Vetweefsel en afterload: onderschatte spelers in de pathogenese van aritmie

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is the cause of significant cardiovascular morbidity and mortality. AF has the tendency to evolve from an arrhythmia limited in time (paroxysmal AF)to an arrhythmia that is continuously present (persistent AF). Structural, electrical and contractile remodeling processes underlying this progressive nature have been identified. It is of true clinical importance to understand this progressive nature of Af and to be able to discriminate patients with a "reversible" substrate for AF from those patients withan "irreversible" substrate for AF. We hypothesize that the structural and functional changes of the left atrium during the progression from parxysmal to persistent AF can be detected with non-invasive imaging methods. Therefore we want to correlate echocardiographic and MRI (magnetic resonance imaging) changes with in vivo pressure-volume loops, ex vivo tensile testing and histological examination. We will use a sheep model ofprogressive AF, based on rapid atrial pacing. Animals will be sacrificed at different time intervals, which allow a complete study at different stages of AF. Degree of fibrosis will be determined by dedicated atrial MRI delayed enhancement protocols. With echocardiography we aim tostudy changes in left atrial strain, strain rate (SR), integrated backscatter (IB) and cyclic variation of integrated backscatter (CVIB).

Publication year:2017

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