Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications.
Identifieur interne : 001E97 ( PubMed/Corpus ); précédent : 001E96; suivant : 001E98Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications.
Auteurs : Dennis H. Lau ; Ulrich Schotten ; Rajiv Mahajan ; Nicholas A. Antic ; Stéphane N. Hatem ; Rajeev K. Pathak ; Jeroen M L. Hendriks ; Jonathan M. Kalman ; Prashanthan SandersSource :
- European heart journal [ 1522-9645 ] ; 2016.
Abstract
Intensive research over the last few decades has seen significant advances in our understanding of the complex mechanisms underlying atrial fibrillation (AF). The epidemic of AF and related hospitalizations has been described as a 'rising tide' with estimates of the global AF burden showing no sign of retreat. There is urgency for effective translational programs in this field to facilitate more individualized and targeted therapy to modify the abnormal atrial substrate responsible for the perpetuation of this arrhythmia. In this review, we chose to focus on several novel aspects of AF pathogenesis whereby practical applications in clinical practice are currently available or potentially not too far away. Specifically, we explored the contribution of atrial fibrosis, epicardial adipose tissue, autonomic nervous system, hyper-coagulability, and focal drivers to adverse atrial remodelling and AF persistence. We also highlighted the potential practical means of monitoring and targeting these factors to achieve better outcomes in patients suffering from this debilitating illness. Emerging data also support a new paradigm for targeting AF substrate with aggressive risk factor management. Finally, multi-disciplinary integrated care approach has shown great promise in improving cardiovascular outcomes of patients with AF along with potential cost savings.
DOI: 10.1093/eurheartj/ehv375
PubMed: 26578197
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Lau</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Schotten, Ulrich" sort="Schotten, Ulrich" uniqKey="Schotten U" first="Ulrich" last="Schotten">Ulrich Schotten</name><affiliation><nlm:affiliation>Department of Physiology, Maastricht University, Maastricht, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Mahajan, Rajiv" sort="Mahajan, Rajiv" uniqKey="Mahajan R" first="Rajiv" last="Mahajan">Rajiv Mahajan</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Antic, Nicholas A" sort="Antic, Nicholas A" uniqKey="Antic N" first="Nicholas A" last="Antic">Nicholas A. Antic</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, Repatriation General Hospital and Department of Medicine, Flinders University, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hatem, Stephane N" sort="Hatem, Stephane N" uniqKey="Hatem S" first="Stéphane N" last="Hatem">Stéphane N. Hatem</name><affiliation><nlm:affiliation>Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital and Institute of Cardiometabolism and Nutrition, Sorbonne Université, INSERM UMR S1166, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pathak, Rajeev K" sort="Pathak, Rajeev K" uniqKey="Pathak R" first="Rajeev K" last="Pathak">Rajeev K. Pathak</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hendriks, Jeroen M L" sort="Hendriks, Jeroen M L" uniqKey="Hendriks J" first="Jeroen M L" last="Hendriks">Jeroen M L. Hendriks</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Kalman, Jonathan M" sort="Kalman, Jonathan M" uniqKey="Kalman J" first="Jonathan M" last="Kalman">Jonathan M. Kalman</name><affiliation><nlm:affiliation>Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Sanders, Prashanthan" sort="Sanders, Prashanthan" uniqKey="Sanders P" first="Prashanthan" last="Sanders">Prashanthan Sanders</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia prash.sanders@adelaide.edu.au.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26578197</idno><idno type="pmid">26578197</idno><idno type="doi">10.1093/eurheartj/ehv375</idno><idno type="wicri:Area/PubMed/Corpus">001E97</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001E97</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications.</title><author><name sortKey="Lau, Dennis H" sort="Lau, Dennis H" uniqKey="Lau D" first="Dennis H" last="Lau">Dennis H. Lau</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Schotten, Ulrich" sort="Schotten, Ulrich" uniqKey="Schotten U" first="Ulrich" last="Schotten">Ulrich Schotten</name><affiliation><nlm:affiliation>Department of Physiology, Maastricht University, Maastricht, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Mahajan, Rajiv" sort="Mahajan, Rajiv" uniqKey="Mahajan R" first="Rajiv" last="Mahajan">Rajiv Mahajan</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Antic, Nicholas A" sort="Antic, Nicholas A" uniqKey="Antic N" first="Nicholas A" last="Antic">Nicholas A. Antic</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, Repatriation General Hospital and Department of Medicine, Flinders University, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hatem, Stephane N" sort="Hatem, Stephane N" uniqKey="Hatem S" first="Stéphane N" last="Hatem">Stéphane N. Hatem</name><affiliation><nlm:affiliation>Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital and Institute of Cardiometabolism and Nutrition, Sorbonne Université, INSERM UMR S1166, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pathak, Rajeev K" sort="Pathak, Rajeev K" uniqKey="Pathak R" first="Rajeev K" last="Pathak">Rajeev K. Pathak</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hendriks, Jeroen M L" sort="Hendriks, Jeroen M L" uniqKey="Hendriks J" first="Jeroen M L" last="Hendriks">Jeroen M L. Hendriks</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Kalman, Jonathan M" sort="Kalman, Jonathan M" uniqKey="Kalman J" first="Jonathan M" last="Kalman">Jonathan M. Kalman</name><affiliation><nlm:affiliation>Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Sanders, Prashanthan" sort="Sanders, Prashanthan" uniqKey="Sanders P" first="Prashanthan" last="Sanders">Prashanthan Sanders</name><affiliation><nlm:affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia prash.sanders@adelaide.edu.au.</nlm:affiliation></affiliation></author></analytic><series><title level="j">European heart journal</title><idno type="eISSN">1522-9645</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Intensive research over the last few decades has seen significant advances in our understanding of the complex mechanisms underlying atrial fibrillation (AF). The epidemic of AF and related hospitalizations has been described as a 'rising tide' with estimates of the global AF burden showing no sign of retreat. There is urgency for effective translational programs in this field to facilitate more individualized and targeted therapy to modify the abnormal atrial substrate responsible for the perpetuation of this arrhythmia. In this review, we chose to focus on several novel aspects of AF pathogenesis whereby practical applications in clinical practice are currently available or potentially not too far away. Specifically, we explored the contribution of atrial fibrosis, epicardial adipose tissue, autonomic nervous system, hyper-coagulability, and focal drivers to adverse atrial remodelling and AF persistence. We also highlighted the potential practical means of monitoring and targeting these factors to achieve better outcomes in patients suffering from this debilitating illness. Emerging data also support a new paradigm for targeting AF substrate with aggressive risk factor management. Finally, multi-disciplinary integrated care approach has shown great promise in improving cardiovascular outcomes of patients with AF along with potential cost savings.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">26578197</PMID><DateCreated><Year>2016</Year><Month>05</Month><Day>22</Day></DateCreated><DateRevised><Year>2016</Year><Month>05</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1522-9645</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>20</Issue><PubDate><Year>2016</Year><Month>May</Month><Day>21</Day></PubDate></JournalIssue><Title>European heart journal</Title><ISOAbbreviation>Eur. Heart J.</ISOAbbreviation></Journal><ArticleTitle>Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications.</ArticleTitle><Pagination><MedlinePgn>1573-81</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/eurheartj/ehv375</ELocationID><Abstract><AbstractText>Intensive research over the last few decades has seen significant advances in our understanding of the complex mechanisms underlying atrial fibrillation (AF). The epidemic of AF and related hospitalizations has been described as a 'rising tide' with estimates of the global AF burden showing no sign of retreat. There is urgency for effective translational programs in this field to facilitate more individualized and targeted therapy to modify the abnormal atrial substrate responsible for the perpetuation of this arrhythmia. In this review, we chose to focus on several novel aspects of AF pathogenesis whereby practical applications in clinical practice are currently available or potentially not too far away. Specifically, we explored the contribution of atrial fibrosis, epicardial adipose tissue, autonomic nervous system, hyper-coagulability, and focal drivers to adverse atrial remodelling and AF persistence. We also highlighted the potential practical means of monitoring and targeting these factors to achieve better outcomes in patients suffering from this debilitating illness. Emerging data also support a new paradigm for targeting AF substrate with aggressive risk factor management. Finally, multi-disciplinary integrated care approach has shown great promise in improving cardiovascular outcomes of patients with AF along with potential cost savings.</AbstractText><CopyrightInformation>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lau</LastName><ForeName>Dennis H</ForeName><Initials>DH</Initials><AffiliationInfo><Affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schotten</LastName><ForeName>Ulrich</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Physiology, Maastricht University, Maastricht, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mahajan</LastName><ForeName>Rajiv</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Antic</LastName><ForeName>Nicholas A</ForeName><Initials>NA</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, Repatriation General Hospital and Department of Medicine, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hatem</LastName><ForeName>Stéphane N</ForeName><Initials>SN</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital and Institute of Cardiometabolism and Nutrition, Sorbonne Université, INSERM UMR S1166, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pathak</LastName><ForeName>Rajeev K</ForeName><Initials>RK</Initials><AffiliationInfo><Affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hendriks</LastName><ForeName>Jeroen M L</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kalman</LastName><ForeName>Jonathan M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sanders</LastName><ForeName>Prashanthan</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia prash.sanders@adelaide.edu.au.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>11</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur Heart J</MedlineTA><NlmUniqueID>8006263</NlmUniqueID><ISSNLinking>0195-668X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Atrial fibrillation</Keyword><Keyword MajorTopicYN="N">Integrated care</Keyword><Keyword MajorTopicYN="N">Mechanisms</Keyword><Keyword MajorTopicYN="N">Pathogenesis</Keyword><Keyword MajorTopicYN="N">Risk factor management</Keyword><Keyword MajorTopicYN="N">Substrate</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>06</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>07</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>11</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>11</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>11</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26578197</ArticleId><ArticleId IdType="pii">ehv375</ArticleId><ArticleId IdType="doi">10.1093/eurheartj/ehv375</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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