Functional and Structural Remodeling as Atrial Fibrillation Progresses in a Persistent Atrial Fibrillation Canine Model

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-04-01 DOI:10.1016/j.jacep.2024.10.001

Eugene Kwan MS , Bram Hunt MS , Eric N. Paccione MS , Ben A. Orkild BS , Jake A. Bergquist PhD , Yuki Ishidoya MD , Kyoichiro Yazaki MD , Jason K. Mendes PhD , Ed V.R. DiBella PhD , Rob S. MacLeod PhD , Derek J. Dosdall PhD , Ravi Ranjan MD PhD

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Abstract

Background

Contractile, electrical, and structural remodeling has been associated with atrial fibrillation (AF), but the progression of functional and structural changes as AF sustains has not been previously evaluated serially.

Objectives

Using a rapid-paced persistent AF canine model, the authors aimed to evaluate the structural and functional changes serially as AF progresses.

Methods

Serial electrophysiological studies in a chronic rapid-paced canine model (n = 19) prior to AF sustaining and repeated at 1, 3, and 6 months of sustained AF were conducted to measure changes in atrial conduction speed and direction. Cardiac late gadolinium enhancement magnetic resonance imaging was performed prior to and following sustained AF to evaluate structural remodeling.

Results

As AF progressed, the overall area of the left atrium with fibrosis increased. Over time, conduction speeds slowed, with speeds decreasing by 0.15 m/s after 3 months and 0.26 m/s after 6 months of sustained AF. Regions that developed fibrosis experienced greater slowing compared with healthy regions (0.32 ± 0.01 m/s decrease vs 0.21 ± 0.01 m/s decrease; P < 0.001). Conduction directions became more aligned (conduction direction heterogeneity decreased from 19.7 ± 0.1° to 17.5 ± 0.1° after 6 months of sustained AF; P < 0.001). Fibrotic regions had a greater decrease in conduction direction heterogeneity (2.7 ± 0.3° vs 2.0 ± 0.2°; P = 0.008).

Conclusions

As AF progressed, functional changes occurred globally throughout the left atrium. Conduction speed slowed, and conduction directions became more aligned over time, with the greatest changes occurring within regions that developed fibrosis.

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持续性房颤犬模型房颤进展过程中的功能和结构重构。

背景：收缩性、电性和结构重构与房颤（AF）有关，但房颤持续时功能和结构变化的进展此前尚未进行连续评估。目的：采用快节奏持续性房颤犬模型，评价房颤进展过程中结构和功能的变化。方法：对慢性快节奏犬模型（n = 19）在房颤持续前和房颤持续1、3和6个月时重复进行连续电生理研究，测量心房传导速度和方向的变化。在持续房颤之前和之后进行心脏晚期钆增强磁共振成像以评估结构重塑。结果：随着房颤的进展，左心房纤维化的总体面积增加。随着时间的推移，传导速度减慢，3个月后减慢0.15 m/s， 6个月后减慢0.26 m/s。与健康区域相比，发生纤维化的区域减慢更大（0.32±0.01 m/s vs 0.21±0.01 m/s）；P < 0.001)。传导方向更加一致(传导方向不均匀性在持续AF 6个月后从19.7±0.1°下降到17.5±0.1°；P < 0.001)。纤维化区传导方向不均匀性明显降低(2.7±0.3°vs 2.0±0.2°；p = 0.008)。结论：随着房颤的进展，整个左心房的功能发生改变。随着时间的推移，传导速度减慢，传导方向变得更加一致，最大的变化发生在发生纤维化的区域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.