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J Am Coll Cardiol. 2015 Aug 25;66(8):943-59. doi: 10.1016/j.jacc.2015.06.1313.

Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications.

Author information

1
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Grodno State Medical University, Grodno, Belarus.
2
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
3
Grodno State Medical University, Grodno, Belarus.
4
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. Electronic address: e.shantsila@bham.ac.uk.

Abstract

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.

KEYWORDS:

cardiac; extracellular matrix; heart failure; myocytes; myofibroblasts

PMID:
26293766
DOI:
10.1016/j.jacc.2015.06.1313
[Indexed for MEDLINE]
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