Non-invasive electromechanical assessment during atrial fibrillation identifies underlying atrial myopathy alterations with early prognostic value

Electromechanical characterization during atrial fibrillation (AF) remains a significant gap in the understanding of AF-related atrial myopathy. This study reports mechanistic insights into the electromechanical remodeling process associated with AF progression and further demonstrates its prognosti...

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Detalles Bibliográficos
Autores: Enríquez-Vázquez, Daniel, Quintanilla, Jorge G., García-Escolano, Alba, Couselo-Seijas, Marinela, Simón-Chica, Ana, Lee, Peter, Alfonso-Almazán, José Manuel, Mahía, Patricia, Redondo-Rodríguez, Andrés, Modrego, Javier, Ortega-Hernández, Adriana, Marcos-Alberca, Pedro, Magni, Ricardo, Calvo, Enrique, Gómez-Gordo, Rubén, Yan, Ping, La Rosa, Giulio, Bustamante-Madrión, José, Pérez-García, Carlos Nicolás, Martín-Sánchez, F Javier, Calvo, David, Hera, Jesús M. de la, García-Torrent, María Jesús, García-Osuna, Álvaro, Ordonez-Llanos, Jordi, Vázquez, Jesús, Pérez-Villacastín, Julián, Pérez-Castellano, Nicasio, Loew, Leslie M., Sánchez-González, Javier, Gómez-Garre, Dulcenombre, Filgueiras-Rama, David
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/366057
Acceso en línea:http://hdl.handle.net/10261/366057
https://api.elsevier.com/content/abstract/scopus_id/85166598475
Access Level:acceso abierto
Descripción
Sumario:Electromechanical characterization during atrial fibrillation (AF) remains a significant gap in the understanding of AF-related atrial myopathy. This study reports mechanistic insights into the electromechanical remodeling process associated with AF progression and further demonstrates its prognostic value in the clinic. In pigs, sequential electromechanical assessment during AF progression shows a progressive decrease in mechanical activity and early dissociation from its electrical counterpart. Atrial tissue samples from animals with AF reveal an abnormal increase in cardiomyocytes death and alterations in calcium handling proteins. High-throughput quantitative proteomics and immunoblotting analyses at different stages of AF progression identify downregulation of contractile proteins and progressive increase in atrial fibrosis. Moreover, advanced optical mapping techniques, applied to whole heart preparations during AF, demonstrate that AF-related remodeling decreases the frequency threshold for dissociation between transmembrane voltage signals and intracellular calcium transients compared to healthy controls. Single cell simulations of human atrial cardiomyocytes also confirm the experimental results. In patients, non-invasive assessment of the atrial electromechanical relationship further demonstrate that atrial electromechanical dissociation is an early prognostic indicator for acute and long-term rhythm control.

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