Latest Insights into Mechanisms behind Atrial Cardiomyopathy: It Is Not always about Ventricular Function

Diagnostics - Tập 11 Số 3 - Trang 449
Bianca-Ana Dmour1, Radu-Ștefan Miftode2, Dan Iliescu Halitchi2, Dana Teodora Anton-Paduraru3, Codruta-Olimpiada Iliescu Halitchi3, Ionela-Larisa Miftode4, Ovidiu Mitu2, Alexandru Dan Costache2, Celina Silvia Stafie5, Irina Iuliana Costache2
1Department of Internal Medicine I (Internal Medicine), Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania
2Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania
3Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania
4Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania
5Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania

Tóm tắt

Atrial cardiomyopathy (ACM) represents a constantly evolving concept, with increasing importance in contemporary research and clinical practice. A better understanding of the mechanisms involved in atrial remodeling and its clinical correlations especially with atrial fibrillation (AF) and other cardiometabolic comorbidities may induce a significant impact on the diagnosis, prognosis, and therapeutic approach of ACM-related comorbidities. Although initially described several decades ago, investigators have only recently highlighted that several renal, metabolic, and cardiovascular diseases are determining factors for atrial remodeling and subsequent ACM. Based on data from multiple recent studies, our research emphasizes the correlations between ACM and other coexisting pathologies including cardiovascular, respiratory, or metabolic diseases, with fibrosis being the most incriminated pathophysiological mechanism. In addition to the usual tests, the paraclinical assessment of ACM is increasingly based on the use of various cardiac biomarkers, while the cardiac magnetic resonance (CMR) has become an increasingly tempting diagnostic too for describing morphofunctional aspects of the heart chambers, with the gadolinium contrast enhanced CMR (LGE-CMR) emerging as a commonly used technique aiming to identify and quantify the precise extent of atrial fibrosis. Further research should be conducted in order to clarify our knowledge regarding atrial remodeling and, therefore, to develop new and improved therapeutic approaches in these patients.

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