Mechanisms of atrial structural changes caused by stretch occurring before and during early atrial fibrillation

被引:206
作者
De Jong, Anne Margreet [1 ,2 ]
Maass, Alexander H. [2 ,3 ]
Oberdorf-Maass, Silke U. [2 ]
Van Veldhuisen, Dirk J. [3 ]
Van Gilst, Wiek H. [1 ,2 ]
Van Gelder, Isabelle C. [1 ,3 ]
机构
[1] Interuniv Cardiol Inst Netherlands, Utrecht, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Expt Cardiol, NL-9700 AB Groningen, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Thoraxctr, NL-9700 RB Groningen, Netherlands
关键词
Atrial fibrillation; Atrium; Remodelling; Stretch; CONGESTIVE-HEART-FAILURE; ANGIOTENSIN-CONVERTING ENZYME; BRAIN NATRIURETIC PEPTIDE; STRICT RATE CONTROL; GENE-EXPRESSION; CANINE MODEL; MATRIX METALLOPROTEINASES; CONTRACTILE DYSFUNCTION; OXIDATIVE STRESS; BLOOD-PRESSURE;
D O I
10.1093/cvr/cvq357
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Structural remodelling occurring before, due to the underlying heart disease, and during atrial fibrillation (AF) sets the stage for permanent AF. Current therapy in AF aims to maintain sinus rhythm in symptomatic patients, but outcome is unfortunately poor. Stretch of the atria is a main contributor to atrial remodelling. In this review, we describe different aspects of structural remodelling as seen in animal models and in patients with AF, including atrial enlargement, cellular hypertrophy, dedifferentiation, fibrosis, apoptosis, and loss of contractile elements. In the second part, we describe downstream signals of mechanical stretch and their contribution to AF and structural remodelling. Ultimately, knowledge of mechanisms underlying structural remodelling may help to identify new pharmacological targets for AF prevention.
引用
收藏
页码:754 / 765
页数:12
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