Structural and Functional Remodeling of the Left Atrium : Clinical and Therapeutic Implications for Atrial Fibrillation

Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These changes include alterations at the levels of ionic channels, cellular energy balance, neurohormonal expression, inflammatory response, a...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2008, Vol.51 (1), p.1-11
Main Authors: CASACLANG-VERZOSA, Grace, GERSH, Bernard J, TSANG, Teresa S. M
Format: Article
Language:English
Subjects:
Aging
Angiotensin II Type 1 Receptor Blockers - pharmacology
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antifibrinolytic Agents - pharmacology
Antifibrinolytic Agents - therapeutic use
Apoptosis
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Biological and medical sciences
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology
Cardiology. Vascular system
Catheter Ablation
Clinical Trials as Topic
Confidence intervals
Drug therapy
Electric Countershock
Electrophysiologic Techniques, Cardiac
Heart
Heart Atria - drug effects
Heart Atria - metabolism
Heart Atria - physiopathology
Heart attacks
Heart failure
Humans
Hypertension
Ischemia
Medical sciences
Mortality
Studies
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Summary:Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These changes include alterations at the levels of ionic channels, cellular energy balance, neurohormonal expression, inflammatory response, and physiologic adaptations. There is convincing evidence demonstrating an important pathophysiological association between LA remodeling and atrial fibrillation (AF). Measures that will prevent, attenuate, or halt these processes of LA remodeling may have a major public health impact with respect to the epidemic of AF. In this review, we describe the mechanisms involved in LA remodeling and highlight the existing and potential therapeutic options for its reversal, and implications for AF development.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2007.09.026