Endothelial (dys)function in lone atrial fibrillation

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.