Structural Changes of Atrial Myocardium During Chronic Atrial Fibrillation

Thijssen, Victor L.J.L.; Ausma, Jannie; Liu, Guo Shu; Allessie, Maurits A.; van Eys, Guillaume J.J.M.; Borgers, Marcel

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Volume 9, Issue 1 , Pages 17-28, January 2000

Structural Changes of Atrial Myocardium During Chronic Atrial Fibrillation

Victor L.J.L. Thijssen
- Department of Molecular Cell Biology & Genetics, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Jannie Ausma
- Department of Molecular Cell Biology & Genetics, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Guo Shu Liu
- Department of Cardiology, PLA General Hospital and Postgraduate Medical School, Beijing, People's Republic of China
Maurits A. Allessie
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Guillaume J.J.M. van Eys
- Department of Molecular Cell Biology & Genetics, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Marcel Borgers
- Department of Molecular Cell Biology & Genetics, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Morphology, Life Sciences, Janssen Research Foundation, Beerse, Belgium
- Address for correspondence: Marcel Borgers, PhD, Dept. Morphology, Life Sciences, Janssen Research Foundation, B-2340 Beerse, Belgium. Tel.: +32-14-602458; Fax: +32-14-605788

Received 7 January 1999; received in revised form 12 November 1999; accepted 30 November 1999.

Abstract

Of all known arrhythmia's, atrial fibrillation (AF) is the most often met in the clinical setting and it is associated with an increase in mortality risk. Several risk factors for AF have been described and several mechanisms of induction and maintenance have been proposed. Studies in patients with AF have shown that structural changes occur in the atria, but the relationship between the structural remodelling and the chronicity of the arrhythmia are not well understood. The changes mainly concern adaptive (dedifferentiation of cardiomyocytes) and maladaptive (degeneration of cells with replacement fibrosis) features. In order to characterise the time course of the structural remodelling the need for animal models which adequately mimic chronic atrial fibrillation in humans is felt essential. In this review, the structural changes that are observed during prolonged sustained AF in patients and animal models, are described. Furthermore, the time course and potential mechanisms of structural remodelling are discussed and methods for elucidation of the underlying molecular mechanisms are presented.