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A Review on Atrial Fibrillation (Computer Simulation and Clinical Perspectives). HEARTS 2022. [DOI: 10.3390/hearts3010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Atrial fibrillation (AF), a heart condition, has been a well-researched topic for the past few decades. This multidisciplinary field of study deals with signal processing, finite element analysis, mathematical modeling, optimization, and clinical procedure. This article is focused on a comprehensive review of journal articles published in the field of AF. Topics from the age-old fundamental concepts to specialized modern techniques involved in today’s AF research are discussed. It was found that a lot of research articles have already been published in modeling and simulation of AF. In comparison to that, the diagnosis and post-operative procedures for AF patients have not yet been totally understood or explored by the researchers. The simulation and modeling of AF have been investigated by many researchers in this field. Cellular model, tissue model, and geometric model among others have been used to simulate AF. Due to a very complex nature, the causes of AF have not been fully perceived to date, but the simulated results are validated with real-life patient data. Many algorithms have been proposed to detect the source of AF in human atria. There are many ablation strategies for AF patients, but the search for more efficient ablation strategies is still going on. AF management for patients with different stages of AF has been discussed in the literature as well but is somehow limited mostly to the patients with persistent AF. The authors hope that this study helps to find existing research gaps in the analysis and the diagnosis of AF.
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Li B, Luo F, Luo X, Li B, Qi L, Zhang D, Tang Y. Effects of atrial fibrosis induced by mitral regurgitation on atrial electrophysiology and susceptibility to atrial fibrillation in pigs. Cardiovasc Pathol 2019; 40:32-40. [DOI: 10.1016/j.carpath.2019.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 01/28/2023] Open
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Ruaengsri C, Schill MR, Lancaster TS, Khiabani AJ, Manghelli JL, Carter DI, Greenberg JW, Melby SJ, Schuessler RB, Damiano RJ. The hemodynamic and atrial electrophysiologic consequences of chronic left atrial volume overload in a controllable canine model. J Thorac Cardiovasc Surg 2018; 156:1871-1879.e1. [PMID: 30336917 DOI: 10.1016/j.jtcvs.2018.05.078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the effects of chronic left atrial volume overload on atrial anatomy, hemodynamics, and electrophysiology using a titratable left ventriculoatrial shunt in a canine model. METHODS Canines (n = 16) underwent implantation of a shunt between the left ventricle and the left atrium. Sham animals (n = 8) underwent a median sternotomy without a shunt. Atrial activation times and effective refractory periods were determined using 250-bipolar epicardial electrodes. Biatrial pressures, systemic pressures, left atrial and left ventricle diameters and volumes, atrial fibrillation inducibility, and durations were recorded at the initial and at 6-month terminal study. RESULTS Baseline shunt fraction was 46% ± 8%. The left atrial pressure increased from 9.7 ± 3.5 mm Hg to 13.8 ± 4 mm Hg (P < .001). At the terminal study, the left atrial diameter increased from a baseline of 2.9 ± 0.05 cm to 4.1 ± 0.6 cm (P < .001) and left ventricular ejection fraction decreased from 64% ± 1.5% to 54% ± 2.7% (P < .001). Induced atrial fibrillation duration (median, range) was 95 seconds (0-7200) compared with 0 seconds (0-40) in the sham group (P = .02). The total activation time was longer in the shunt group compared with the sham group (72 ± 11 ms vs 62 ± 3 ms, P = .003). The right atrial and not left atrial effective refractory periods were shorter in the shunt compared with the sham group (right atrial effective refractory period: 156 ± 11 ms vs 141 ± 11 ms, P = .005; left atrial effective refractory period: 142 ± 23 ms vs 133 ± 11 ms, P = .35). CONCLUSIONS This canine model of mitral regurgitation reproduced the mechanical and electrical remodeling seen in clinical mitral regurgitation. Left atrial size increased, with a corresponding decrease in left ventricle systolic function, and an increased atrial activation times, lower effective refractory periods, and increased atrial fibrillation inducibility. This model provides a means to understand the remodeling by which mitral regurgitation causes atrial fibrillation.
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Affiliation(s)
- Chawannuch Ruaengsri
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo; Division of Cardiothoracic Surgery, Department of Surgery, Mahidol University, Ramathibodi Hospital, Bangkok, Thailand
| | - Matthew R Schill
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Timothy S Lancaster
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Ali J Khiabani
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Joshua L Manghelli
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Daniel I Carter
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Jason W Greenberg
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Spencer J Melby
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Richard B Schuessler
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo
| | - Ralph J Damiano
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
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Sun SJ, Yao JL, Xu LB, Rui Q, Zhang NN, Chen M, Jiang YF, Yang HJ, Zhou YF. Cardiac structural remodeling in hypertensive cardiomyopathy. Hypertens Res 2016; 40:450-456. [PMID: 28003648 DOI: 10.1038/hr.2016.169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/24/2016] [Accepted: 10/21/2016] [Indexed: 12/28/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF), which is a primary driver of morbidity and mortality, accounts for approximately half of all heart failure cases. Therefore, it is essential to develop preclinical animal models for HFpEF pharmacological treatment strategies. We created a porcine model of severe hypertension and hyperlipidemia by using a combination of deoxycorticosterone acetate (DOCA, 100 mg kg-1), Western diet (WD) and angiotensin II infusion. Systolic blood pressure, echocardiography and invasive pressure-volume loop were assessed at baseline, 12 weeks and 18 weeks. A detailed histological assessment was also performed to determine the cardiac structural remodeling. Compared with controls (n=10), hypertensive animals (n=10) showed markedly higher systolic blood pressure (181 vs. 86 mm Hg) at 18 weeks. Concentric remodeling, characterized by a normal chamber size with a thicker wall, was observed in hypertensive animals. Left ventricle diastolic function showed a tendency toward decline, according to the echocardiographic data. Hemodynamic data showed that the end-diastolic pressure-volume relationship was elevated without changes in the end-systolic pressure-volume relationship. Histological results revealed that the fibrotic area in hypertensive animals (P<0.05 vs. controls) and the fibrotic area in the posterior wall of hypertensive animals' left atria were larger than other sites of the left atria (P<0.05 vs. other sites). This model can mimic clinical HFpEF to some degree. We found that the posterior wall of the left atrium is more susceptible to atrial remodeling associated with hypertension compared with other regions of the left atrium.
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Affiliation(s)
- Si-Jia Sun
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Jia-Lu Yao
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.,Department of Cardiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Lang-Biao Xu
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Qing Rui
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Nan-Nan Zhang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Min Chen
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Yu-Feng Jiang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Hua-Jia Yang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
| | - Ya-Feng Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China
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Evaluation of Atrial Conduction Times, Epicardial Fat Thickness and Carotid Intima-Media Thickness in Patients With Ankylosing Spondylitis. Arch Rheumatol 2016; 31:353-358. [PMID: 29901030 DOI: 10.5606/archrheumatol.2016.5867] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 12/22/2016] [Indexed: 01/20/2023] Open
Abstract
Objectives This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature. Patients and methods The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3±8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2±8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups. Results Interatrial (29.5±5.8 ms vs. 17.9±5.3 ms) left and right intraatrial EMD (18.2±4.6 ms and 11.7±3.5 ms vs. 11.9±3.2 ms and 7.1±3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50±0.11 mm and 0.44±0.06 mm vs. 0.51±0.11 mm and 0.43±0.04 mm, respectively) and EFT (0.73±0.15 cm and 0.63±0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01). Conclusion To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.
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Cardiac pathology in Irish wolfhounds with heart disease. J Vet Cardiol 2016; 18:57-70. [DOI: 10.1016/j.jvc.2015.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/04/2015] [Accepted: 10/07/2015] [Indexed: 11/15/2022]
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Altun B, Tasolar H, Gazï E, Gungor AC, Uysal A, Temïz A, Barutcu A, Acar G, Colkesen Y, Ozturk U, Akkoy M. Atrial electromechanical coupling intervals in pregnant subjects. Cardiovasc J Afr 2014; 25:15-20. [PMID: 24626515 PMCID: PMC3959184 DOI: 10.5830/cvja-2013-085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 11/29/2013] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate atrial conduction abnormalities obtained by tissue Doppler imaging (TDI) and electrocardiogram analysis in pregnant subjects. METHODS A total of 30 pregnant subjects (28 ± 4 years) and 30 controls (28 ± 3 years) were included. Systolic and diastolic left ventricular (LV) function was measured using conventional echocardiography and TDI. Inter-atrial, intraatrial and intra-left atrial electromechanical coupling (PA) intervals were measured with TDI. P-wave dispersion (PD) was calculated from a 12-lead electrocardiogram. RESULTS Atrial electromechanical coupling at the septal and left lateral mitral annulus (PA septal, PA lateral) was significantly prolonged in pregnant subjects (62.1 ± 2.7 vs 55.3 ±3.2 ms, p < 0.001; 45.7 ± 2.5 vs 43.1 ± 2.7 ms, p < 0.001, respectively). Inter-atrial (PA lateral - PA tricuspid), intra-atrial (PA septum - PA tricuspid) and intra-left atrial (PA lateral - PA septum) electromechanical coupling intervals, maximum P-wave (Pmax) duration and PD were significantly longer in the pregnant subjects (26.4 ± 4.0 vs 20.2 ± 3.6 ms, p < 0.001; 10.0 ± 2.0 vs 8.0 ± 2.6 ms, p = 0.002; 16.4 ± 3.3 vs 12.2 ± 3.0 ms, p < 0.001; 103.1 ± 5.4 vs 96.8 ± 7.4 ms, p ± 0.001; 50.7 ± 6.8 vs 41.6 ± 5.5 ms, p < 0.001, respectively). We found a significant positive correlation between inter-atrial and intraleft atrial electromechanical coupling intervals and Pmax (r = 0.282, p = 0.029, r = 0.378, p = 0.003, respectively). CONCLUSION This study showed that atrial electromechanical coupling intervals and PD, which are predictors of AF, were longer in pregnant subjects and this may cause an increased risk of AF in pregnancy.
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Affiliation(s)
- Burak Altun
- Department of Cardiology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Hakan Tasolar
- Department of Cardiology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Emïne Gazï
- Department of Cardiology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Aysenur Cakir Gungor
- Department of Obstetrics and Gynecology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ahmet Uysal
- Department of Obstetrics and Gynecology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ahmet Temïz
- Department of Obstetrics and Gynecology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ahmet Barutcu
- Department of Cardiology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Gurkan Acar
- Department of Cardiology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Yucel Colkesen
- Department of Cardiology, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ufuk Ozturk
- Department of Cardiology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Murat Akkoy
- Department of Cardiology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Balouch MA, Kolek MJ, Darbar D. Improved understanding of the pathophysiology of atrial fibrillation through the lens of discrete pathological pathways. Glob Cardiol Sci Pract 2014; 2014:24-36. [PMID: 25054116 PMCID: PMC4104374 DOI: 10.5339/gcsp.2014.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/19/2014] [Indexed: 12/19/2022] Open
Abstract
Atrial fibrillation (AF) is a common disorder with a complex and incompletely understood pathophysiology. Genetic approaches to understanding the pathophysiology of AF have led to the identification of several biological pathways important in the pathogenesis of the arrhythmia. These include pathways important for cardiac development, generation and propagation of atrial electrical impulses, and atrial remodeling and fibrosis. While common and rare genetic variants in these pathways are associated with increased susceptibility to AF, they differ substantially among patients with lone versus typical AF. Furthermore, how these pathways converge to a final common clinical phenotype of AF is unclear and might also vary among different patient populations. Here, we review the contemporary knowledge of AF pathogenesis and discuss how derangement in cardiac development, ion channel dysfunction, and promotion of atrial fibrosis may contribute to this common and important clinical disorder.
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Affiliation(s)
- Muhammad A Balouch
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew J Kolek
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dawood Darbar
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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McGann C, Akoum N, Patel A, Kholmovski E, Revelo P, Damal K, Wilson B, Cates J, Harrison A, Ranjan R, Burgon NS, Greene T, Kim D, Dibella EVR, Parker D, Macleod RS, Marrouche NF. Atrial fibrillation ablation outcome is predicted by left atrial remodeling on MRI. Circ Arrhythm Electrophysiol 2013; 7:23-30. [PMID: 24363354 DOI: 10.1161/circep.113.000689] [Citation(s) in RCA: 283] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Although catheter ablation therapy for atrial fibrillation (AF) is becoming more common, results vary widely, and patient selection criteria remain poorly defined. We hypothesized that late gadolinium enhancement MRI (LGE-MRI) can identify left atrial (LA) wall structural remodeling (SRM) and stratify patients who are likely or not to benefit from ablation therapy. METHODS AND RESULTS LGE-MRI was performed on 426 consecutive patients with AF without contraindications to MRI before undergoing their first ablation procedure and on 21 non-AF control subjects. Patients were categorized by SRM stage (I-IV) based on the percentage of LA wall enhancement for correlation with procedure outcomes. Histological validation of SRM was performed comparing LGE-MRI with surgical biopsy. A total of 386 patients (91%) with adequate LGE-MRI scans were included in the study. After ablation, 123 patients (31.9%) experienced recurrent atrial arrhythmias during the 1-year follow-up. Recurrent arrhythmias (failed ablations) occurred at higher SRM stages with 28 of 133 (21.0%) in stage I, 40 of 140 (29.3%) in stage II, 24 of 71 (33.8%) in stage III, and 30 of 42 (71.4%) in stage IV. In multivariate analysis, ablation outcome was best predicted by advanced SRM stage (hazard ratio, 4.89; P<0.0001) and diabetes mellitus (hazard ratio, 1.64; P=0.036), whereas increased LA volume and persistent AF were not significant predictors. LA wall enhancement was significantly greater in patients with AF versus non-AF controls (16.6±11.2% versus 3.1±1.9%; P<0.0001). Histological evidence of remodeling from surgical biopsy specimens correlated with SRM on LGE-MRI. CONCLUSIONS Atrial SRM is identified on LGE-MRI, and extensive LGE (≥30% LA wall enhancement) predicts poor response to catheter ablation therapy for AF.
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Affiliation(s)
- Christopher McGann
- Comprehensive Arrhythmia Research and Management Center, Division of Cardiology, Department of Surgery, Department of Radiology, Scientific Computing and Imaging Institute, Bioengineering, Department of Pathology, and Division of Epidemiology, University of Utah Health Sciences Center, Salt Lake City
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Tekce H, Ozturk S, Aktas G, Tekce BK, Erdem A, Ozyasar M, Duman TT, Yazici M. The effects of a single dialysis session on atrial electromechanical conduction times and functions. Kidney Blood Press Res 2013; 37:622-30. [PMID: 24356552 DOI: 10.1159/000355742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Abnormalities in atrial electromechanical delay (EMD) times and mechanical functions are considered as independent predictors of atrial fibrillation. However, to date, effects of a single hemodialysis (HD) session and acute volume-preload changes on atrial-EMD functions have not been investigated by Tissue Doppler Echocardiography (TDE). The aim of the present study was to evaluate atrial-EMD times and mechanical functions in HD patients. METHODS Thirty-five non-diabetic, normotensive HD patients and 35 healthy control subjects were enrolled in the study. Standard and TDE performed before mid-week dialysis session for hemodialysis group and on admission for control group. RESULTS Interatrial and left-right intraatrial-EMD intervals and left atrial mechanical volumes were significantly longer in hemodialysis group compared to controls (all p<0.01) and were reduced after HD session. Furthermore, removed ultrafiltration volume was associated with reduction in atrial-EMD intervals and functional volumes. LA-passive emptying volume, ultrafiltration volume, LV-E/E' ratio, and Vp were independent predictors of interatrial-EMD. CONCLUSIONS The present study confirms negative effects in HD patients of structural remodeling and reveals negative effects of electrical remodeling. Prolonged inter and intraatrial-EMD intervals should be the underlying pathophysiological factors of increased rate of atrial fibrillation in the HD population.
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Affiliation(s)
- Hikmet Tekce
- Department of Nephrology, AIB University Hospital, 14280 Bolu, Turkey
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Ayhan S, Ozturk S, Alcelik A, Ozlu MF, Erdem A, Memioglu T, Ozdemir M, Yazici M. Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose. J Interv Card Electrophysiol 2012; 35:247-52; discussion 252. [DOI: 10.1007/s10840-012-9722-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 08/12/2012] [Indexed: 12/31/2022]
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Shin SY, Lim HE, Choi UJ, Choi CU, Kim SH, Kim JW, Kim EJ, Rha SW, Park CG, Seo HS, Oh DJ, Shin C, Kim YH. Impaired Transport Function of the Left Atrium in Patients with Lone Paroxysmal Atrial Fibrillation. Echocardiography 2010; 28:44-51. [DOI: 10.1111/j.1540-8175.2010.01271.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Crosara S, Borgarelli M, Perego M, Häggström J, La Rosa G, Tarducci A, Santilli RA. Holter monitoring in 36 dogs with myxomatous mitral valve disease. Aust Vet J 2010; 88:386-92. [DOI: 10.1111/j.1751-0813.2010.00628.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Crosara
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - M Borgarelli
- Department of Clinical Science, Kansas State University, 1800 Denison Ave, Manhattan, KS, USA
| | - M Perego
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Uppsala, Sweden
| | - G La Rosa
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - A Tarducci
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - RA Santilli
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
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Woodcock EA, Grubb DR, Filtz TM, Marasco S, Luo J, McLeod-Dryden TJ, Kaye DM, Sadoshima J, Du XJ, Wong C, McMullen JR, Dart AM. Selective activation of the “b” splice variant of phospholipase Cβ1 in chronically dilated human and mouse atria. J Mol Cell Cardiol 2009; 47:676-83. [DOI: 10.1016/j.yjmcc.2009.08.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 08/20/2009] [Accepted: 08/20/2009] [Indexed: 11/15/2022]
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Oakes RS, Badger TJ, Kholmovski EG, Akoum N, Burgon NS, Fish EN, Blauer JJE, Rao SN, DiBella EVR, Segerson NM, Daccarett M, Windfelder J, McGann CJ, Parker D, MacLeod RS, Marrouche NF. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation 2009; 119:1758-67. [PMID: 19307477 DOI: 10.1161/circulationaha.108.811877] [Citation(s) in RCA: 792] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is associated with diffuse left atrial fibrosis and a reduction in endocardial voltage. These changes are indicators of AF severity and appear to be predictors of treatment outcome. In this study, we report the utility of delayed-enhancement magnetic resonance imaging (DE-MRI) in detecting abnormal atrial tissue before radiofrequency ablation and in predicting procedural outcome. METHODS AND RESULTS Eighty-one patients presenting for pulmonary vein antrum isolation for treatment of AF underwent 3-dimensional DE-MRI of the left atrium before the ablation. Six healthy volunteers also were scanned. DE-MRI images were manually segmented to isolate the left atrium, and custom software was implemented to quantify the spatial extent of delayed enhancement, which was then compared with the regions of low voltage from electroanatomic maps from the pulmonary vein antrum isolation procedure. Patients were assessed for AF recurrence at least 6 months after pulmonary vein antrum isolation, with an average follow-up of 9.6+/-3.7 months (range, 6 to 19 months). On the basis of the extent of preablation enhancement, 43 patients were classified as having minimal enhancement (average enhancement, 8.0+/-4.2%), 30 as having moderate enhancement (21.3+/-5.8%), and 8 as having extensive enhancement (50.1+/-15.4%). The rate of AF recurrence was 6 patients (14.0%) with minimal enhancement, 13 (43.3%) with moderate enhancement, and 6 (75%) with extensive enhancement (P<0.001). CONCLUSIONS DE-MRI provides a noninvasive means of assessing left atrial myocardial tissue in patients suffering from AF and might provide insight into the progress of the disease. Preablation DE-MRI holds promise for predicting responders to AF ablation and may provide a metric of overall disease progression.
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Affiliation(s)
- Robert S Oakes
- Atrial Fibrillation Program, University of Utah School of Medicine, Salt Lake City, UT 84132-2400, USA
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Lim HE, Kim YH, Kim SH, Kim EJ, Pak HN, Kim YH, Baik I, Shin C. Impact of obstructive sleep apnea on the atrial electromechanical activation time. Circ J 2008; 73:249-55. [PMID: 19106459 DOI: 10.1253/circj.cj-08-0813] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is closely associated with atrial fibrillation, which is provoked by electrical and structural remodeling. However, the association between OSA and atrial remodeling has not been fully elucidated. METHODS AND RESULTS Atrial electromechanical activation time (EMAT) was investigated using tissue Doppler imaging (TDI) in men with severe OSA (n=24) and control subjects (n=24). The EMAT was determined as the time interval from the initiation of P-wave deflection until the peak of local lateral left atrial (LA) TDI signal. The early diastolic velocity of the mitral annulus (E(a)) and the EMAT were significantly lower and longer in OSA cases than in controls (E(a): 6.1+/-0.9 cm/s vs 7.3+/-1.5 cm/s, P=0.001; EMAT: 129.7+/-11.5 ms vs 118.5+/-12.3 ms, P=0.002). Among OSA cases, the apnea - hypopnea index (AHI) was significantly correlated with EMAT (r=0.660, P<0.001), E(a) (r=-0.609, P=0.002), LA dimension (r=0.486, P=0.016), and early diastolic velocity of mitral flow (E)/E(a) ratio (r=0.418, P=0.042). In multivariate stepwise linear regression analysis, EMAT was independently associated with AHI (P=0.025) and E(a) (P=0.028) in OSA cases. CONCLUSION EMAT measured by TDI could be a useful parameter for identifying atrial remodeling in patients with severe OSA.
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Affiliation(s)
- Hong Euy Lim
- Division of Cardiology, Cardiovascular Center, College of Natural Science, Kookmin University, Seoul, Korea
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