Atrial disease and heart failure: the common soil hypothesis proposed by the Heart Failure Association of the European Society of Cardiology

Andrew J S Coats, Stephane Heymans, Dimitrios Farmakis*, Stefan D Anker, Johannes Backs, Johann Bauersachs, Rudolf A De boer, Jelena Čelutkienė, John G F Cleland, Dobromir Dobrev, Isabelle C Van gelder, Stephan Von haehling, Gerhard Hindricks, Ewa Jankowska, Dipak Kotecha, Linda W Van laake, Mitja Lainscak, Lars H Lund, Ida Gjervold Lunde, Alexander R LyonAristomenis Manouras, Davor Miličić, Christian Mueller, Marija Polovina, Piotr Ponikowski, Giuseppe Rosano, Petar M Seferović, Carsten Tschöpe, Rolf Wachter, Frank Ruschitzka*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A proposed conceptual framework for understanding atrial disease. Subclinical atrial disease develops under the effect of stressors such as aging, cardio-metabolic risk factors and diseases, and genetic predisposition that activate pathogenic mechanisms, such as inflammation, endothelial and microvascular dysfunction, fibrosis, hypercoagulability and atrial stretch that in turn affect the atrial myocardium. Subclinical atrial disease is characterized by structural, electrical and functional changes, also termed atrial remodelling, that progress to overt clinical disease, manifesting as atrial fibrillation, heart failure and further to thromboembolism. The potential detection of subclinical atrial disease with imaging, biomarkers and other modalities offers a window opportunity for interventions that would prevent deterioration to clinical disease and could potentially allow reversal of subclinical disease. CMR, cardiac magnetic resonance; CT, computed tomography; ECG, electrocardiogram; RF, risk factors.
Original languageEnglish
Pages (from-to)863-867
Number of pages5
JournalEuropean Heart Journal
Volume43
Issue number9
Early online date7 Dec 2021
DOIs
Publication statusPublished - 1 Mar 2022

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