Electrophysiological, Electroanatomical, and Structural Remodeling of the Atria as Consequences of Sustained Obesity

摘要: Abstract Background Obesity and atrial fibrillation (AF) are public health issues with significant consequences. Objectives This study sought to delineate the development of global electrophysiological structural substrate for AF in sustained obesity. Methods Ten sheep fed ad libitum calorie-dense diet induce obesity over 36 weeks were maintained this state another weeks; 10 lean carefully controlled weight served as controls. All underwent electroanatomic mapping; hemodynamic imaging assessment (echocardiography dual-energy x-ray absorptiometry); histology molecular evaluation. Evaluation included voltage, conduction velocity (CV), refractoriness (7 sites, 2 cycle lengths), vulnerability AF, fatty infiltration, fibrosis, transforming growth factor (TGF)-β1 expression. Results Compared age-matched controls, chronically obese demonstrated greater total body fat (p  0.8) or ERP heterogeneity (p > 0.3). was associated more episodes (p = 0.02), prolongation 0.01), cumulative duration 0.02) AF. Epicardial infiltrated posterior LA in the group Conclusions Sustained results biatrial endocardial remodeling characterized by enlargement, abnormalities, fractionated electrograms, increased profibrotic TGF-β1 expression, interstitial propensity reduced voltage infiltration of contiguous muscle epicardial fat, representing a unique