© 2001 by European Society of Cardiology
Copyright © 2001, European Society of Cardiology
Structural remodelling during chronic atrial fibrillation: act of programmed cell survival
aDepartment of Molecular Cell Biology, Cardiovascular Research Institute Maastricht, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
bDepartment of Physiology, Cardiovascular Research Institute Maastricht, University Maastricht, Maastricht, The Netherlands
m.borgers{at}molcelb.unimaas.nl
* Corresponding author. Tel.: +31-43-388-1428; fax: +31-43-388-4151
Atrial fibrillation is the most common cardiac arrhythmia with an overall prevalence of almost 1%. Increasing prevalence and associated risks such as stroke and mortality have increased the need for better and more reliable therapeutic treatment. This has stimulated research to elucidate the pathophysiological mechanisms underlying atrial fibrillation. Atrial fibrillation is primarily characterised by electrical remodelling and functional deterioration. Both phenomena are reversible but after prolonged duration of atrial fibrillation, a discrepancy occurs between rapid electrical remodelling and slow recovery of contractile function. Recent studies have indicated that morphological remodelling might underlie this incongruity. In experimental models of lone atrial fibrillation, the remodelling involves cellular changes that are reminiscent of dedifferentiation and are characterised by cellular volume increase, myolysis, glycogen accumulation, mitochondrial changes and chromatin redistribution. The absence of clear signs of degeneration in these models points towards cardiomyocyte adaptation or a mechanism of programmed cell survival. In patients with atrial fibrillation cardiomyocyte degeneration does occur along with dedifferentiation which might be the result of underlying cardiac pathologies or longer duration of atrial fibrillation. In this review we focus on structural remodelling during atrial fibrillation. The different aspects of histological and ultrastructural changes as well as their role in atrial dysfunction and cardiomyocyte survival are discussed. We briefly describe the underlying molecular remodelling. and possible mechanisms responsible for remodelling involving calcium overload and stretch are presented.
KEYWORDS Atrial function; Contractile apparatus; Electron microscopy; Remodelling; Supraventricular arrhythmia
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Qi, J. Xiao, Y. Zhang, J. Li, Y. Liu, P. Li, L. Liang, B. Jiang, W. Wen, C. Zhao, et al. Effects of Potassium Channel Blockers on Changes in Refractoriness of Atrial Cardiomyocytes Induced by Stretch Experimental Biology and Medicine, July 1, 2009; 234(7): 779 - 784. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mayr, S. Yusuf, G. Weir, Y.-L. Chung, U. Mayr, X. Yin, C. Ladroue, B. Madhu, N. Roberts, A. De Souza, et al. Combined metabolomic and proteomic analysis of human atrial fibrillation. J. Am. Coll. Cardiol., February 5, 2008; 51(5): 585 - 594. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Ruchat, N. Virag, L. Dang, J. Schlaepfer, E. Pruvot, and L. Kappenberger A biophysical model of atrial fibrillation ablation: what can a surgeon learn from a computer model? Europace, November 1, 2007; 9(suppl_6): vi71 - vi76. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Ad, S. Barnett, E. A. Lefrak, A. Korach, A. Pollak, D. Gilon, and A. Elami Impact of follow-up on the success rate of the cryosurgical maze procedure in patients with rheumatic heart disease and enlarged atria J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1073 - 1079. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Wiggers, H. E. Botker, V.L.J.L. Thijssen, M. Borgers, M.-H. Lenders, F.C.S. Ramaekers, G. Suzuki, B. Palka, J.A. Fallavollita, S.A. Thomas, et al. Letter Regarding Article by Thijssen et al, "Temporal and Spatial Variations in Structural Protein Expression During the Progression From Stunned to Hibernating Myocardium" * Response Circulation, June 7, 2005; 111(22): e378 - e379. [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Barth, S. Merk, E. Arnoldi, L. Zwermann, P. Kloos, M. Gebauer, K. Steinmeyer, M. Bleich, S. Kaab, M. Hinterseer, et al. Reprogramming of the Human Atrial Transcriptome in Permanent Atrial Fibrillation: Expression of a Ventricular-Like Genomic Signature Circ. Res., May 13, 2005; 96(9): 1022 - 1029. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Oberti, L. Wang, L. Li, J. Dong, S. Rao, W. Du, and Q. Wang Genome-Wide Linkage Scan Identifies a Novel Genetic Locus on Chromosome 5p13 for Neonatal Atrial Fibrillation Associated With Sudden Death and Variable Cardiomyopathy Circulation, December 21, 2004; 110(25): 3753 - 3759. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V.L.J.L. Thijssen, M. Borgers, M.-H. Lenders, F.C.S. Ramaekers, G. Suzuki, B. Palka, J.A. Fallavollita, S.A. Thomas, and J.M. Canty Jr Temporal and Spatial Variations in Structural Protein Expression During the Progression From Stunned to Hibernating Myocardium Circulation, November 23, 2004; 110(21): 3313 - 3321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L.J.L. Thijssen, J. Ausma, L. Gorza, H. M.W. van der Velden, M. A. Allessie, I. C. Van Gelder, M. Borgers, and G. J.J.M. van Eys Troponin I Isoform Expression in Human and Experimental Atrial Fibrillation Circulation, August 17, 2004; 110(7): 770 - 775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Todd, S. P. Fynn, A. P. Walden, W. J. Hobbs, S. Arya, and C. J. Garratt Repetitive 4-Week Periods of Atrial Electrical Remodeling Promote Stability of Atrial Fibrillation: Time Course of a Second Factor Involved in the Self-Perpetuation of Atrial Fibrillation Circulation, March 23, 2004; 109(11): 1434 - 1439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Ausma and M. Borgers Dedifferentiation of atrial cardiomyocytes: from in vivo to in vitro Cardiovasc Res, July 1, 2002; 55(1): 9 - 12. [Full Text] [PDF]
|
|
|
|
|
|
K. Shinagawa, Y.-F. Shi, J.-C. Tardif, T.-K. Leung, and S. Nattel Dynamic Nature of Atrial Fibrillation Substrate During Development and Reversal of Heart Failure in Dogs Circulation, June 4, 2002; 105(22): 2672 - 2678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. M.W van der Velden and H. J Jongsma Cardiac gap junctions and connexins: their role in atrial fibrillation and potential as therapeutic targets Cardiovasc Res, May 1, 2002; 54(2): 270 - 279. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kostin, G. Klein, Z. Szalay, S. Hein, E. P Bauer, and J. Schaper Structural correlate of atrial fibrillation in human patients Cardiovasc Res, May 1, 2002; 54(2): 361 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L.J.L Thijssen, H. M.W van der Velden, E. P van Ankeren, J. Ausma, M. A Allessie, M. Borgers, G. J.J.M van Eys, and H. J Jongsma Analysis of altered gene expression during sustained atrial fibrillation in the goat Cardiovasc Res, May 1, 2002; 54(2): 427 - 437. [Abstract] [Full Text] [PDF]
|
|