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Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited

Summary Atrial fibrillation is the most common sustained cardiac arrhythmia, which is associated with a high risk of stroke and thromboembolism. Increasing evidence suggests that the thrombogenic tendency in atrial fibrillation is related to several underlying pathophysiological mechanisms. Abnormal... Full description

Journal Title: The Lancet (British edition) 2009, Vol.373 (9658), p.155-166
Main Author: Watson, Timothy, MRCP
Other Authors: Shantsila, Eduard, MD , Lip, Gregory YH, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
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recordid: cdi_proquest_miscellaneous_66811799
title: Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited
format: Article
creator:
  • Watson, Timothy, MRCP
  • Shantsila, Eduard, MD
  • Lip, Gregory YH, Prof
subjects:
  • Abridged Index Medicus
  • Atrial fibrillation
  • Atrial Fibrillation - complications
  • Atrial Fibrillation - physiopathology
  • Biological and medical sciences
  • Cardiac arrhythmia
  • Cardiac dysrhythmias
  • Cardiology. Vascular system
  • Cardiovascular disease
  • Complications and side effects
  • Development and progression
  • Drugs
  • Fibrinolysis - physiology
  • General aspects
  • Heart
  • Humans
  • Internal Medicine
  • Medical sciences
  • Mortality
  • Risk factors
  • Scanning electron microscopy
  • Sinuses
  • Stroke (Disease)
  • Thromboembolism
  • Thrombosis
  • Thrombosis - etiology
  • Tomography
  • von Willebrand Factor - physiology
ispartof: The Lancet (British edition), 2009, Vol.373 (9658), p.155-166
description: Summary Atrial fibrillation is the most common sustained cardiac arrhythmia, which is associated with a high risk of stroke and thromboembolism. Increasing evidence suggests that the thrombogenic tendency in atrial fibrillation is related to several underlying pathophysiological mechanisms. Abnormal changes in flow are evident by stasis in the left atrium, and seen as spontaneous echocontrast. Abnormal changes in vessel walls—essentially, anatomical and structural defects—include progressive atrial dilatation, endocardial denudation, and oedematous or fibroelastic infiltration of the extracellular matrix. Additionally, abnormal changes in blood constituents are well described, and include haemostatic and platelet activation, as well as inflammation and growth factor changes. These changes result in the fulfilment of Virchow's triad for thrombogenesis, and accord with a prothrombotic or hypercoagulable state in this arrhythmia. In this Review, we present an overview of the established and purported mechanisms for thrombogenesis in atrial fibrillation.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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creatorcontribWatson, Timothy, MRCP ; Shantsila, Eduard, MD ; Lip, Gregory YH, Prof
descriptionSummary Atrial fibrillation is the most common sustained cardiac arrhythmia, which is associated with a high risk of stroke and thromboembolism. Increasing evidence suggests that the thrombogenic tendency in atrial fibrillation is related to several underlying pathophysiological mechanisms. Abnormal changes in flow are evident by stasis in the left atrium, and seen as spontaneous echocontrast. Abnormal changes in vessel walls—essentially, anatomical and structural defects—include progressive atrial dilatation, endocardial denudation, and oedematous or fibroelastic infiltration of the extracellular matrix. Additionally, abnormal changes in blood constituents are well described, and include haemostatic and platelet activation, as well as inflammation and growth factor changes. These changes result in the fulfilment of Virchow's triad for thrombogenesis, and accord with a prothrombotic or hypercoagulable state in this arrhythmia. In this Review, we present an overview of the established and purported mechanisms for thrombogenesis in atrial fibrillation.
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subjectAbridged Index Medicus ; Atrial fibrillation ; Atrial Fibrillation - complications ; Atrial Fibrillation - physiopathology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular disease ; Complications and side effects ; Development and progression ; Drugs ; Fibrinolysis - physiology ; General aspects ; Heart ; Humans ; Internal Medicine ; Medical sciences ; Mortality ; Risk factors ; Scanning electron microscopy ; Sinuses ; Stroke (Disease) ; Thromboembolism ; Thrombosis ; Thrombosis - etiology ; Tomography ; von Willebrand Factor - physiology
ispartofThe Lancet (British edition), 2009, Vol.373 (9658), p.155-166
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descriptionSummary Atrial fibrillation is the most common sustained cardiac arrhythmia, which is associated with a high risk of stroke and thromboembolism. Increasing evidence suggests that the thrombogenic tendency in atrial fibrillation is related to several underlying pathophysiological mechanisms. Abnormal changes in flow are evident by stasis in the left atrium, and seen as spontaneous echocontrast. Abnormal changes in vessel walls—essentially, anatomical and structural defects—include progressive atrial dilatation, endocardial denudation, and oedematous or fibroelastic infiltration of the extracellular matrix. Additionally, abnormal changes in blood constituents are well described, and include haemostatic and platelet activation, as well as inflammation and growth factor changes. These changes result in the fulfilment of Virchow's triad for thrombogenesis, and accord with a prothrombotic or hypercoagulable state in this arrhythmia. In this Review, we present an overview of the established and purported mechanisms for thrombogenesis in atrial fibrillation.
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19Risk factors
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26Tomography
27von Willebrand Factor - physiology
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abstractSummary Atrial fibrillation is the most common sustained cardiac arrhythmia, which is associated with a high risk of stroke and thromboembolism. Increasing evidence suggests that the thrombogenic tendency in atrial fibrillation is related to several underlying pathophysiological mechanisms. Abnormal changes in flow are evident by stasis in the left atrium, and seen as spontaneous echocontrast. Abnormal changes in vessel walls—essentially, anatomical and structural defects—include progressive atrial dilatation, endocardial denudation, and oedematous or fibroelastic infiltration of the extracellular matrix. Additionally, abnormal changes in blood constituents are well described, and include haemostatic and platelet activation, as well as inflammation and growth factor changes. These changes result in the fulfilment of Virchow's triad for thrombogenesis, and accord with a prothrombotic or hypercoagulable state in this arrhythmia. In this Review, we present an overview of the established and purported mechanisms for thrombogenesis in atrial fibrillation.
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pubElsevier Ltd
pmid19135613
doi10.1016/S0140-6736(09)60040-4