Abstract
Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These changes include alterations at the levels of ionic channels, cellular energy balance, neurohormonal expression, inflammatory response, and physiologic adaptations. There is convincing evidence demonstrating an important pathophysiological association between LA remodeling and atrial fibrillation (AF). Measures that will prevent, attenuate, or halt these processes of LA remodeling may have a major public health impact with respect to the epidemic of AF. In this review, we describe the mechanisms involved in LA remodeling and highlight the existing and potential therapeutic options for its reversal, and implications for AF development.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Aging
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Angiotensin II Type 1 Receptor Blockers / pharmacology
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Angiotensin II Type 1 Receptor Blockers / therapeutic use
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Angiotensin-Converting Enzyme Inhibitors / pharmacology
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use
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Antifibrinolytic Agents / pharmacology
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Antifibrinolytic Agents / therapeutic use
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Atrial Fibrillation / physiopathology*
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Atrial Fibrillation / therapy
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Catheter Ablation
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Clinical Trials as Topic
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Electric Countershock
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Electrophysiologic Techniques, Cardiac
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Heart Atria / drug effects
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Heart Atria / metabolism*
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Heart Atria / physiopathology*
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Humans
Substances
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Angiotensin II Type 1 Receptor Blockers
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Angiotensin-Converting Enzyme Inhibitors
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Antifibrinolytic Agents