Atrial enlargement in response to pathological stimuli (e.g., hypertension, mitral valve disease) and physiological stimuli (exercise, pregnancy) can be comparable in magnitude, but the diseased enlarged atria is associated with complications such as atrial fibrillation (AF), whereas physiological atrial enlargement is not. Pathological atrial enlargement and AF is also observed in a small percentage of athletes undergoing extreme/intense endurance sport and pregnant women with preeclampsia. Differences between physiological and pathological atrial enlargement and underlying mechanisms are poorly understood. This review describes human and animal studies characterizing atrial enlargement under physiological and pathological conditions and highlights key knowledge gaps and clinical challenges, including: 1) the limited ability of atria to reverse remodel; and 2) distinguishing physiological and pathological enlargement via imaging/biomarkers. Finally, this review discusses how targeting distinct molecular mechanisms underlying physiological and pathological atrial enlargement could provide new therapeutic and diagnostic strategies for preventing or reversing atrial enlargement and AF.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jacc.2021.04.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Efficacy and Safety of Cardiac Myosin Inhibitors Versus Placebo in Patients with Symptomatic Obstructive Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials.
Am J Cardiol
January 2025
Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, Massachusetts, USA. Electronic address: https://twitter.com/AGoldsweig.
Introduction: Obstructive hypertrophic cardiomyopathy (oHCM) is a genetic disorder characterized by myocardial hypertrophy, which can obstruct left ventricular outflow. Cardiac myosin inhibitors (CMIs) have emerged as a novel therapeutic agent targeting cardiac muscle hypercontractility.
Objective: To compare the efficacy and safety of CMIs mavacamten and aficamten vs.
Inhibition of P2X7 receptor mitigates atrial fibrillation susceptibility in isoproterenol-induced rats.
Biochem Biophys Res Commun
January 2025
Department of Cardiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China. Electronic address:
Background: Atrial fibrillation (AF) is a common cardiac arrhythmia that is characterized by atrial electrical remodeling. The P2X7 receptor (P2X7R), an ATP-gated ion channel, has been implicated in cardiovascular pathologies; however, its role in atrial electrical remodeling remains unclear. This study investigated whether inhibition of P2X7R could mitigate isoproterenol (ISO)-induced atrial electrical remodeling in rats and explored the underlying mechanisms.
View Article and Find Full Text PDFSnare-Assisted Flexion of 27-French Leadless Pacemaker Delivery Sheath: A Case Report.
J Cardiovasc Electrophysiol
January 2025
TriHealth Heart & Vascular Institute, Cincinnati, Ohio, USA.
Introduction: A leadless pacemaker (LLPM) was recommended for a patient with intermittent complete heart block and near-syncope.
Methods And Results: Delivery of LLPM is through a large sheath that has limited deflection and steerability. This report describes the successful deployment of a ventricular LLPM in a patient with prior surgical correction of AV septal defect with subsequent significant right atrial enlargement.
Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure.
J Cardiothorac Surg
January 2025
Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
The Cox-Maze IV (CMIV) procedure is the mainstay in surgical treatment of atrial fibrillation (AF), but the rate of AF recurrence after the CMIV procedure in patients with persistent AF is difficult to accurately evaluate. In this study, we aimed to develop and validate a risk prediction model of AF recurrence within 1 year after undergoing the Cox-Maze IV procedure. We retrospectively enrolled 303 consecutive patients who underwent the Cox-Maze IV procedure for persistent AF concomitant with other cardiac procedures at our institute between 2019 and 2021.
View Article and Find Full Text PDFLeft Ventricular Hemodynamic Forces Changes in Fabry Disease: A Cardiac Magnetic Resonance Study.
J Magn Reson Imaging
January 2025
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Hemodynamic force (HDF) from cardiac MRI can indicate subclinical myocardial dysfunction, and help identify early cardiac changes in patients with Fabry disease (FD). The hemodynamic change in FD patients remains unclear.
Purpose: To explore HDF changes in FD and the potential of HDF measurements as diagnostic markers indicating early cardiac changes in FD.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!