Author + information
- Received May 15, 2015
- Revision received June 18, 2015
- Accepted June 22, 2015
- Published online August 25, 2015.
- Mikhail S. Dzeshka, MD∗,†,
- Gregory Y.H. Lip, MD∗,‡,
- Viktor Snezhitskiy, PhD† and
- Eduard Shantsila, PhD∗∗ ()
- ∗University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
- †Grodno State Medical University, Grodno, Belarus
- ‡Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- ↵∗Reprint requests and correspondence:
Dr. Eduard Shantsila, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, West Midlands B18 7QH, United Kingdom.
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.
Dr. Dzeshka was supported by a European Heart Rhythm Association Academic Fellowship Programme. Dr. Lip has served as a consultant for Bayer, Astellas, Merck, Sanofi, Bristol-Myers Squibb/Pfizer, Biotronik, Medtronic, Portola, Boehringer Ingelheim, Microlife, and Daiichi-Sankyo; and has been on the speakers bureau for Bayer, Bristol-Myers Squibb/Pfizer, Medtronic, Boehringer Ingelheim, Microlife, and Daiichi-Sankyo. Drs. Snezhitskiy and Shantsila have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 15, 2015.
- Revision received June 18, 2015.
- Accepted June 22, 2015.
- American College of Cardiology Foundation
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