Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been repo...Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.展开更多
目的分析近20年房颤心房纤维化相关领域的研究现状、热点及趋势。方法以Web of Science核心合集数据库为数据来源,利用可视化分析软件CiteSpace对近20年房颤心房纤维化相关研究进行可视化分析,探讨相关研究的作者、国家/机构分布、期刊...目的分析近20年房颤心房纤维化相关领域的研究现状、热点及趋势。方法以Web of Science核心合集数据库为数据来源,利用可视化分析软件CiteSpace对近20年房颤心房纤维化相关研究进行可视化分析,探讨相关研究的作者、国家/机构分布、期刊分布状况以及对关键词进行分析。结果纳入1468篇SCI文章,发文量最高的作者是Nattel S,引文量最高的是Burstein B。美国和中国为该领域研究的主要国家,美国犹他大学、约翰霍普金斯大学是房颤心房纤维化研究的重要机构,载文量最多的期刊是《Journal of cardiovascular electrophysiology》,被引频次最高的期刊是《Circulation》,主要的研究热点是①心力衰竭/心肌梗死并发心房颤动与心房纤维化研究;②心房纤维化评估在心房颤动导管消融/基质消融中的应用③炎症及氧化应激在房颤心房纤维化中的作用机制研究。研究的前沿方向主要有①关于房颤患者的患病率、复发率和死亡率的研究;②房颤患者中风的预防;③基于心肌成纤维细胞探讨房颤相关机制的研究;④房颤患者的管理;⑤通过延迟增强MRI评估心房组织纤维化程度。结论本研究为了解房颤心房纤维化相关研究提供了一个视角,为研究者识别潜在的合作者和合作机构、热点话题和研究前沿提供了有价值的信息。展开更多
Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasi...Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasing anisotropy of impulse propagation and building of boundaries that promote re-entry in the atrial walls that maybe directly relevant for the mechanisms responsible for maintaining AF. Whether or not fibrosis is a result of structural remodelling caused by persistent AF or a manifestation of occult myocardial process that leads to development of arrhythmia is less clear. Human data indicate the presence of association between persistency of AF and the extent of structural changes in atrial myocardium. The role atrial fibrosis plays in the mechanisms of AF, however, may differ between patients with structurally normal hearts, such as lone AF, and those with advanced cardiovascular comorbidities.展开更多
文摘Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.
文摘目的分析近20年房颤心房纤维化相关领域的研究现状、热点及趋势。方法以Web of Science核心合集数据库为数据来源,利用可视化分析软件CiteSpace对近20年房颤心房纤维化相关研究进行可视化分析,探讨相关研究的作者、国家/机构分布、期刊分布状况以及对关键词进行分析。结果纳入1468篇SCI文章,发文量最高的作者是Nattel S,引文量最高的是Burstein B。美国和中国为该领域研究的主要国家,美国犹他大学、约翰霍普金斯大学是房颤心房纤维化研究的重要机构,载文量最多的期刊是《Journal of cardiovascular electrophysiology》,被引频次最高的期刊是《Circulation》,主要的研究热点是①心力衰竭/心肌梗死并发心房颤动与心房纤维化研究;②心房纤维化评估在心房颤动导管消融/基质消融中的应用③炎症及氧化应激在房颤心房纤维化中的作用机制研究。研究的前沿方向主要有①关于房颤患者的患病率、复发率和死亡率的研究;②房颤患者中风的预防;③基于心肌成纤维细胞探讨房颤相关机制的研究;④房颤患者的管理;⑤通过延迟增强MRI评估心房组织纤维化程度。结论本研究为了解房颤心房纤维化相关研究提供了一个视角,为研究者识别潜在的合作者和合作机构、热点话题和研究前沿提供了有价值的信息。
文摘Atrial fibrosis is common in atrial fibrillation （AF）. Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasing anisotropy of impulse propagation and building of boundaries that promote re-entry in the atrial walls that maybe directly relevant for the mechanisms responsible for maintaining AF. Whether or not fibrosis is a result of structural remodelling caused by persistent AF or a manifestation of occult myocardial process that leads to development of arrhythmia is less clear. Human data indicate the presence of association between persistency of AF and the extent of structural changes in atrial myocardium. The role atrial fibrosis plays in the mechanisms of AF, however, may differ between patients with structurally normal hearts, such as lone AF, and those with advanced cardiovascular comorbidities.
