Atrial cardiomyopathy: from cell to bedside.

Journal article


Li, Mengmeng, Ning, Yuye, Tse, Gary, Saguner, Ardan M, Wei, Meng, Day, John D, Luo, Guogang and Li, G. 2022. Atrial cardiomyopathy: from cell to bedside. ESC Heart Failure. https://doi.org/10.1002/ehf2.14089
AuthorsLi, Mengmeng, Ning, Yuye, Tse, Gary, Saguner, Ardan M, Wei, Meng, Day, John D, Luo, Guogang and Li, G.
AbstractAtrial cardiomyopathy refers to structural and electrical remodelling of the atria, which can lead to impaired mechanical function. While historical studies have implicated atrial fibrillation as the leading cause of cardioembolic stroke, atrial cardiomyopathy may be an important, underestimated contributor. To date, the relationship between atrial cardiomyopathy, atrial fibrillation, and cardioembolic stroke remains obscure. This review summarizes the pathogenesis of atrial cardiomyopathy, with a special focus on neurohormonal and inflammatory mechanisms, as well as the role of adipose tissue, especially epicardial fat in atrial remodelling. It reviews the current evidence implicating atrial cardiomyopathy as a cause of embolic stroke, with atrial fibrillation as a lagging marker of an increased thrombogenic atrial substrate. Finally, it discusses the potential of antithrombotic therapy in embolic stroke with undetermined source and appraises the available diagnostic techniques for atrial cardiomyopathy, including imaging techniques such as echocardiography, computed tomography, and magnetic resonance imaging as well as electroanatomic mapping, electrocardiogram, biomarkers, and genetic testing. More prospective studies are needed to define the relationship between atrial cardiomyopathy, atrial fibrillation, and embolic stroke and to establish a prompt diagnosis and specific treatment strategies in these patients with atrial cardiomyopathy for the secondary and even primary prevention of embolic stroke. [Abstract copyright: © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.]
KeywordsPathogenesis; Atrial cardiomyopathy; Atrial fibrillation; Embolic stroke; Diagnosis
Year2022
JournalESC Heart Failure
PublisherWiley
ISSN2055-5822
Digital Object Identifier (DOI)https://doi.org/10.1002/ehf2.14089
Official URLhttps://onlinelibrary.wiley.com/doi/full/10.1002/ehf2.14089
FunderClinical Research Center of the First Affiliated Hospital of Xi'an Jiaotong University
the Natural Science Foundation of Shaanxi Province
Publication dates
Online03 Aug 2022
Publication process dates
Deposited22 Aug 2022
Accepted10 Jul 2022
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