Abstract：
Atrial cardiomyopathy is defined as any complex of structural, architectural, contractile or electrophysiological changes affecting atria, with the potential to produce clinically relevant manifestations. Most of our knowledge about the mechanistic aspects of atrial cardiomyopathy is derived from studies investigating animal models of atrial fibrillation and atrial tissue samples obtained from individuals who have a history of atrial fibrillation. Several noninvasive tools have been reported to characterize atrial cardiomyopathy in patients, which may be relevant for predicting the risk of incident atrial fibrillation and its related outcomes, such as stroke. Here, we provide an overview of the pathophysiological mechanisms involved in atrial cardiomyopathy, and discuss the complex interplay of these mechanisms, including aging, left atrial pressure overload, metabolic disorders and genetic factors. We discuss clinical tools currently available to characterize atrial cardiomyopathy, including electrocardiograms, cardiac imaging and serum biomarkers. Finally, we discuss the clinical impact of atrial cardiomyopathy, and its potential role for predicting atrial fibrillation, stroke, heart failure and dementia. Overall, this review aims to highlight the critical need for a clinically relevant definition of atrial cardiomyopathy to improve treatment strategies.
摘要：
心房心肌病被定义为任何复杂的结构，建筑,影响心房的收缩或电生理变化，有可能产生临床相关表现。我们对心房心肌病的机理方面的大部分知识都来自研究房颤的动物模型和从有房颤病史的个体获得的心房组织样本的研究。已经报道了几种非侵入性工具来表征患者的心房心肌病，这可能与预测房颤事件的风险及其相关结果有关，如中风。这里,我们概述了心房心肌病的病理生理机制，并讨论这些机制的复杂相互作用，包括衰老，左心房压力超负荷,代谢紊乱和遗传因素。我们讨论了目前可用来表征心房心肌病的临床工具，包括心电图,心脏成像和血清生物标志物。最后,我们讨论心房心肌病的临床影响，以及它对预测心房颤动的潜在作用，中风,心力衰竭和痴呆。总的来说,这篇综述旨在强调对心房心肌病的临床相关定义的迫切需要,以改进治疗策略.
