title: Alterations in atrial perfusion during atrial fibrillation.
abstract: Left atrial (LA) perfusion during disease states has been a topic of much interest, because the clinical implications and detrimental effects of lack of blood flow to the atria are numerous. In the chronic setting, changes in perfusion may lead to LA ischaemia and structural remodelling, a factor implicated in the self-perpetuation of chronic atrial fibrillation (AF). The association between AF and altered LA perfusion has been studied, but a direct causal association between perfusion changes and AF has not been established. A comprehensive literature search of Medline, Embase and Google Scholar databases was conducted from 1960 to February 2014. We systematically analysed reference lists of physiological articles and reviews for other possibly relevant studies. The aim of this review is to provide a comprehensive discussion of the AF-mediated changes in LA perfusion and the potential mechanisms underlying the alterations in coronary flow to the LA in this setting. In addition, we discuss the clinical contexts in which changes in LA perfusion may be relevant. Finally, this article highlights the need for longitudinal studies of AF that would elucidate the changes in LA perfusion resulting from chronic AF and lead to advancements in effective treatments to prevent progression of this disease.
authors: Comprehensive Arrhythmia and Research Management Center, Division of Cardiology, Department of Radiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA christina.pacchia@hsc.utah.edu.
authors: Christina F
authors: CF
authors: Pacchia
authors: Comprehensive Arrhythmia and Research Management Center, Division of Cardiology, Department of Radiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors: Derek J
authors: DJ
authors: Dosdall
authors: Comprehensive Arrhythmia and Research Management Center, Division of Cardiology, Department of Radiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors: Ravi
authors: R
authors: Ranjan
authors: Comprehensive Arrhythmia and Research Management Center, Division of Cardiology, Department of Radiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors: Edward
authors: E
authors: DiBella
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology*; D018450:Disease Progression; D005355:Fibrosis / Q000473:pathology / Q000503:physiopathology; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D017202:Myocardial Ischemia / Q000473:pathology / Q000503:physiopathology*