Unique role of epicardial adipose tissue in atrial fibrosis: ‘Atrial remodeling of a new sort’

Pivotal studies over the last few decades have identified the important role of electrical and structural remodeling in different atrial fibrillation (AF) substrates.1 More recently, epicardial adipose tissue (EAT) has emerged as an important pro-arrhythmic substrate for AF and may in part explain the clinical association between obesity and AF.2, 3 Expansion of EAT, which often occurs as a consequence of weight gain, has been shown to predict greater risk for AF development and severity, as well as poorer outcomes following rhythm control strategies.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research

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Abstract Introduction: Metabolic syndrome (MetS) is defined as an association between diabetes, hypertension, obesity and dyslipidemia and an increased risk of cardiovascular disease. Mitral annular calcification (MAC) is associated with several cardiovascular disorders, including coronary artery disease, atrial fibrillation (AF), heart failure, ischemic stroke and increased mortality. The CHA2DS2-VASc score is used to estimate thromboembolic risk in AF. However, the association among MAC, MetS and thromboembolic risk is unknown and was evaluated in the current study. Methods: The study group consisted of 94 patients with ...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 7 November 2019Source: IJC Heart &VasculatureAuthor(s): Ernaldo G. Marcos, Ruben R. De With, Bart A. Mulder, Isabelle C. Van Gelder, Michiel RienstraAbstractBackgroundWomen are underrepresented in major atrial fibrillation (AF) trials. In addition, data regarding clinical profile and outcome in young AF patients is limited. Therefore we aimed to investigate the clinical profile, AF progression rate and cardiovascular outcome between sexes in patients with young-onset AF.MethodsA total of 497 patients with AF-onset
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Publication date: Available online 6 November 2019Source: JACC: Heart FailureAuthor(s): Milton PackerAbstractBoth obesity and type 2 diabetes are important risk factors for the development of heart failure with a preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF). However, adiposity and diabetes are risk factors for systemic thromboembolism, even in the absence of AF, because both can lead to the development of an inflammatory and fibrotic ...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Abstract Background: Limited clinical data exist describing the use of direct-acting oral anticoagulants (DOACs) in patients with body mass index (BMI)>40 kg/m2 or body weight>120 kg. Thus, DOAC therapy in this population remains controversial. Objectives: To investigate rivaroxaban as a safe and effective alternative to warfarin for venous thromboembolism (VTE) treatment and prevention of stroke in patients with atrial fibrillation identified as extremely obese or of high body weight. Methods: A retrospective chart review was performed at 2 academic medical centers in patients ≥18 years old and BMI>40...
Source: The Annals of Pharmacotherapy - Category: Drugs & Pharmacology Authors: Tags: Ann Pharmacother Source Type: research
Abstract Atrial fibrillation (AF) is prevalent in patients with obesity and diabetes, and such patients often exhibit cardiac steatosis. Since the role of cardiac steatosis per se in the induction of AF has not been elucidated, the present study was designed to explore the relation between cardiac steatosis and AF. Transgenic (Tg) mice with cardiac-specific overexpression of perilipin 2 (PLIN2) were housed in the laboratory for more than 12 months before the study. Electron microscopy of the atrium of PLIN2-Tg mice showed accumulation of small lipid droplets around mitochondrial chains, and 5- to 9-fold greater at...
Source: Am J Physiol Endocri... - Category: Endocrinology Authors: Tags: Am J Physiol Endocrinol Metab Source Type: research
Due to fixed dosing of direct oral anticoagulants (DOACs), uncertainty exists about their efficacy in a population of obese/overweight patients.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
In this study, the enhanced mice live somewhat longer than their unmodified peers, though not as much longer as is the case for the application of telomerase gene therapy. The mice do also exhibit reduced cancer risk, however. The scientists here class telomere shortening as a cause of aging, which is not a point universally agreed upon. Reductions in average telomere length in tissues looks much more like a downstream consequence of reduced stem cell activity than an independent mechanism. Researchers obtain the first mice born with hyper-long telomeres and show that it is possible to extend life without any geneti...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
AbstractAtrial fibrillation (AF) is common in patients with obesity and diabetes; the arrhythmia (if long ‐standing) is typically managed by rate‐control and anticoagulation. However, the coexistence of these two metabolic disorders complicates therapeutic options for rate‐control. The likely pathogenesis of AF in these patients is an expansion of epicardial adipose tissue, whose inflammation is t ransmitted to the left atrium causing electromechanical remodeling. However, this same process is also transmitted to the left ventricle, impairing its distensibility and its ability to tolerate volume, leading to heart fai...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: COMPREHENSIVE REVIEWS Source Type: research
Fitbit or Apple Watch for running? Garmin or Misfit for swimming? Sleep Cycle or Sleep as Android for sleep tracking? What about measuring heart rate, blood pressure, or tracking how to cut out stress from your life? Dozens of gadgets on the healthcare wearable market promise you a healthier lifestyle, but it’s easy to go astray in the jungle of digital health gadgets. Let me show you my top choices when it comes to health wearables and trackers. Guidance in the health wearable universe By now, I have tested and used more than a hundred devices and gadgets that measure health parameters or vital signs. Thus,...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Health Sensors & Trackers Portable Diagnostics activity fitness fitness trackers Health 2.0 Healthcare Innovation meditation mental health Personalized medicine sleep sleep optimization sleep tracking stress technology wear Source Type: blogs
AbstractIn the last 40  years, concern about the obesity epidemic has increased. Data from the current literature highlight a strong relationship between obesity and atrial fibrillation (AF), particularly in relation to an increased risk for incident and recurrent AF. A phenomenon called the “obesity paradox” has eme rged: the apparently counterintuitive evidence from epidemiological data indicating that overweight and obese patients may have a better prognosis than healthy-weight patients. A differential impact of oral anticoagulants (OACs) in terms of effectiveness and safety in the various body mass ind...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
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