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Atrial cardiomyopathy: new pathophysiological and clinical aspects
Nicola Pierucci1, Marco V Mariani2, Giovanni Iannetti2
1Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy - npierucci@gmail.com.
Minerva Cardiology and Angiology
|June 23, 2025
Summary
Atrial cardiomyopathy (ACM) contributes to atrial fibrillation (AF) through structural and electrical changes. Understanding ACM mechanisms and using advanced imaging can improve AF patient outcomes.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Pathophysiology
Background:
- Atrial cardiomyopathy (ACM) is increasingly recognized as a significant factor in atrial fibrillation (AF) development and persistence.
- ACM involves complex atrial myocardial remodeling driven by conditions like hypertension, heart failure, and obesity.
- Key mechanisms include fibrosis, inflammation, and oxidative stress, creating a pro-arrhythmic and pro-thrombotic state.
Purpose of the Study:
- To review the role of ACM as a contributor to AF.
- To discuss the pathophysiological mechanisms and clinical implications of ACM.
- To highlight emerging diagnostic tools and future research directions.
Main Methods:
- Literature review focusing on ACM and AF.
- Analysis of pathophysiological mechanisms including fibrosis, inflammation, and oxidative stress.
- Discussion of advanced imaging techniques like left atrial strain and cardiac MRI.
Main Results:
- ACM's structural, electrical, and functional remodeling promotes AF.
- Epicardial adipose tissue and genetic factors play roles in ACM.
- Advanced imaging aids in assessing atrial remodeling and guiding therapy.
Conclusions:
- Understanding the ACM-AF relationship can lead to earlier identification and targeted interventions.
- Further research is needed for early ACM markers and specific treatments.
- Refining diagnostic criteria and exploring novel therapies are crucial for managing ACM and associated risks.
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