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Uremic Toxins and Atrial Fibrillation: Mechanisms and Therapeutic Implications

Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
YUMINO Heart Clinic, Toshima-ku, Tokyo 171-0033, Japan
Author to whom correspondence should be addressed.
Toxins 2019, 11(10), 597;
Received: 23 September 2019 / Revised: 7 October 2019 / Accepted: 10 October 2019 / Published: 13 October 2019
(This article belongs to the Special Issue The Endothelial Effects of Uremic Toxins)
Atrial fibrillation (AF) is the most prevalent arrhythmia in the general population. There is a close association between chronic kidney disease (CKD) and AF. In recent years, attention has been focused on the relationship between AF and uremic toxins, including indoxyl sulfate (IS). Several animal studies have shown that IS promotes the development and progression of AF. IS has been shown to cause fibrosis and inflammation in the myocardium and exacerbate AF by causing oxidative stress and reducing antioxidative defense. Administration of AST-120, an absorbent of uremic toxins, decreases uremic toxin-induced AF in rodents. We have recently reported that patients with a higher serum IS level exhibit a higher rate of AF recurrence after catheter ablation, with serum IS being a significant predictor of AF recurrence. In this review, we discuss the possible mechanisms behind the AF-promoting effects of uremic toxins and summarize the reported clinical studies of uremic toxin-induced AF. View Full-Text
Keywords: atrial fibrillation; uremic toxin; indoxyl sulfate; chronic kidney disease atrial fibrillation; uremic toxin; indoxyl sulfate; chronic kidney disease
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Yamagami, F.; Tajiri, K.; Yumino, D.; Ieda, M. Uremic Toxins and Atrial Fibrillation: Mechanisms and Therapeutic Implications. Toxins 2019, 11, 597.

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