Document Detail


Hypertension and atrial fibrillation: evidence of progressive atrial remodeling with electrostructural correlate in a conscious chronically instrumented ovine model.
MedLine Citation:
PMID:  20466075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypertension accounts for more atrial fibrillation (AF) than any other predisposing factor.
OBJECTIVE: The purpose of this study was to characterize the time course, extent, and electrostructural correlation of atrial remodeling in chronic hypertension.
METHODS: Thirty-two sheep were studied: 21 with induced "one-kidney, one-clip" hypertension and 11 controls. Sequential closed-chest electrophysiologic studies were performed in 12 conscious animals (6 hypertensive, 6 controls) to evaluate progressive remodeling over 15 weeks. Additional atrial structural/functional analyses were performed in 5 controls and at 5, 10, and 15 weeks of hypertension (five per time point) via histology/cardiac magnetic resonance imaging to correlate with open-chest electrophysiologic parameters.
RESULTS: The hypertensive group developed a progressive increase in mean arterial pressure (P <.001). Mean effective refractory periods were uniformly higher at all time points (P <.001). Progressive biatrial hypertrophy (P = .003), left atrial dysfunction (P <.05) and greater AF inducibility were seen early with increased inflammation from 5 weeks of hypertension. In contrast, significant conduction slowing (P <.001) with increased heterogeneity (P <.001) along with increased interstitial fibrosis resulted in longer and more fractionated AF episodes only from 10 weeks of hypertension. Significant electrostructural correlation was seen in conduction abnormalities and AF inducibility with both atrial inflammation and fibrosis.
CONCLUSION: Hypertension is associated with early and progressive changes in atrial remodeling. Atrial remodeling occurs at different time domains in chronic hypertension with significant electrostructural correlation of the remodeling cascade. Early institution of antihypertensive treatment may prevent formation of substrate capable of maintaining AF.
Authors:
Dennis H Lau; Lorraine Mackenzie; Darren J Kelly; Peter J Psaltis; Anthony G Brooks; Michael Worthington; Arumuga Rajendram; Douglas R Kelly; Yuan Zhang; Pawel Kuklik; Adam J Nelson; Christopher X Wong; Stephen G Worthley; Mohan Rao; Randall J Faull; James Edwards; David A Saint; Prashanthan Sanders
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-11
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  7     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1282-90     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and Discipline of Medicine, University of Adelaide, Adelaide, Australia.
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MeSH Terms
Descriptor/Qualifier:
Animals
Atrial Fibrillation / etiology*,  pathology,  physiopathology
Atrial Function / physiology*
Chronic Disease
Consciousness
Disease Models, Animal
Disease Progression
Electrophysiologic Techniques, Cardiac
Heart Atria / pathology,  physiopathology*
Heart Conduction System / physiopathology*
Hypertension / complications*,  pathology,  physiopathology
Magnetic Resonance Imaging
Sheep, Domestic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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