to ROC analysis, in patients after COVID-19, fibrous tissue (<0,5 mV) occupies more than half of the area, while normal tissue (>0,75 mV) — ~30% or less.Conclusion. This study shows that SARS-CoV-2 infection may cause left atrial remodeling in the form of diffuse fibrosis. The arrhythmia substrate in patients after COVID-19 can be localized not only in pulmonary vein mouths, but also in other left atrial areas. This must be taken into account before ablation, even if the procedure is being performed for the first time. It is recommended to perform amplitude mapping for all patients who have had SARS-CoV-2 infection in order to identify fibrous zones and plan the operation extent.

Inflammatory Biomarkers in Atrial Fibrillation

2019 ◽  
Vol 26 (5) ◽  
pp. 837-854 ◽  
Author(s):  
Effimia Zacharia ◽  
Nikolaos Papageorgiou ◽  
Adam Ioannou ◽  
Gerasimos Siasos ◽  
Spyridon Papaioannou ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Plasma Levels ◽  
Large Scale ◽  
Inflammatory Biomarkers ◽  
Inflammatory Pathways ◽  
Inflammatory State ◽  
Anti Inflammatory ◽  
Underlying Mechanisms

During the last few years, a significant number of studies have attempted to clarify the underlying mechanisms that lead to the presentation of atrial fibrillation (AF). Inflammation is a key component of the pathophysiological processes that lead to the development of AF; the amplification of inflammatory pathways triggers AF, and, in tandem, AF increases the inflammatory state. Indeed, the plasma levels of several inflammatory biomarkers are elevated in patients with AF. In addition, the levels of specific inflammatory biomarkers may provide information regarding to the AF duration. Several small studies have assessed the role of anti-inflammatory treatment in atrial fibrillation but the results have been contradictory. Large-scale studies are needed to evaluate the role of inflammation in AF and whether anti-inflammatory medications should be routinely administered to patients with AF.

scholarly journals Tips and Pearls for Tracheostomy during the Covid-19 Pandemic

2021 ◽  
Vol 25 (03) ◽  
pp. e459-e462
Author(s):  
Darwin Kaushal ◽  
Shilpa Goyal ◽  
Nithin Prakasan Nair ◽  
Kapil Soni ◽  
Bikram Choudhury ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Present Article ◽  
Critically Ill ◽  
Current Literature ◽  
Literature Search ◽  
Scientific Evidence ◽  
Early Tracheostomy ◽  
Life Saving ◽  
Number Of Patients ◽  
Elective Tracheostomy

AbstractThe number of critically-ill coronavirus disease 2019 (Covid-19) patients requiring mechanical ventilation is on the rise. Most guidelines suggest keeping the patient intubated and delay elective tracheostomy. Although the current literature does not support early tracheostomy, the number of patients undergoing it is increasing. During the pandemic, it is important that surgeons and anesthesiologists know the different aspects of tracheostomy in terms of indication, procedure, tube care and complications. A literature search was performed to identify different guidelines and available evidence on tracheostomy in Covid-19 patients. The purpose of the present article is to generate an essential scientific evidence for life-saving tracheostomy procedures.

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