Genetics Of Atrial Fibrilation: In Search Of Novel Therapeutic Targets.

Genetics Of Atrial Fibrilation: In Search Of Novel Therapeutic Targets. Cardiovasc Hematol Disord Drug Targets. 2019 Feb 06;: Authors: Lozano-Velasco E, Garcia-Padilla C, Aránega AE, Franco D Abstract Atrial fibrillation (AF) is the most frequent arrhythmogenic disease in humans, ranging from 2% in the general population and raising up to 10-12% in 80+ years. Genetic analyses of AF familiar cases have identified a series of point mutations in distinct ion channels, supporting a causative link. However, these genetic defects only explain a minority of AF patients. Genome-wide association studies identified single nucleotide polymorphisms (SNPs), close to PITX2 on 4q25 chromosome, that are highly associated to AF. Subsequent GWAS studies have identified several new loci, involving additional transcription and growth factors. Furthermore, these risk 4q25 SNPs serve as surrogate biomarkers to identify AF recurrence in distinct surgical and pharmacological interventions. Experimental studies have demonstrated an intricate signalling pathway supporting a key role of the homeobox transcription factor PITX2 as a transcriptional regulator. Furthermore, cardiovascular risk factors such hyperthyroidism, hypertension and redox homeostasis have been identified to modulate PITX2 driven gene regulatory networks. We provide herein a state-of-the-art review of the genetic bases of atrial fibrillation, our current understanding of the genetic regulatory networks inv...
Source: Cardiovascular and Hematological Disorders Drug Targets - Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research

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A simple clinical score, C2HEST (C2: CAD / COPD (1 point each); H: Hypertension; E: Elderly (Age ≥75, doubled); S: Systolic HF (doubled); T: Thyroid disease (hyperthyroidism)) has been proposed to predict incident AF, with good discrimination and internal calibration. To define high risk patients at particular age strata for incident AF in a nationwide population cohort, who could potentially be targeted for AF screening, we used a nationwide cohort study of all Danish citizen aged ≥65 years to evaluate the performance of the C2HEST score.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
CONCLUSIONS: The prevalence of CT in patients with overt hyperthyroidism was relatively low. Cardiac complications were AF and CHF with a clear predominance of AF. Advanced age was the only independent risk factor of CT. Cardiac complications may be seen even if hyperthyroidism is not biologically severe. PMID: 31235068 [PubMed - as supplied by publisher]
Source: Annales d'Endocrinologie - Category: Endocrinology Authors: Tags: Ann Endocrinol (Paris) Source Type: research
ConclusionEarly repolarization was associated with lone atrial fibrillation. Early repolarization may indicate increased susceptibility to atrial fibrillation.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ CLINICAL Source Type: research
Abstract BACKGROUND: The incidence of atrial fibrillation (AF) is increasing, conferring a major healthcare issue in Asia. No risk score for predicting incident AF has been specifically developed in Asian subjects. Our aim was to investigate risk factors for incident AF in Asian subjects and to combine them into a simple clinical risk score. METHODS: Risk factors for incident AF were analyzed in 471,446 subjects from the Chinese Yunnan Insurance Database (internal derivation cohort), and then combined into a simple clinical risk score. External application of the new score was performed in 451,199 subjects fr...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Conclusions: Older age and levels of UA, DBIL, and GGT influenced the occurrence of AF in thyrotoxic patients receiving RAI. DBIL level was an important factor in predicting AF in patients with hyperthyroidism. Thus, thyrotoxic patients who have the above-mentioned risk factors should undergo routine pulse palpation and active antithyroid drug therapy. Keywords: Atrial Fibrillation, Hyperthyroidism, Clinical Feature, Radioactive Iodine Therapy, Direct Bilirubin
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Endocrine/Neuroendocrine Posters Source Type: research
We report a case of a male patient with stroke caused by atrial fibrillation (AF) due to thyrotoxicosis. At hospital admission, he presented hypertension and AF. Magnetic resonance imaging confirmed a right-side ischemic area. The thyrotoxicosis was confirmed by thyroid function and thyroid scintigraphy that showed goiter with diffuse hypercaptation. The patient was treated with tapazole and total thyroidectomy, and pathological findings suggested Graves ’ disease. Hyperthyroidism is associated with increased supraventricular ectopic activity in patients with a normal heart, and may be an important causal link betwee...
Source: Case Reports in Neurology - Category: Neurology Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to determine the role of pulmonary vein (PV) triggers in different types of atrial fibrillation (AF) as well as to determine based on prospective randomized data which other approaches may increase the success rate of radiofrequency ablation of persistent AF.Recent FindingsSpecial attention must be paid to detect, diagnose, and optimize management of reversible or treatable causes of persistent AF such as obesity, obstructive sleep apnea, hypertension, hypo- or hyperthyroidism, inflammatory and infectious diseases, and stress. Though the role of PVs is more pronounced ...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
Opinion statementSpecial attention must be paid to detect, diagnose, and optimize management of reversible or treatable causes of long-standing persistent atrial fibrillation (LSPAF) such as obesity, obstructive sleep apnea (OSA), hypertension, hypo or hyperthyroidism, inflammatory and infectious diseases, and stress. Though, we strongly believe that the role of the pulmonary veins (PVs) is more pronounced in paroxysmal atrial fibrillation (AF) than in persistent AF, performing an adequate pulmonary vein isolation is still key in LSPAF. Patients with LSPAF will frequently require a more aggressive mapping and ablative appr...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
In this study the majority of the patients (78), i.e., 22.03% were in the age group of 61–70 years. Majority of the patients were female (58.19%). Males comprised of 41.81%. The common symptoms of atrial fibrillation in the patients were palpitation 85.31% and breathlessness 82.77%. Next common symptoms were fatigue 73.16%, PND 70.06% and swelling of dependant parts 68.93% respectively. Giddiness 57.91% and orthopnea 53.67% were the next common presenting symptoms. Chest pain was the presenting complaint in 22.32% cases and limb weakness or stroke in 7.34% cases. Involuntary movements 3.95% and sleep apnea 1.97% were...
Source: Journal of Indian College of Cardiology - Category: Cardiology Source Type: research
e A Abstract Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation. Symptomatic patients will desire rhythm control. Rhythm control optio...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
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