ArticleHeart rhythm O22021
Racial difference in atrial size and extracellular matrix homeostatic response to hypertension: Is this a potential mechanism of reduced atrial fibrillation in African Americans?
Article in Heart rhythm O2, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Postoperative atrial fibrillation in emergent non-cardiac surgery: Risk factors and outcomes from a ten-year intensive-care unit retrospective study.World journal of critical care medicine · 2025Article
- Racial Disparities in Atrial Fibrillation After Coronary Artery Bypass: Impact of Left Atrial Volume.Annals of thoracic surgery short reports · 2023Article
- Disparities in cardio-oncology: Implication of angiogenesis, inflammation, and chemotherapy.Life sciences · 2023Article
- Prognostic value of left atrial size in hypertensive African Americans undergoing stress echocardiography.World journal of cardiology · 2021Article
- The atrial fibrillation paradox -connecting hypertension to atrial disease and stroke.American journal of preventive cardiology · 2021Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundAtrial fibrillation (AF) is less common in African Americans (AA) than Caucasians (C) despite a higher prevalence of risk factors such as hypertension (HTN).
objectiveTest the hypothesis that differences in extracellular matrix (ECM) between AA and C in response to HTN might attenuate atrial enlargement and alter myocardial fibrosis.
methodsECM-related plasma biomarkers and echo data were collected from 326 C and 129 AA subjects with no history of AF, stratified by the presence of HTN, HTN with left ventricular hypertrophy (LVH), or HTN with LVH and heart failure with preserved ejection fraction (HFpEF).
resultsLeft atrial size was significantly smaller and the extent of enlargement in the presence of HTN was less in AA despite similar ventricular relative wall thickness, echocardiographic measures of diastolic function, and 6 minute-walk-test. AA had significantly lower levels of collagen I telopeptide and higher levels of collagen I propeptide among all strata, suggesting unique collagen homeostasis. Matrix metalloproteinases (MMP) and tissue inhibitors of matrix metalloproteinase (TIMP) showed a distinctive response to HTN in AA, with significantly lower levels of MMP-2, MMP-3, and MMP-8 in AA with HTN and significantly lower levels of TIMP-1 and TIMP-3 in AA with HTN and AA with LVH. AA had significantly lower levels of NT-pro-BNP in all strata.
conclusionThis cross-sectional study demonstrates a racial disparity in ECM blood biomarkers and atrial remodeling in response to HTN and in the development of LVH and HFpEF that may partly help explain the decreased risk of AF in AA.
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