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 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. Electromechanical characterization during atrial fibrillation (AF) remains a significant gap in the understanding of AF-related atrial myopathy. Here, the authors use non-invasive atrial electromechanical assessment during AF to identify early remodeling changes associated with underlying myopathy, which in the clinic decrease the probability of acute and mid-term successful rhythm control

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 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.This work was supported by the European Union Horizon 2020 research and innovation program under Grant Agreement#965286. The study was also supported by the Ministry of Science and Innovation (MCIN) (PID2019- 109329RB-I00 and PGC2018-097019-B-I00) funded by MCIN / AEI / 10.13039/501100011033, the Instituto de Salud Carlos III (Fondo de Investigación Sanitaria grant PRB3) (PT17/0019/0003- ISCIII-SGEFI / ERDF, ProteoRed), the Fundación Interhospitalaria para la Investigación Cardiovascular, the Fundación Salud 2000 and by “la Caixa” Banking Foundation (project code HR17-00247). The Centro Nacional de Investigaciones Cardiovasculares (CNIC) is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación (MCIN) and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (CEX2020- 001041-S funded by MICIN/AEI/10.13039/501100011033). We also thank Asunción Conde and Sergey Mironov for their support on monitoring database quality and advice in ECG signal processing, respectively.S

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

Depto. de MedicinaFac. de MedicinaFALSEpu

El Quijote a través de la Educación Física : propuestas prácticas para Educación Infantil, Primaria, Secundaria y Bachillerato

Resumen basado en el de la publicaciónSe muestra el procedimiento seguido para trabajar la obra de Miguel de Cervantes, El Ingenioso hidalgo Don Quijote de la Mancha, desde el área de Educación Física, a través de los juegos populares que aparecen en ella. Se presenta el relato de la investigación llevada a cabo, así como su adaptación y aplicación en Educación Física en las etapas de Educación Infantil, Primaria, Secundaria y Bachillerato. A partir de la localización y el conocimiento de los juegos motores populares que aparecen en la novela, se pasa al plan de acción: diseñar una propuesta de intervención educativa en las distintas etapas o niveles mencionados. A estos efectos, el juego como elemento cultural se ha trabajado en la pista-gimnasio a partir de los textos del Quijote, de su lectura y comentario en el aula desde la perspectiva globalizadora en Infantil, en las áreas de Lengua, Música y Conocimiento del Medio en Primaria y en las áreas de Lengua, Ciencias, Historia, Música y Geografía en Educación Secundaria y Bachillerato, todo ello complementándose con la realización de clases teórico-prácticas en la pista y en el gimnasio en las clases de Educación Física.AndalucíaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]