Can an increase in the pulmonary vein volume measured by three dimensional computed tomography predict the presence of atrial fibrillation?

Putative protective effects of sodium-glucose cotransporter 2 inhibitors on atrial fibrillation through risk factor modulation and off-target actions: potential mechanisms and future directions

Atrial fibrillation, the most common cardiac arrhythmia, results in substantial morbidity and mortality related to its increased risks of stroke, heart failure, and impaired cognitive function. The incidence and prevalence of atrial fibrillation in the general population is rising, making atrial fibrillation treatment and management of its risk factors highly relevant clinical targets. One well-studied risk factor for the development of atrial fibrillation is diabetes mellitus. Inhibitors of sodium-glucose cotransporter 2 (SGLT2), common medications used to treat diabetes mellitus, have been observed to decrease the incidence of atrial fibrillation. This review discusses the SGLT2 and its role in glucose homeostasis, molecules inhibiting the transporter, possible physiological mechanisms responsible for the decreased incident atrial fibrillation in patients treated with SGLT2 inhibitors and proposes mechanistic studies to further our understanding of the biological processes involved.

Fluid Retention In The Pulmonary Circulation As A Cause Of Pulmonary Vein Dilatation And Atrial Fibrillation Development In Chronic Heart Failure Patients

Objective — The study objective was to perform a transthoracic echocardiographic study of the remodeling of the left atrium and the maximum and minimum diameters of pulmonary veins, as well as remodeling regression in the process of heart failure treatment, in patients with chronic heart failure (CHF) and different forms of atrial fibrillation (AF). Material and Methods — The prospective study included patients having CHF with paroxysmal AF (n=38) and permanent AF (n=36) and without arrhythmia (n=225); the patients had their maximum and minimum diameters of the pulmonary vein measured, additionally to the standard echocardiographic protocol, before and after six months of standard therapy including a loop diuretic. Results — Structural changes in the left atrium and pulmonary veins of patients with CHF having permanent atrial fibrillation were significantly more distinct than those in patients with paroxysmal AF, in patients without arrhythmia, and in the control group. A decrease in the maximum and minimum diameters of the pulmonary vein followed by termination of AF attacks within a year of observation was detected after CHF treatment with a loop diuretic in patients with paroxysmal AF and permanent AF. Conclusion — Prescribing loop diuretics to patients with pulmonary vein dilatation detected during transthoracic echocardiography in subjects with paroxysmal AF and permanent AF results in a decrease in PV diameters and termination of AF attacks in paroxysmal AF.