As most know, the leading cause of death in developed and developing countries is coronary heart disease (CHD). CHD occurs when plaque is formed within the coronary arteries and therefore has a difficult time distributing blood and oxygen to the cardiac muscle tissue. Over recent years there has been seen an increased correlation between atrial fibrillation (AF) and the cause of CHD and vice versa due to their common risk factors. CHD can cause AF due to reentry formation, focal ectopic activity, and neural remodeling, all of which are common cardiac arrhythmia origins. To me, the most interesting cause here is the neural remodeling in which the autonomic nervous system change’s function due to CHD and therefore causes AF. On the other hand, AF can cause CHD via atherosclerosis, mismatched blood supply and oxygen consumption, and thrombosis by changing the heart’s ability to affectively beat. Interestingly enough, atherosclerosis from AF has been hypothesized to cause CHD because of the increased von Williebrand factor in these patients, making their blood vessels weaker and narrowing the blood supply potential. In this journal entry it was found that patients that already had AF developed CHD 34% of the time. With this comorbidity much worse outcomes occur, such as myocardial infarctions and even death. Although there is a clear and proven correlation between CHD and AF, the exact mechanisms for their causation are still unknown. What research needs to be done to break up this “vicious cycle”? Knowing that one disease causes the other, if we can prevent either from their initial onset, then the comorbidity will never occur.
As someone who has a family lineage of heart disease it is important for me to understand this dual relationship and watch out for the common risk factors more than the average person. Some of these risk factors include: hypertension, diabetes, obesity, and sleep apnea. I can combat these factors by maintaining a healthy lifestyle and focusing on heart healthy foods and exercise. Knowing that I am higher risk to develop heart disease and therefore AF, what further research can be done in terms of preventative care for not only me but others who suffer from similar genetic backgrounds?
Source: Liang, F., & Wang, Y. (2021). Coronary Heart Disease and Atrial Fibrilation: A Vicious Cycle. In American Journal of Physiology-Heart and Circulatory Physiology (Vol, 320, Issue 1, pp. H1-H12). American Physiological Society. https://doi.org/10.1152/ajpheart.00702.2020
I love this topic and how you related it to that of your own life as precautions. In the article titled "Psychological Stress, Inflammation, and Coronary Heart Disease," I found it very interesting that both short term and long term stressors can increase one's chances of developing CHF or symptoms similar to the disease. Also with long term and short term stress, they find that this has a linkage to inflammation in the body, leading me to believe that this can be one of the causes that increases plague in the coronary artery leading to CHD. (Wirtz, P. H., & von Känel, R. (2017). Psychological Stress, Inflammation, and Coronary Heart Disease. Current cardiology reports, 19(11), 111. https://doi.org/10.1007/s11886-017-0919-x)
ReplyDeleteAlso in the article titled "Oxidative Stress and Atrial Fibrillation: An Update," the author's mention that one of the leading causes to A-Fib is oxidative stress along with other variables like lifestyle, diet, inflammation, etc. When looking at both of these articles, they lead me to believe that the potential for long term or short term stress and inflammation can influence the oxidative stress in which can lead to A-Fib from that of CHD.
I forgot my source for the second article so I will add it here! Korantzopoulos, P., Letsas, K., Fragakis, N., Tse, G., & Liu, T. (2018). Oxidative stress and atrial fibrillation: an update. Free radical research, 52(11-12), 1199–1209. https://doi.org/10.1080/10715762.2018.1500696
ReplyDeleteI found an interesting article discussing ways in which diagnosing and treating AF can be improved. These suggestions come from the “roadmap initiative” started by the World Heart Federation. The roadmap initiative that took place in 2017 led to technological innovation in terms of identifying AF, found methods to control arrhythmias, along with other improvements. They currently suggest increasing patient’s health literacy, developing new preventative strategies, informing patients and doctors about risk factors, greater access to pharmacologic treatment, etc. It seems that these roadmap initiatives could lead to better preventative treatment that could then break up the cycle you discussed.
ReplyDeleteFreedman, B., Hindricks, G., Banerjee, A., Baranchuk, A., Ching, C. K., Du, X., Fitzsimons, D., Healey, J. S., Ikeda, T., Lobban, T. C. A., Mbakwem, A., Narasimhan, C., Neubeck, L., Noseworthy, P., Philbin, D. M., Jr, Pinto, F. J., Rwebembera, J., Schnabel, R. B., Svendsen, J. H., Aguinaga, L., … Stepinska, J. (2021). World Heart Federation Roadmap on Atrial Fibrillation - A 2020 Update. Global heart, 16(1), 41. https://doi.org/10.5334/gh.1023.
Hey there,
ReplyDeleteI found an interesting article that may be helpful for you (and potentially others). Your blog post spoke about possible preventative care for your genetic predisposition for heart disease. This article is specific to the preventative care used for atrial fibrillation diagnoses.
One of the primary ways we can quickly identify dangerous heart rhythms in the hospital and in the field for EMS, is an EKG or ECG. This article goes into depth on how EKG's can be performed once and even up to a continuous two-week cycle to see if patients continuously run AF or intermittently.
Take a look, let me know what you think. It's a great article to pair up with Emma's comment above. Hope this helps.
Schnabel, R. B., Marinelli, E. A., Arbelo, E., Boriani, G., Boveda, S., Buckley, C. M., Camm, A. J., Casadei, B., Chua, W., Dagres, N., de Melis, M., Desteghe, L., Diederichsen, S. Z., Duncker, D., Eckardt, L., Eisert, C., Engler, D., Fabritz, L., Freedman, B., Gillet, L., … Kirchhof, P. (2023). Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET/EHRA consensus conference. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 25(1), 6–27. https://doi.org/10.1093/europace/euac062