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Reverse dedifferentiation of atrial cardiomyocytes after restoration of sinus rhythm from atrial fibrillation in goats

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Journal of Geriatric Cardiology 2009年第4期6卷 230-236页

作者： Feng-Xiang Zhang Ming-Long Chen Bing Yang Wei-Zhu Ju Hong-Wu Chen Dong-Jie Xu Chun Chen Ke-Jiang Cao Cardiovascular Medical Center of Jiangsu Province First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China.

Objective Chronic atrial fibrillation （AF） results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF. In this study, we aimed to investigate the changes oftitin and a-smooth muscle actin （α-SMA） after long time of AF reversal. Methods Twenty-four goats were randomized into four groups：（1） sinus rhythm （SR）, （2） 3 months AF （3-too AF）, （3） 3 months SR after 3 months AF （3-mo post AF）, （4） 6 months SR after 3-mo AF （6-mo post AF）, with 6 in each group. By pacing on the anterior bottom of left atria appendage （LAA）, we established a goat model of chronic AF. Atria effective refractory period （AERP） was measured with electrophysiological methods. Ultra-structure was studied with echocardiography, light and electron microscopy. Titin and α-SMA protein expressions were determined by Western blot. Results The animals underwent high rate pacing on LAA for a mean of 42.23± 21.70 days before presenting AF. electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats. Echocardiography displayed that the size of left atrium resumed almost in 6-too post AF goats （P〈 0.01）. Pathological and electron microscopic examination revealed the disorder of myofibrils, augmentation of intercellular space, myolysis, accumulation of glycogen, and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats. They recovered mostly in 6-mo post AF goats. Western blot showed that the band density oftitin significantly reduced in 3-mo AF goats compared to SR ones [1826 ± 319 vs 5012±854, P 〈 0.01]. In 3- and 6-mo post AF goats, titin increased gradually and it reversed completely in 6-mo post AF goats （3841 ± 601 and 4523 ±833 respectively, P 〈 0.01）. Conversely, the band density ofa-SMAwas significantly higher in 3-mo AF goats （5324 ± 948） than in SR ones （1619 ±271, P 〈 0.01）. In 3- and 6-mo post-AF goats, α-SMA decreased gradually, and it recovered mostly in 6- mo post AF goats （4437 ± 792 and 2205 ±

关键词： cardiology atrial fibrillation reverse remodeling dedifferentiation electrophysiological study

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Arrhythmic syncope: From diagnosis to management

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World Journal of Cardiology 2023年第4期15卷 119-141页

作者： Jaume Francisco Pascual Pablo Jordan Marchite Jesús Rodríguez Silva Nuria Rivas Gándara Unitat d’Arritmies Servei de Cardiologia VHIR Hospital Universitari Vall d’HebronBarcelona 08035Spain Grup de Recerca Cardiovascular Vall d’Hebron Institut de RecercaBarcelona 08035Spain CIBER de Enfermedades Cardiovasculares Instituto de Salud Carlos ⅢMadrid 28029Spain Departament de Medicina Universitat Autònoma de BarcelonaBellaterra 08193Spain

Syncope is a concerning symptom that affects a large proportion of *** can be related to a heterogeneous group of pathologies ranging from trivial causes to diseases with a high risk of sudden ***,benign causes are the most frequent,and identifying high-risk patients with potentially severe etiologies is crucial to establish an accurate diagnosis,initiate effective therapy,and alter the *** term cardiac syncope refers to those episodes where the cause of the cerebral hypoperfusion is directly related to a cardiac disorder,while arrhythmic syncope is cardiac syncope specifically due to rhythm ***,arrhythmias are the most common cause of cardiac *** bradyarrhythmia and tachyarrhythmia can cause a sudden decrease in cardiac output and produce *** this review,we summarized the main guidelines in the management of patients with syncope of presumed arrhythmic ***,we presented a thorough approach to syncope work-up through different tests depending on the clinical characteristics of the patients,risk stratification,and the management of syncope in different scenarios such as structural heart disease and channelopathies.

关键词： Syncope Arrhythmia electrophysiological study Loop recorder Myocardiopathy Atrioventricular conduction block

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