Article Figures & Data
Figures
- Figure 1.
Incidence of Atrial Fibrillation Associated With Increasing Components of Metabolic Syndrome
Figure adjusted for the following covariates at baseline: age (45 to < 50, 50 to < 55, 55 to < 60, ≥ 60), sex, race, center, educational attainment, smoking status and cigarette-years of smoking (quartiles).
Reprinted from Chamberlain AM et al, Metabolic syndrome and incidence of atrial fibrillation among blacks and whites in the Atherosclerosis Risk in Communities (ARIC) Study, Am Heart J, 2010, Vol 159, Issue 5, Pages 850-856, with permission from 2010 Mosby, Inc.
- Figure 2.
New Paradigm for Heart Failure With HFpEF: Importance of Comorbidities
Comorbidities induce a systemic proinflammatory state with elevated plasma levels of interleukin (IL)-6, tumor necrosis factor (TNF)-a, soluble ST2 (sST2), and pentraxin 3. Coronary microvascular endothelial cells reactively produce reactive oxygen species (ROS), vascular cell adhesion molecule (VCAM), and E-selectin. Production of ROS leads to formation of peroxynitrite (ONOO) and reduced nitric oxide (NO) bioavailability, both of which lower soluble guanylate cyclase (sGC) activity in adjacent cardiomyocytes. Lower sGC activity decreases cyclic guanosine monophosphate concentration and protein kinase G (PKG) activity. Low PKG activity increases resting tension (Fpassive) of cardiomyocytes because of hypophosphorylation of titin and removes the brake on prohypertrophic stimuli inducing cardiomyocyte hypertrophy. VCAM and E-selectin expression in endothelial cells favors migration into the subendothelium of monocytes. These monocytes release transforming growth factor b (TGF-b). The latter stimulates conversion of fibroblasts to myofibroblasts, which deposit collagen in the interstitial space. COPD = chronic obstructive pulmonary disease; HPEF = heart failure with preserved ejection fraction.
Reprinted from J Am Coll Cardiol. Vol 62, A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. Pages 263-7, Copyright 2013, with permission from American College of Cardiology Foundation.
- Figure 3.
Metabolic Syndrome and Atrial Fibrillation
AF, atrial fibrillation; EF, ejection fraction; LA, left atrium.
Reproduced with permission from G Breithardt, MD.
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