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Isolation and Characterization of Cardiac Mesenchymal Stromal Cells from Endomyocardial Bioptic Samples of Arrhythmogenic Cardiomyopathy Patients
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Atrial cardiomyopathy: from cell to bedside

Mengmeng Li1, Yuye Ning1,2, Gary Tse3,4

  • 1Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

ESC Heart Failure
|August 3, 2022
PubMed

Insights

Atrial cardiomyopathy, a remodelling of heart atria, may be an underestimated cause of cardioembolic stroke, potentially preceding atrial fibrillation. Further research is needed for diagnosis and prevention.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Stroke Medicine

Background:

  • Atrial cardiomyopathy involves structural and electrical changes in the atria, leading to impaired function.
  • While atrial fibrillation is linked to cardioembolic stroke, atrial cardiomyopathy's role is underestimated.
  • The interplay between atrial cardiomyopathy, atrial fibrillation, and cardioembolic stroke requires clarification.

Purpose of the Study:

  • To review the pathogenesis of atrial cardiomyopathy, focusing on neurohormonal, inflammatory, and adipose tissue mechanisms.
  • To examine evidence linking atrial cardiomyopathy to embolic stroke, with atrial fibrillation as a potential consequence.
  • To discuss diagnostic methods and therapeutic strategies for atrial cardiomyopathy and associated stroke risk.

Main Methods:

  • Literature review of atrial cardiomyopathy pathogenesis, stroke association, and diagnostic techniques.
  • Focus on neurohormonal, inflammatory, and epicardial fat roles in atrial remodelling.
  • Appraisal of diagnostic tools including imaging (echocardiography, CT, MRI), electroanatomic mapping, ECG, biomarkers, and genetic testing.

Main Results:

  • Atrial cardiomyopathy is characterized by neurohormonal activation, inflammation, and epicardial fat accumulation.
  • Atrial cardiomyopathy may precede atrial fibrillation, creating a pro-thrombotic atrial substrate.
  • Current diagnostic techniques offer insights but require further validation in prospective studies.

Conclusions:

  • Atrial cardiomyopathy is a significant, potentially primary, driver of cardioembolic stroke.
  • Atrial fibrillation may be a marker of underlying atrial cardiomyopathy and thrombogenic risk.
  • Prompt diagnosis and targeted therapies for atrial cardiomyopathy are crucial for stroke prevention.

Keywords:
Atrial cardiomyopathyAtrial fibrillationDiagnosisEmbolic strokePathogenesis

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