Non-invasive electromechanical assessment during atrial fibrillation identifies underlying atrial myopathy alterations with early prognostic value
Por:
Enríquez-Vázquez D., Quintanilla J.G., García-Escolano A., Couselo-Seijas M., Simón-Chica A., Lee P., Alfonso-Almazán J.M., Mahía P., Redondo-Rodríguez A., Modrego J., Ortega-Hernández A., Marcos-Alberca P., Magni R., Calvo E., Gómez-Gordo R., Yan P., La Rosa G., Bustamante-Madrión J., Pérez-García C.N., Martín-Sánchez F.J., Calvo D., de la Hera J.M., García-Torrent M.J., García-Osuna Á., Ordonez-Llanos J., Vázquez J., Pérez-Villacastín J., Pérez-Castellano N., Loew L.M., Sánchez-González J., Gómez-Garre D., Filgueiras-Rama D.
Publicada:
4 ago 2023
Ahead of Print:
4 ago 2023
Resumen:
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.
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.
Filiaciones:
Enríquez-Vázquez D.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Complexo Hosp Univ A Coruna, Inst Invest Biomed Coruna INIB, Serv Cardiol, La Coruna, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Quintanilla J.G.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
García-Escolano A.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Univ Politecn Madrid, ETSI Telecomunicac, Madrid, Spain
Couselo-Seijas M.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Simón-Chica A.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Lee P.:
Essel Res & Dev Inc, Toronto, ON, Canada
Alfonso-Almazán J.M.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Mahía P.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
Redondo-Rodríguez A.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Modrego J.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Lab Microbiota & Biol Vasc, Madrid, Spain
Ortega-Hernández A.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Lab Microbiota & Biol Vasc, Madrid, Spain
Marcos-Alberca P.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
Magni R.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Calvo E.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Gómez-Gordo R.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Lab Microbiota & Biol Vasc, Madrid, Spain
Yan P.:
Univ Connecticut, Sch Med, Richard D Berlin Ctr Cell Anal & Modeling, Farmington, CT USA
La Rosa G.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Bustamante-Madrión J.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Emergency Dept, Madrid, Spain
Pérez-García C.N.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
Martín-Sánchez F.J.:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Emergency Dept, Madrid, Spain
Calvo D.:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias, Oviedo, Spain
de la Hera J.M.:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias, Oviedo, Spain
García-Torrent M.J.:
Univ Complutense Madrid, Dept Med, Madrid, Spain
García-Osuna Á.:
Hosp Santa Creu & Sant Pau, Dept Clin Biochem, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Inst Invest Biomed, IIB Sant Pau, Barcelona, Spain
Ordonez-Llanos J.:
Hosp Santa Creu & Sant Pau, Dept Clin Biochem, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Fdn Clin Biochem & Mol Pathol, Madrid, Spain
Vázquez J.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Pérez-Villacastín J.:
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
Fdn Interhosp Invest Cardiovasc FIC, Madrid, Spain
Pérez-Castellano N.:
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
Fdn Interhosp Invest Cardiovasc FIC, Madrid, Spain
Loew L.M.:
Univ Connecticut, Sch Med, Richard D Berlin Ctr Cell Anal & Modeling, Farmington, CT USA
Sánchez-González J.:
Philips Healthcare Iberia, Madrid, Spain
Gómez-Garre D.:
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Lab Microbiota & Biol Vasc, Madrid, Spain
Filgueiras-Rama D.:
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Cardiovasc Inst, Madrid, Spain
gold, All Open Access; Gold
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