Pathogenesis, Diagnosis and Treatment of Cardiomyopathy and Cardiac Arrhythmias

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 617

Special Issue Editor


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Guest Editor
Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
Interests: atrial functional study; cryoablation technique for AF; arrhythmogenesis and inflammation in patients with AF; 3D-guided VT ablation; ventricular arrhythmia; VPC and hemodynamics; VPC and stroke

Special Issue Information

Dear Colleagues,

Arrhythmias significantly contribute to increased morbidity and mortality, and cardiomyopathies (CM) are the leading cause of syncope and sudden cardiac death (SCD) in young people. Electrocardiographic findings and arrhythmias are closely related to cardiomyopathies. Both may be an early indication of a specific diagnosis or are the consequence of structural changes in a heart with myocardial fibrosis and decreased contractility. The spectrum of arrhythmias ranges from bradyarrhythmia to atrial and/or ventricular premature beats to atrial tachyarrhythmia and/or life-threatening ventricular arrhythmia. Atrial fibrillation (AF) represents the most common arrhythmia and is associated with an increased risk of cardio-thromboembolic events, heart failure and mortality in patients with CM, and there is growing evidence for atrial fibrillation ablation in an era of steadily increasing catheter ablation in patients with atrial fibrillation without CM. SCD prevention plays an important role in the new recommendations. These guidelines include five Class I indications for intracardiac defibrillator (ICD) treatment for CM as secondary preventions and are consistent with the 2022 ESC Guidelines for ventricular arrhythmia patient management and SCD prevention. This extends previously established individualized decision-making concepts and supports individual management and risk stratification by etiology. Recommendations for genetic testing have increased, and the guidelines acknowledge the growing evidence for specific high-risk genotypes, regardless of left ventricular morphology and function. For example, this includes a Class I recommendation for genetic testing in all patients who meet the diagnostic criteria for CM and serial genetic testing of relatives if there is a possibility of pathologic variants in the index patient. Alongside genetic testing, the role of cardiac MRI has increased in recent years, but randomized trials to guide ICD therapy are still lacking. Therefore, most guidelines emphasize the importance of an etiology-based, tailored, individualized management approach that integrates the patient's medical history, electrocardiogram (ECG) and echocardiography, CMR, laboratory analyses, genetics and electrophysiological studies.

The scope of this Special Issue encompasses various aspects of cardiomyopathy and cardiac arrhythmias, including but not limited to:

  • The identification and characterization of underlying mechanisms and genetic factors contributing to cardiomyopathy and cardiac arrhythmias.
  • Advances in diagnostic modalities, such as innovative imaging techniques, molecular markers, genetics and electrophysiological studies.
  • Evaluation of novel therapeutic strategies and pharmacological interventions.

Dr. Sung Il Im
Guest Editor

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Keywords

  • arrhythmia
  • cardiomyopathy
  • pathogenesis
  • diagnosis

Published Papers (1 paper)

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Research

15 pages, 1321 KiB  
Article
Sex Differences in the Expression of Cardiac Remodeling and Inflammatory Cytokines in Patients with Obstructive Sleep Apnea and Atrial Fibrillation
by Chun-Ting Shih, Hui-Ting Wang, Yung-Che Chen, Ya-Ting Chang, Pei-Ting Lin, Po-Yuan Hsu, Meng-Chih Lin and Yung-Lung Chen
Biomedicines 2024, 12(6), 1160; https://doi.org/10.3390/biomedicines12061160 - 23 May 2024
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Abstract
Although there is a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF) and numerous investigations have examined the mechanism of AF development in OSA patients, which includes cardiac remodeling, inflammation, and gap junction-related conduction disorder, there is limited information regarding the [...] Read more.
Although there is a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF) and numerous investigations have examined the mechanism of AF development in OSA patients, which includes cardiac remodeling, inflammation, and gap junction-related conduction disorder, there is limited information regarding the differences between the sexes. This study analyzes the impact of sex differences on the expression of cardiac remodeling, inflammatory cytokines, and gap junctions in patients with OSA and AF. A total of 154 individuals diagnosed with sleep-related breathing disorders (SRBDs) were enrolled in the study and underwent polysomnography and echocardiography. Significant OSA was defined as an apnea–hypopnea index (AHI) of ≥15 per hour. Exosomes were purified from the plasma of all SRBD patients and incubated in HL-1 cells to investigate their effects on inflammatory cytokines and GJA1 expression. The differences in cardiac remodeling and expression of these biomarkers in both sexes were analyzed. Of the 154 enrolled patients, 110 patients were male and 44 patients were female. The LA sizes and E/e’ ratios of male OSA patients with concomitant AF were greater than those of control participants and those without AF (all p < 0.05). Meanwhile, female OSA patients with AF had a lower left ventricular ejection fraction than those OSA patients without AF and control subjects (p < 0.05). Regarding the expression of inflammatory cytokines and GJA1, the mRNA expression levels of GJA1 were lower and those of IL-1β were higher in those male OSA patients with AF than in those male OSA patients without AF and control subjects (p < 0.05). By contrast, mRNA expression levels of HIF-1α were higher in those female OSA patients with and without AF than in control subjects (p < 0.05). In conclusion, our study revealed sex-specific differences in the risk factors and biomarkers associated with AF development in patients with OSA. Full article
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