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Updated: Apr 25, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Endothelial (dys)function in lone atrial fibrillation
Marija M Polovina, Gregory Y H Lip, Tatjana S Potpara1
1Cardiology Clinic, Clinical Centre of Serbia, Visegradska 26, 11000 Belgrade, Serbia. maki.marijapolovina@gmail.com.
Insights
Atrial fibrillation (AF) is a common heart rhythm disorder linked to blood clot risk. This review explores how endothelial dysfunction, or damage to blood vessel linings, contributes to this risk, even in lone AF cases.
Area of Science:
- Cardiology
- Vascular Biology
- Arrhythmology
Background:
- Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults.
- AF significantly increases the risk of thromboembolism.
- Endothelial dysfunction is increasingly recognized as a contributor to thrombogenesis in AF.
Purpose of the Study:
- To review current evidence on endothelial function and injury in AF.
- To focus on endothelial (dys)function specifically in lone AF patients.
- To highlight the role of endothelial dysfunction in AF-related thrombotic risk.
Main Methods:
- Literature review of contemporary evidence.
- Analysis of studies investigating endothelial biomarkers in AF.
- Examination of research on endothelial function in peripheral and coronary circulation of AF patients.
Main Results:
- AF is associated with thrombogenic atrial endocardial lesions.
- Elevated circulating biomarkers of endothelial dysfunction (e.g., von Willebrand factor, E-selectin) are observed in AF.
- Impaired endothelium-dependent vasodilation and endothelial dysfunction are present even in lone AF without comorbidities.
Conclusions:
- Endothelial dysfunction is a significant factor in the thrombotic risk associated with atrial fibrillation.
- Biomarkers of endothelial injury are linked to adverse outcomes in AF.
- Endothelial dysfunction occurs in AF patients irrespective of other cardiovascular risk factors or comorbidities.
Abstract:
Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia in adult population and confers significant thromboembolic risk. Endothelial dysfunction has been recognized as a possible contributor to thrombogenesis in AF. The arrhythmia has been associated with thrombogenic atrial endocardial lesions and evidence of increased circulating biomarkers of endothelial dysfunction (e.g. von Willebrand factor, soluble thrombomodulin, E-selectin, asymmetric dimethylarginine, circulating endothelial cells and microparticles), and impairment of endothelium-dependent vasodilatation in the peripheral and coronary circulation has been reported in AF patients. Increased levels of biomarkers of endothelial origin (e.g. von Willebrand factor, soluble thrombomodulin, E-selectin, asymmetric dimethylarginine) have been associated with adverse outcomes in AF patients. Importantly, endothelial dysfunction has been documented in AF patients without cardio-pulmonary comorbidities or risk factors (so-called 'lone AF'), as well. In this review, we provide an overview of contemporary evidence for the alterations in endothelial function and endothelial injury in AF, with a focus on endothelial (dys)function in lone AF.
