Cardiac Fibrosis in Patients With Atrial Fibrillation Mechanisms and Clinical Implications

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:66

Review

Dzeshka, Mikhail S.^1,2  Lip, Gregory Y. H.^1,3  Snezhitskiy, Viktor²  Shantsila, Eduard¹ 

[1] Univ Birmingham, City Hosp, Ctr Cardiovasc Sci, Birmingham B18 7QH, W Midlands, England

[2] Grodno State Med Univ, Grodno, BELARUS

[3] Aalborg Univ, Thrombosis Res Unit, Dept Clin Med, Aalborg, Denmark

关键词: cardiac;    extracellular matrix;    heart failure;    myocytes;    myofibroblasts;   

DOI  :  10.1016/j.jacc.2015.06.1313

来源: Elsevier

【 摘 要 】

Atrial fibrillation (AF) is associated with structural, electrical, and contractile remodeling of the atria. Development and progression of atrial fibrosis is the hallmark of structural remodeling in AF and is considered the substrate for AF perpetuation. In contrast, experimental and clinical data on the effect of ventricular fibrotic processes in the pathogenesis of AF and its complications are controversial. Ventricular fibrosis seems to contribute to abnormalities in cardiac relaxation and contractility and to the development of heart failure, a common finding in AF. Given that AF and heart failure frequently coexist and that both conditions affect patient prognosis, a better understanding of the mutual effect of fibrosis in AF and heart failure is of particular interest. In this review paper, we provide an overview of the general mechanisms of cardiac fibrosis in AF, differences between fibrotic processes in atria and ventricles, and the clinical and prognostic significance of cardiac fibrosis in AF. (C) 2015 by the American College of Cardiology Foundation.

【 授权许可】

Free