Cardiac fibrosis in patients with atrial fibrillation: Mechanisms and clinical implications

atrial fibrillation, heart failure, cardiac fibrosisAtrial 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 to be substrate for AF perpetuation. In contrast, experimental and clinical data on impact of ventricular fibrotic processes in pathogenesis of AF and its complications are controversial. Ventricular fibrosis appears to contribute to abnormalities in cardiac relaxation and contractility, and development of heart failure, a common finding in AF. Given the frequent coexistence of AF and heart failure and the fact that both conditions affect patient prognosis better understanding of mutual impact of fibrosis in AF and heart failure is of particular interest. In this review article, we provide an overview on 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

Cardiac fibrosis in patients with atrial fibrillation: Mechanisms and clinical implications

atrial fibrillation, heart failure, cardiac fibrosisAtrial 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 to be substrate for AF perpetuation. In contrast, experimental and clinical data on impact of ventricular fibrotic processes in pathogenesis of AF and its complications are controversial. Ventricular fibrosis appears to contribute to abnormalities in cardiac relaxation and contractility, and development of heart failure, a common finding in AF. Given the frequent coexistence of AF and heart failure and the fact that both conditions affect patient prognosis better understanding of mutual impact of fibrosis in AF and heart failure is of particular interest. In this review article, we provide an overview on 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

The influence of atrial fibrillation on the prognostic value of brain natriuretic peptide (BNP) in risk assesment of paroxysmal ventricular tachycardia

The aim of the study was to assess the predictive value of BNP in risk assessment of paroxysmal ventricular tachycardia (PVT) in patients with HF and AF.Цель исследования – оценить прогностическую значимость BNP в отношении риска развития пароксизмальной желудочковой тахикардии (ПЖТ) у пациентов с СН со сниженной систолической функцией ЛЖ и постоянной или длительно персистирующей формой ФП

Relationship of sex hormone levels with the development of drug-induced QT interval prolongation in women taking class III antiarrhythmic drugs

The aim of this study - to establish prognostic value of serum sex hormones levels for the drug-induced QT interval prolongation (LQTS) and polymorphic ventricular tachycardia (PVT) in women taking class III antiarrhythmic drugs.Цель исследования - установить прогностическое значение уровней половых гормонов для развития лекарственно-индуцированного синдрома удлинения интервала QT (СУИ QT) и полиморфной желудочковой тахикардии (ЖТ) у женщин, принимающих антиаритмические препараты III класса

METHODOLOGICAL APPROACHES TO MEASURING AND ESTIMATING THE DURATION OF QT INTERVAL OF A STANDARD ELECTROCARDIOGRAM

Interpretation of each electrocardiogram should include measurement and evaluation of the QT interval, because both an increase and a decrease in its duration are associated with a risk of polymorphic ventricular tachycardia and sudden cardiac death. This article reflects the methodological approaches to determining, measuring and evaluating the duration of the QT interval, describes the nature of its dependence on gender, age and heart rate of the patient, and also describes a number of indicators calculated on its basis. Recommendations for measuring and evaluating the QT interval of a standard electrocardiogram have been formulated on the basis of the literature analysis

PROSPECTS FOR THE USE OF BIOMARKERS (ADIPONECTIN, P-SELECTIN, INTEGRIN Ββ3) AS BIOCHEMICAL PREDICTORS OF RESTENOSIS IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER CORONARY STENTING

Aim.To analyze the literature data about the role of adiponectin, P-selectin and integrin β3 in the pathogenesis of the development of in-stent restenosis in patients with coronary heart disease after coronary stenting, as well as the possibility of using the listed biomarkers as predictors of restenosis. Results. We examined some aspects of the pathogenesis of the development of in-stent restenosis in patients with coronary heart disease after coronary stenting, including the role of adiponectin, P-selectin and integrin β3, and their prognostic significance. Conclusions. The presented data indicate the probable role of adiponectin, P-selectin and integrin β3 in the pathogenesis of in-stent restenosis development in patients with coronary heart disease after coronary stenting. However, the results of the performed studies, in which the prognostic value of the above biomarkers in respect to the development of restenosis within the stent was evaluated, are contradictory in nature

LONG QT SYNDROME. PART 1

Long QT syndrome (LQTS) is a potentially life-threatening channelopathy, accompanied by a prolonged QT interval on a 12-channel ECG, syncopal conditions and a high risk of sudden cardiac death due to the development of torsade de pointes (TdP) polymorphic ventricular tachycardia. The primary goal in the management of patients with LQTS at the present stage is prevention of undiagnosed forms, its adequate treatment and prophylaxis, facilitated by the rapid development of molecular biology and genetics. The first part of the present review reflects the history of LQTS research and the latest achievements in studying its etiology, epidemiology, pathogenesis and clinical features

LONG QT SYNDROME. PART 2

Long QT syndrome (LQTS) is a potentially life-threatening canalopathy, accompanied by prolonged QT interval on a 12-channel ECG, syncopal conditions and a high risk for sudden cardiac death due to the development of torsade de pointes (TdP) polymorphic ventricular tachycardia. The primary goal in management of patients with LQTS at the present stage is prevention of undiagnosed forms, adequate treatment and prophylaxis, facilitated by the rapid development of molecular biology and genetics. The second part of the present review reflects the latest achievements in its diagnosis and management

WAVELET TRANSFORM AS A METHOD OF ANALYSIS OF SPECTRAL CHARACTERISTICS OF CARDIOLOGICAL TIME SERIES

Background. Today, when most processes and phenomena have a periodic structure that is not always homogeneous and depends on a number of irregular events, the classical spectral analysis based on the Fourier transform does not always allow an objective and reliable investigation. A promising alternative to the classical spectral analysis can be a wavelet transform, based on a well-localized function in both time and frequency domains, which allows us to analyze irregular processes. The purpose of the research was to analyze the potentials of the wavelet transform for the analysis of the spectral characteristics of cardiological time series with some heterogeneity; to develop a software application that allows performing wavelet analysis of data and building wavelet spectra, which are illustrative and easy in interpreting the obtained results. Material and methods. 37 cardiological time series were studied. We developed an application for the application package Mathematika 5.0 that allows building and analyzing the wavelet spectra of the studied data. Results. An alternative method for analyzing the spectral characteristics of the studied cardiological time series has been developed and clearly demonstrated. It allows observing the dynamics of the change in periods over the entire observation interval without performing the interval splitting, as would be required by the classical Fourier analysis. Conclusion. For the studied groups of patients the identified periods, found with the help of the wavelet transform have been presented. The advantages of using wavelets over the classical spectral analysis, which in cases of unstable time series does not allow tracking the dynamics of the changing in the data spectrum, have been demonstrated