Open Access
Atrial Fibrillation Atrial Fibrillation Current Knowledge and Future Directions in Epidemiology and Genomics
Jared W. Magnani,Michiel Rienstra,Honghuang Lin,Moritz F. Sinner,Steven A. Lubitz,David D. McManus,Patrick T. Ellinor,Emelia J. Benjamin +7 more
- 01 Jan 2011
201
TL;DR: How epidemiology and “omic” advances will contribute towards a systems biology approach that will help to unravel the pathogenesis, risk stratification, and novel targets for AF therapies is sought.
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Abstract: Atrial fibrillation (AF) is of public health importance and profoundly increases morbidity, mortality and health-related expenditures. Morbidities include the increased risks of cardiovascular outcomes such as heart failure and stroke, and the deleterious effects on quality of life, functional status and cognition. The clinical epidemiology of AF, its risk factors and outcomes, have been extensively investigated. Genetic advances over the last decade have facilitated the identification of mutations and common polymorphisms associated with AF. Metabolomics, proteomics and other “omics” technologies have only recently been applied to the study of AF, and have not yet been systematically investigated. Systems biology approaches, while still in their infancy, offer the promise of providing novel insights into pathways influencing AF risk. In the present review, we address the current state of the epidemiology and genomics of AF. We seek to emphasize how epidemiology and “omic” advances will contribute towards a systems biology approach that will help to unravel the pathogenesis, risk stratification, and novel targets for AF therapies. Our purpose is to articulate questions and challenges that hinge on integrating novel scientific advances in the epidemiology and genomics of AF. As a reference we have provided a glossary in the inset box.
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Citations
Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation☆
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
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Evaluating the Atrial Myopathy Underlying Atrial Fibrillation Identifying the Arrhythmogenic and Thrombogenic Substrate
Jeffrey J. Goldberger,Rishi Arora,David Green,Philip Greenland,Daniel C. Lee,Donald M. Lloyd-Jones,Michael Markl,Jason Ng,Sanjiv J. Shah +8 more
TL;DR: Evaluation of stasis via imaging and biomarkers associated with thrombogenesis may provide enhanced approaches to assess risk for stroke in patients with AF and better delineation of the atrial myopathy that serves as the substrate for AF and thromboembolic complications might improve treatment outcomes.
236
An update on the prognosis of patients with atrial fibrillation.
TL;DR: The most recently discovered AF-related prognostic factors are described, some new prognostic algorithms for estimating the risk from AF and its complications are discussed, and it is highlighted that additional efforts are needed to prevent AF- related cardiovascular morbidity and mortality.
173
Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II.
Utibe R. Essien,DaJuanicia N. Holmes,Larry R. Jackson,Gregg C. Fonarow,Kenneth W. Mahaffey,James A. Reiffel,Benjamin A. Steinberg,Larry A. Allen,Paul Chan,James V. Freeman,Rosalia Blanco,Karen S. Pieper,Jonathan P. Piccini,Eric D. Peterson,Daniel E. Singer +14 more
TL;DR: Black and Hispanic patients are less likely than white patients to use direct-acting oral anticoagulants for atrial fibrillation, with no difference between white and Hispanic groups in use of DOACs.
Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction
TL;DR: The syndrome of heart failure with preserved ejection fraction (HFpEF) received a lot of attention, but little therapeutic progress was made.
129
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Jenkins Ls,Michael A. Brodsky,Eleanor Schron,Chung M,Thomas P. Rocco,Lader E,Constantine M,Sheppard R,Holmes D,Mateski D,Floden L,Prasun M,H L Greene,Lynn Shemanski +13 more
TL;DR: Quality of life was comparable between rate- and rhythm-control treatment strategies in AF and was similar with sinus rhythm versus AF, and attempts to improve QoL by restoring sinus Rhythm will usually be unsuccessful.
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The identification of functional modules from the genomic association of genes
TL;DR: Comparative genome analysis allows identification of a level of functional interaction between that of pairwise interactions, and of the complete genome, and the properties of such networks are studied to identify functional modules: sets of proteins that together are involved in a biological process.
Ethnic Distribution of ECG Predictors of Atrial Fibrillation and Its Impact on Understanding the Ethnic Distribution of Ischemic Stroke in the Atherosclerosis Risk in Communities (ARIC) Study
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Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation.
Paul Dorian,Miney Paquette,David Newman,Martin S. Green,Stuart J. Connolly,Mario Talajic,Denis Roy +6 more
TL;DR: In patients with symptomatic AF, QOL improves after treatment, independent of the specific drug used for treatment, especially true for patients in whom treatment prevents AF recurrence.
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Ablation of a Ca2+-activated K+ channel (SK2 channel) results in action potential prolongation in atrial myocytes and atrial fibrillation.
Ning Li,Valeriy Timofeyev,Dipika Tuteja,Danyan Xu,Ling Lu,Qian Zhang,Zhao Zhang,Anil Singapuri,Trevine R. Albert,Amutha V. Rajagopal,Chris T. Bond,Muthu Periasamy,John P. Adelman,Nipavan Chiamvimonvat,Nipavan Chiamvimonvat +14 more
TL;DR: The data support the important functional roles ofSK2 channels in cardiac repolarization in atrial myocytes and predict that knockout of SK2 channels may predispose the atria to tachy‐arrhythmias due to the fact that the late phase of the cardiac action potential is highly susceptible to aberrant excitation.
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