Affiliation:
1. 1st Department of Cardiology, ‘Hippokration' Hospital, University of Athens Medical School, Athens, Greece
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in
clinical practice and an important contributor to cardiovascular morbidity and mortality. Although
the exact mechanisms behind AF are not completely elucidated, the underlying pathophysiological
changes have been well described. Predisposal factors for AF include the older
age, the increased left atrial size, the decreased left atrial function, the presence of heart failure
and left ventricular systolic dysfunction and the presence of coronary heart disease or
pulmonary or mitral valve disease. In addition to these factors, emerging evidence demonstrate
that myocardial strain, fibrosis and inflammation, are associated with AF as well as the
pathogenesis of the arrhythmia. The natruretic peptide system including Atrial Natriuretic
Peptide (ANP), Brain Natriuretic Peptide (BNP) and C-type Natriuretic Peptide (CNP) is indicative
of the level of myocardial strain which may predispose to AF. As a result, the aforementioned
peptides are increased in AF patients. The levels of myocardial fibrosis biomarkers,
such as ST2 and Galectin-3, are elevated suggesting atrial structural abnormalities, while
the increased levels of CRP and Interleukin-6 supplement the inflammatory profile of AF patients.
Emerging data for the aforementioned biomarkers are discussed in the present review.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology,Molecular Medicine,Drug Discovery,Biochemistry,Organic Chemistry
Cited by
46 articles.
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