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Review
. 2024 Feb 20;13(5):1207.
doi: 10.3390/jcm13051207.

Atrial Fibrillation and Early Vascular Aging: Clinical Implications, Methodology Issues and Open Questions-A Review from the VascAgeNet COST Action

Giacomo Pucci  1   2 , Andrea Grillo  3 , Kalliopi V Dalakleidi  4 , Emil Fraenkel  5 , Eugenia Gkaliagkousi  6 , Spyretta Golemati  7 , Andrea Guala  8   9 , Bernhard Hametner  10 , Antonios Lazaridis  6 , Christopher C Mayer  10 , Ioana Mozos  11 , Telmo Pereira  12   13 , Dave Veerasingam  14 , Dimitrios Terentes-Printzios  15 , Davide Agnoletti  16   17
Affiliations
Review

Atrial Fibrillation and Early Vascular Aging: Clinical Implications, Methodology Issues and Open Questions-A Review from the VascAgeNet COST Action

Giacomo Pucci et al. J Clin Med. .

Abstract

Atrial fibrillation (AF), the most common cardiac arrhythmia, is associated with adverse CV outcomes. Vascular aging (VA), which is defined as the progressive deterioration of arterial function and structure over a lifetime, is an independent predictor of both AF development and CV events. A timing identification and treatment of early VA has therefore the potential to reduce the risk of AF incidence and related CV events. A network of scientists and clinicians from the COST Action VascAgeNet identified five clinically and methodologically relevant questions regarding the relationship between AF and VA and conducted a narrative review of the literature to find potential answers. These are: (1) Are VA biomarkers associated with AF? (2) Does early VA predict AF occurrence better than chronological aging? (3) Is early VA a risk enhancer for the occurrence of CV events in AF patients? (4) Are devices measuring VA suitable to perform subclinical AF detection? (5) Does atrial-fibrillation-related rhythm irregularity have a negative impact on the measurement of vascular age? Results showed that VA is a powerful and independent predictor of AF incidence, however, its role as risk modifier for the occurrence of CV events in patients with AF is debatable. Limited and inconclusive data exist regarding the reliability of VA measurement in the presence of rhythm irregularities associated with AF. To date, no device is equipped with tools capable of detecting AF during VA measurements. This represents a missed opportunity to effectively perform CV prevention in people at high risk. Further advances are needed to fill knowledge gaps in this field.

Keywords: arterial stiffness; arteriosclerosis; atrial fibrillation; cardiovascular disease; endothelial dysfunction; flow mediated dilation; pulse wave velocity; vascular aging.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of the review process.
Figure 2
Figure 2
Results of included studies according to methods and the five questions considered in the paper.
See this image and copyright information in PMC

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