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00925njm 22002777a 4500 dc Enríquez-Vázquez, Daniel author Quintanilla, Jorge G author García-Escolano, Alba author Couselo-Seijas, Marinela author Simón-Chica, Ana author Lee, Peter author Alfonso-Almazan, Jose M. author Mahía, Patricia author Redondo-Rodríguez, Andrés author Modrego, Javier author Ortega-Hernández, Adriana author Marcos-Alberca, Pedro author Magni, Ricardo author Calvo, Enrique author Gómez-Gordo, Rubén author Yan, Ping author La Rosa, Giulio author Bustamante-Madrión, José author Pérez-García, Carlos Nicolás author Martín-Sánchez, F Javier author Calvo, David author de la Hera, Jesús M author García-Torrent, María Jesús author García-Osuna, Álvaro author Ordonez-Llanos, Jordi author Vazquez, Jesus author Pérez-Villacastín, Julián author Pérez-Castellano, Nicasio author Loew, Leslie M author Sánchez-González, Javier author Gómez-Garre, Dulcenombre author Filgueiras-Rama, David author 2023-08-04 Electromechanical characterization during atrial fibrillation (AF) remains a significant gap in the understanding of AF-related atrial myopathy. This study reports mechanistic insights into the electromechanical remodeling process associated with AF progression and further demonstrates its prognostic value in the clinic. In pigs, sequential electromechanical assessment during AF progression shows a progressive decrease in mechanical activity and early dissociation from its electrical counterpart. Atrial tissue samples from animals with AF reveal an abnormal increase in cardiomyocytes death and alterations in calcium handling proteins. High-throughput quantitative proteomics and immunoblotting analyses at different stages of AF progression identify downregulation of contractile proteins and progressive increase in atrial fibrosis. Moreover, advanced optical mapping techniques, applied to whole heart preparations during AF, demonstrate that AF-related remodeling decreases the frequency threshold for dissociation between transmembrane voltage signals and intracellular calcium transients compared to healthy controls. Single cell simulations of human atrial cardiomyocytes also confirm the experimental results. In patients, non-invasive assessment of the atrial electromechanical relationship further demonstrate that atrial electromechanical dissociation is an early prognostic indicator for acute and long-term rhythm control. Nat Commun. 2023 Aug 4;14(1):4613. 10.1038/s41467-023-40196-y 2041-1723 Nature communications 37542075 http://hdl.handle.net/20.500.12105/16393 Non-invasive electromechanical assessment during atrial fibrillation identifies underlying atrial myopathy alterations with early prognostic value.