{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:24:41Z","timestamp":1788449081696,"version":"build-2803163510"},"reference-count":175,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Healthcare Research"},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","award":["NIHR302961"],"award-info":[{"award-number":["NIHR302961"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030827","name":"NHS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030827","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UK Department of Health and Social Care"},{"name":"Research Fund\u2014Flanders","award":["1102026N"],"award-info":[{"award-number":["1102026N"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Atrial cardiomyopathy (AtCM) encompasses all forms of electrical atrial dysfunction in combination with mechanical atrial dysfunction, atrial enlargement, and\/or excessive atrial fibrosis. A growing body of evidence suggests that AtCM not only represents a consequence of ventricular and valvular heart disease but also, critically, serves as the substrate driving atrial fibrillation (AF) and independently contributes to thromboembolic risk and heart failure (HF). Recent advances in cardiac imaging, electrocardiography, and electroanatomic mapping have enabled characterization of AtCM and quantification of its severity, defining a continuum from atrial health to overt atrial failure. This framework creates an opportunity for targeted interventions that may reverse AtCM and prevent progression to clinical disease.<\/jats:p>\n                  <jats:p>This scientific statement summarizes contemporary evidence regarding the natural history, determinants, and therapeutic modification of AtCM. We describe how targeted management of relevant lifestyle factors and comorbidities may prevent or attenuate AtCM progression and report the response of AtCM to pharmacological and structural interventions for HF and valve disease. Recognition of the bidirectional relationship between AtCM and AF has provided important insights into arrhythmia-mediated remodelling and generated the strongest evidence to date for reverse atrial remodelling following successful rhythm-control strategies. We also review emerging atrial-directed therapies targeting fibrosis, inflammation, metabolic dysfunction, and infiltrative disease.<\/jats:p>\n                  <jats:p>While AtCM appears to be, at least in part, a modifiable disease process, current evidence remains largely observational or mechanistic. We therefore highlight key evidence gaps and future research priorities to identify potentially reversible disease, develop targeted therapies, and translate state-of-the-art atrial phenotyping into improved patient outcomes.<\/jats:p>","DOI":"10.1093\/ejhf\/xuag268","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:39:15Z","timestamp":1787053155000},"source":"Crossref","is-referenced-by-count":0,"title":["Strategies for preventing and reversing atrial cardiomyopathy: current evidence, therapeutic targets, and future directions. A European Journal of Heart Failure expert consensus statement"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4225-3693","authenticated-orcid":false,"given":"Rosita","family":"Zakeri","sequence":"first","affiliation":[{"name":"School of Cardiovascular Medicine & Metabolic Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, The James Black Centre , 125 Coldharbour Lane, London SE5 9NU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-5349","authenticated-orcid":false,"given":"Massimiliano","family":"Camilli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart , Rome ,","place":["Italy"]},{"name":"Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 1 , Rome 00168 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6682-0074","authenticated-orcid":false,"given":"Emilia","family":"D\u2019Elia","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiovascular Department, ASST Papa Giovanni XXIII , Bergamo ,","place":["Italy"]},{"name":"School of Medicine and Surgery, University Milano Bicocca , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Sebastien","family":"Hulot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM, CIC1418, PARCC U970, F-CRIN INI-CRCT , Paris F-75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-5062","authenticated-orcid":false,"given":"Massimo","family":"Iacoviello","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Foggia , Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1795-855X","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Sisti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital of Gubbio-Gualdo Tadino , Gubbio ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otilia","family":"Tica","sequence":"additional","affiliation":[{"name":"Cardiology Department, County Emergency Clinical Hospital of Bihor , Oradea ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Tokmakova","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv, First Department of Internal Diseases, University Hospital for Active Treatment \u2018Sv. Georgi\u2019 EAD , Plovdiv ,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-3453","authenticated-orcid":false,"given":"Jerremy","family":"Weerts","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili and Department of Experimental and Applied Medicine, Institute of Cardiology, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-8201","authenticated-orcid":false,"given":"Wojciech","family":"Kosmala","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Wroclaw Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-197X","authenticated-orcid":false,"given":"Antoni","family":"Bayes-Genis","sequence":"additional","affiliation":[{"name":"Hospital Universitari Germans Trias I Pujol, CIBERCV c\/ del canyet SN , 08916 Badalona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"2026090310570367200_xuag268-B1","first-page":"205","article-title":"Familial atrial cardiomyopathy with heart block","volume":"34","author":"Nagle","year":"1972","journal-title":"Br Heart J"},{"key":"2026090310570367200_xuag268-B2","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1093\/oxfordjournals.qjmed.a067320","article-title":"Familial atrial cardiomyopathy with heart block","volume":"41","author":"Williams","year":"1972","journal-title":"Q J Med"},{"key":"2026090310570367200_xuag268-B3","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1002\/ejhf.3782","article-title":"Atrial cardiomyopathy: from healthy atria to atrial failure. 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