{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:27:51Z","timestamp":1787113671575,"version":"build-2736575974"},"reference-count":163,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Atrial cardiomyopathy (ACM) is defined as any complex of structural, architectural, functional, electrophysiological, and molecular changes affecting the atria that may result in clinically significant health consequences. ACM can be caused by a variety of factors, including age-related changes, valvular or vascular disease, genetic diseases, congestive heart failure, metabolic diseases, cardiovascular disease (CVD) risk factors such as arterial hypertension (AH) or obesity, obstructive sleep apnea, and other infectious or noninfectious diseases predisposing to chronic inflammation. The diagnosis of ACM relies on several modalities, including electrocardiography, echocardiography, cardiac magnetic resonance imaging (MRI), computed tomography (CT), electroanatomical mapping (EAM), genetic studies, and biomarkers, which can detect and characterize structural, mechanical, and electrical atrial dysfunction. These changes often include structural atrial remodeling (fibrosis), abnormal structure of the atrial wall and its components, and contractile and electrical dysfunctions. When assessing aspects of ACM, structural changes in the atria such as left atrium (LA) size and fibrosis; LA architectural changes such as the expression of remodeling; changes in LA mechanics such as echocardiographic stress indices; changes in reservoir function and changes in contraction; biological factors determining changes in biomarkers; possible genetic predispositions and higher expression of certain genes encoding certain proteins; and arrhythmogenic factors associated with a higher risk of atrial fibrillation (AF) and stroke and a worse short- and long-term prognosis are very important. When considering the challenges of diagnosing ACM, it should be noted that without standardized diagnostics, most ACM diagnostic situations remain primarily research tools rather than practical clinical diagnostic methods. This review critically evaluates the evidence and translational gaps in the diagnosis of ACM, synthesizing the emerging role of advanced diagnostics and their clinical and prognostic implications as a key future tool for individual risk stratification.<\/jats:p>","DOI":"10.3390\/jcm15166317","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"6317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atrial Cardiomyopathy: Pathophysiology, Diagnostic Approaches, and Prognostic Implications\u2014A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Greta","family":"Barauskiene","sequence":"first","affiliation":[{"name":"Clinical Cardiology Laboratory, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindaugas","family":"Barauskas","sequence":"additional","affiliation":[{"name":"Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus 9, LT-44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-2297","authenticated-orcid":false,"given":"Sandrita","family":"Simonyte","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta Justina","family":"Vaskelyte","sequence":"additional","affiliation":[{"name":"Clinical Cardiology Laboratory, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"euae204","DOI":"10.1093\/europace\/euae204","article-title":"Atrial cardiomyopathy revisited-evolution of a concept: A clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS)","volume":"26","author":"Goette","year":"2024","journal-title":"Europace"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Goette, A., and Lendeckel, U. (2021). Atrial Cardiomyopathy: Pathophysiology and Clinical Consequences. Cells, 10.","DOI":"10.3390\/cells10102605"},{"key":"ref_3","first-page":"2184","article-title":"Post-translational Modifications: A New Perspective on the Pathogenesis of Atrial Cardiomyopathy","volume":"41","author":"Sun","year":"2025","journal-title":"Can. J. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1038\/s41569-024-01088-w","article-title":"Translation of pathophysiological mechanisms of atrial fibrosis into new diagnostic and therapeutic approaches","volume":"22","author":"Schotten","year":"2025","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1152\/physrev.00020.2025","article-title":"The clinical pathophysiology of atrial fibrillation: Outstanding questions from bedside to bench and back","volume":"106","author":"Boehmer","year":"2026","journal-title":"Physiol. Rev."},{"key":"ref_6","first-page":"e286","article-title":"Left Atrial Appendage Thrombus and Embolic Stroke","volume":"49","author":"Chang","year":"2018","journal-title":"Stroke"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.yjmcc.2010.10.033","article-title":"Transforming growth factor (TGF)-\u03b2 signaling in cardiac remodeling","volume":"51","author":"Dobaczewski","year":"2011","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jacep.2023.02.012","article-title":"Atrial Fibrosis, Endocardial Damage, and Thrombosis in Atrial Fibrillation: Association with Underlying Conditions or Causal?","volume":"9","author":"Nattel","year":"2023","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7348","DOI":"10.1096\/fj.201802510R","article-title":"Disruption of both ROCK1 and ROCK2 genes in cardiomyocytes promotes autophagy and reduces cardiac fibrosis during aging","volume":"33","author":"Shi","year":"2019","journal-title":"FASEB J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1038\/nrcardio.2016.203","article-title":"Expert consensus document: Mitochondrial function as a therapeutic target in heart failure","volume":"14","author":"Brown","year":"2017","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1161\/CIRCULATIONAHA.112.001207","article-title":"MicroRNA29: A mechanistic contributor and potential biomarker in atrial fibrillation","volume":"127","author":"Dawson","year":"2013","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1093\/eurheartj\/eht099","article-title":"Human epicardial adipose tissue induces fibrosis of the atrial myocardium through the secretion of adipo-fibrokines","volume":"36","author":"Venteclef","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1111\/jce.15083","article-title":"Atrial fibrillation and atrial cardiomyopathies","volume":"32","author":"Baman","year":"2021","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3768","DOI":"10.1002\/ehf2.14089","article-title":"Atrial cardiomyopathy: From cell to bedside","volume":"9","author":"Li","year":"2022","journal-title":"ESC Heart Fail."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e002955","DOI":"10.1136\/openhrt-2024-002955","article-title":"Characterisation of patients who develop atrial fibrillation-induced cardiomyopathy","volume":"11","author":"Ahluwalia","year":"2024","journal-title":"Open Heart"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e034268","DOI":"10.1161\/JAHA.124.034268","article-title":"Left Atrial Cardiomyopathy: A Puzzling Disease Process Short of an Easy Answer","volume":"13","author":"Petzl","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"25124","DOI":"10.31083\/RCM25124","article-title":"Atrial Cardiomyopathy: From Diagnosis to Treatment","volume":"26","author":"Liu","year":"2025","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1007\/s10554-024-03196-7","article-title":"Prognostic value of left atrial size and function by cardiac magnetic resonance in non-ischemic cardiomyopathy","volume":"40","author":"Benjamin","year":"2024","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.cardfail.2024.06.017","article-title":"Atrial Mechanics, Atrial Cardiomyopathy and Impact of Atrial Interventions","volume":"30","author":"Kittipibul","year":"2024","journal-title":"J. Card. Fail."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Conte, M., Petraglia, L., Cabaro, S., Valerio, V., Poggio, P., Pilato, E., Attena, E., Russo, V., Ferro, A., and Formisano, P. (2022). Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.932262"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.acvd.2024.02.001","article-title":"Groupe de Reflexion sur la Recherche Cardiovasculaire (GRRC). Left atrial cardiomyopathy: Pathophysiological insights, assessment methods and clinical implications","volume":"117","author":"Ninni","year":"2024","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"241","DOI":"10.23736\/S2724-5683.25.06725-0","article-title":"Atrial cardiomyopathy: New pathophysiological and clinical aspects","volume":"74","author":"Pierucci","year":"2026","journal-title":"Minerva Cardiol. Angiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1016\/j.hrthm.2016.05.028","article-title":"EHRA\/HRS\/APHRS\/SOLAECE expert consensus on atrial cardiomyopathies: Definition, characterization, and clinical implication","volume":"14","author":"Goette","year":"2017","journal-title":"Heart Rhythm."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.jacc.2017.06.033","article-title":"Atrial Cardiomyopathy: A Useful Notion in Cardiac Disease Management or a Passing Fad?","volume":"70","author":"Guichard","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1002\/ejhf.3782","article-title":"Atrial cardiomyopathy: From healthy atria to atrial failure. A clinical consensus statement of the Heart Failure Association of the ESC","volume":"27","author":"Weerts","year":"2025","journal-title":"Eur. J. Heart Fail."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.amjcard.2008.02.099","article-title":"Usefulness of left atrial volume index to predict heart failure hospitalization and mortality in ambulatory patients with coronary heart disease and comparison to left ventricular ejection fraction (from the Heart and Soul Study)","volume":"102","author":"Ristow","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"qyae061","DOI":"10.1093\/ehjimp\/qyae061","article-title":"Unveiling the reliability of left atrial strain measurement: A dedicated speckle tracking software perspective in controls and cases","volume":"2","author":"Mandoli","year":"2024","journal-title":"Eur. Heart J. Imaging Methods Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e015969","DOI":"10.1161\/CIRCIMAGING.123.015969","article-title":"Left Atrial Strain to Predict Postoperative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting","volume":"17","author":"Pastore","year":"2024","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rusali, C.A., Lupu, I.C., Rusali, L.M., and Cojocaru, L. (2025). Left Atrial Strain\u2014Current Review of Clinical Applications. Diagnostics, 15.","DOI":"10.20944\/preprints202504.2558.v1"},{"key":"ref_30","first-page":"113","article-title":"Left atrial strain: The conduit role in diastolic dysfunction","volume":"76","author":"Tsartsalis","year":"2024","journal-title":"Hell. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1111\/jce.12116","article-title":"Left atrial sphericity: A new method to assess atrial remodeling. Impact on the outcome of atrial fibrillation ablation","volume":"24","author":"Bisbal","year":"2013","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e004229","DOI":"10.1161\/CIRCIMAGING.115.004229","article-title":"Left Atrial Volumes and Function by Three-Dimensional Echocardiography: Reference Values, Accuracy, Reproducibility, and Comparison with Two-Dimensional Echocardiographic Measurements","volume":"9","author":"Badano","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3975","DOI":"10.1002\/ehf2.13496","article-title":"Role of 3D echocardiography-determined atrial volumes in distinguishing between pre-capillary and post-capillary pulmonary hypertension","volume":"8","author":"Jenei","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Gentille-Lorente, D., Hern\u00e1ndez-Pinilla, A., Satue-Gracia, E., Muria-Subirats, E., Forcadell-Peris, M.J., Gentille-Lorente, J., Ballesta-Ors, J., Mart\u00edn-Lujan, F.M., and Clua-Espuny, J.L. (2023). Echocardiography and Electrocardiography in Detecting Atrial Cardiomyopathy: A Promising Path to Predicting Cardioembolic Strokes and Atrial Fibrillation. J. Clin. Med., 12.","DOI":"10.3390\/jcm12237315"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1093\/europace\/euw161","article-title":"EHRA\/HRS\/APHRS\/SOLAECE expert consensus on atrial cardiomyopathies","volume":"18","author":"Goette","year":"2016","journal-title":"Europace"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kreimer, F., and Gotzmann, M. (2022). Left Atrial Cardiomyopathy\u2014A Challenging Diagnosis. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.942385"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/ejechocard\/jeq119","article-title":"Switching to volumetric left atrial measurements: Impact on routine echocardiographic practice","volume":"12","author":"Vyas","year":"2011","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1136\/heartjnl-2019-315174","article-title":"Left atrial dimension and cardiovascular outcomes in patients with and without atrial fibrillation: A systematic review and meta-analysis","volume":"105","author":"Froehlich","year":"2019","journal-title":"Heart"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/j.jacc.2019.01.059","article-title":"Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review","volume":"73","author":"Thomas","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4533","DOI":"10.1093\/eurheartj\/ehab523","article-title":"Genetics, atrial cardiomyopathy, and stroke: Enough components for a sufficient cause?","volume":"42","author":"Camen","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1056\/NEJM200011163432003","article-title":"The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction","volume":"343","author":"Kim","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Paddock, S., Tsampasian, V., Assadi, H., Mota, B.C., Swift, A.J., Chowdhary, A., Swoboda, P., Levelt, E., Sammut, E., and Dastidar, A. (2021). Clinical Translation of Three-Dimensional Scar, Diffusion Tensor Imaging, Four-Dimensional Flow, and Quantitative Perfusion in Cardiac MRI: A Comprehensive Review. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.682027"},{"key":"ref_43","first-page":"384","article-title":"Association of Left Atrial Fibrosis Detected by Delayed Enhancement Magnetic Resonance Imaging and Risk of Stroke in Patients with Atrial Fibrillation","volume":"4","author":"Peters","year":"2011","journal-title":"J. Atr. Fibrillation"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1161\/CIRCEP.113.000689","article-title":"Atrial fibrillation ablation outcome is predicted by left atrial remodeling on MRI","volume":"7","author":"McGann","year":"2014","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1093\/europace\/euaa252","article-title":"Magnetic resonance-guided re-ablation for atrial fibrillation is associated with a lower recurrence rate: A case-control study","volume":"22","author":"Quinto","year":"2020","journal-title":"Europace"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/jce.12650","article-title":"RI Assessment of Ablation-Induced Scarring in Atrial Fibrillation: Analysis from the DECAAF Study","volume":"26","author":"Akoum","year":"2015","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12968-018-0517-0","article-title":"Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: A multicenter study","volume":"21","author":"Khan","year":"2019","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_48","first-page":"65","article-title":"Left Atrial Volume Determinants in Patients with Non-Ischemic Dilated Cardiomyopathy","volume":"105","author":"Mancuso","year":"2015","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e019545","DOI":"10.1161\/JAHA.120.019545","article-title":"Prognostic Value of Minimal Left Atrial Volume in Heart Failure with Preserved Ejection Fraction","volume":"10","author":"Shin","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1093\/ehjci\/jeae136","article-title":"Left atrial volume as risk marker: Is minimum volume superior to maximum volume?","volume":"25","author":"Smiseth","year":"2024","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Cojan-Minzat, B.O., Zlibut, A., Muresan, I.D., Orzan, R.I., Cionca, C., Horvat, D., David, L., Visan, A.C., Florea, M., and Agoston-Coldea, L. (2021). Left Atrial Geometry and Phasic Function Determined by Cardiac Magnetic Resonance Are Independent Predictors for Outcome in Non-Ischaemic Dilated Cardiomyopathy. Biomedicines, 9.","DOI":"10.3390\/biomedicines9111653"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Kessler Iglesias, C., Pouliopoulos, J., Thomas, L., Hayward, C.S., Jabbour, A., and Fatkin, D. (2023). Atrial cardiomyopathy: Current and future imaging methods for assessment of atrial structure and function. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1099625"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.echo.2016.09.007","article-title":"Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis","volume":"30","author":"Pathan","year":"2017","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"29","DOI":"10.21037\/cdt.2017.06.08","article-title":"Left atrial function: Evaluation by strain analysis","volume":"8","author":"Gan","year":"2018","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Moln\u00e1r, A.\u00c1., S\u00e1nta, A., P\u00e1sztor, D.T., and Merkely, B. (2023). Atrial Cardiomyopathy in Valvular Heart Disease: From Molecular Biology to Clinical Perspectives. Cells, 12.","DOI":"10.3390\/cells12131796"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e007696","DOI":"10.1161\/CIRCIMAGING.118.007696","article-title":"Left Atrial Reservoir Function and Outcome in Heart Failure with Reduced Ejection Fraction","volume":"11","author":"Carluccio","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1002\/ehf2.15302","article-title":"Prognostic value of left atrial strain in acute and chronic heart failure: A meta-analysis","volume":"12","author":"Pastore","year":"2025","journal-title":"ESC Heart Fail."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Pelaia, G., Concolino, D., and Sabatino, J. (2023). Left Atrial Strain in Cardiomyopathies and Congenital Heart Disease: A Call for Its Integration into Clinical Practice. J. Clin. Med., 12.","DOI":"10.3390\/jcm12155084"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1540-8175.2010.01329.x","article-title":"Chronic mitral regurgitation: Left atrial deformation analysis by two-dimensional speckle tracking echocardiography","volume":"28","author":"Cameli","year":"2011","journal-title":"Echocardiography"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.echo.2013.05.019","article-title":"Left Atrial Function by Two-Dimensional Speckle-Tracking Echocardiography in Patients with Severe Organic Mitral Regurgitation: Association with Guidelines-Based Surgical Indication and Postoperative (Long-Term) Survival","volume":"26","author":"Debonnaire","year":"2013","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.echo.2015.07.004","article-title":"Predictive value of left atrial deformation on prognosis in severe primary mitral regurgitation","volume":"28","author":"Yang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1093\/ejechocard\/jep085","article-title":"Left atrial function and deformation in chronic primary mitral regurgitation","volume":"10","author":"Borg","year":"2009","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.echo.2012.11.016","article-title":"Two-dimensional atrial systolic strain imaging predicts atrial fibrillation at 4-year follow-up in asymptomatic rheumatic mitral stenosis","volume":"26","author":"Ancona","year":"2013","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.amjcard.2010.06.029","article-title":"Impact of aortic valve stenosis on left atrial phasic function","volume":"106","author":"Magne","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1016\/j.ijcard.2012.04.057","article-title":"Severity of aortic stenosis predicts early post-operative normalization of left atrial size and function detected by myocardial strain","volume":"167","author":"Lisi","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1093\/ehjci\/jev230","article-title":"Prognostic value of left atrial reservoir function in patients with severe aortic stenosis: A 2D speckle-tracking echocardiographic study","volume":"17","author":"Galli","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s10554-013-0346-z","article-title":"Left atrial booster-pump function as a predictive parameter for new-onset postoperative atrial fibrillation in patients with severe aortic stenosis","volume":"30","author":"Imanishi","year":"2014","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e010435","DOI":"10.1161\/CIRCEP.121.010435","article-title":"P Wave Parameters and Indices: A Critical Appraisal of Clinical Utility, Challenges, and Future Research\u2014A Consensus Document Endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology","volume":"15","author":"Chen","year":"2022","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1111\/jce.14608","article-title":"Association between interatrial block, left atrial fibrosis, and mechanical dyssynchrony: Electrocardiography-magnetic resonance imaging correlation","volume":"31","author":"Ciuffo","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Huang, T., Chen, J., M\u00fcller-Edenborn, B., Mayer, L., Eichenlaub, M., Weidmann, Z.M., Allgeier, J., Bohnen, M., Lehrmann, H., and Trenk, D. (2022). Validating left atrial fractionation and low-voltage substrate during atrial fibrillation and sinus rhythm\u2014A high-density mapping study in persistent atrial fibrillation. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.1000027"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Ohguchi, S., Inden, Y., Yanagisawa, S., Fujita, R., Yasuda, K., Katagiri, K., Oguri, M., and Murohara, T. (2022). Regional left atrial conduction velocity in the anterior wall is associated with clinical recurrence of atrial fibrillation after catheter ablation: Efficacy in combination with the ipsilateral low voltage area. BMC Cardiovasc. Disord., 22.","DOI":"10.1186\/s12872-022-02881-6"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/joa3.13146","article-title":"Slow left atrial conduction velocity in the anterior wall calculated by electroanatomic mapping predicts atrial fibrillation recurrence after catheter ablation-Systematic review and meta-analysis","volume":"40","author":"Lukito","year":"2024","journal-title":"J. Arrhythm."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijcard.2018.07.135","article-title":"Advanced interatrial block is an electrocardiographic marker for recurrence of atrial fibrillation after electrical cardioversion","volume":"272","author":"Fujimoto","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jelectrocard.2019.06.008","article-title":"Correlation of P-wave properties with the size of left atrial low voltage areas in patients with atrial fibrillation","volume":"56","author":"Schreiber","year":"2019","journal-title":"J. Electrocardiol."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Weinsaft, J.W., Kochav, J.D., Kim, J., Gurevich, S., Volo, S.C., Afroz, A., Petashnick, M., Kim, A., Devereux, R.B., and Okin, P.M. (2014). P wave area for quantitative electrocardiographic assessment of left atrial remodeling. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0099178"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1093\/eurjhf\/hfp097","article-title":"Galectin-3: A novel mediator of heart failure development and progression","volume":"11","author":"Voors","year":"2009","journal-title":"Eur. J. Heart Fail."},{"key":"ref_77","first-page":"599","article-title":"Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review)","volume":"41","author":"Dong","year":"2018","journal-title":"Int. J. Mol. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1007\/s00059-017-4538-5","article-title":"Galectin-3 as a marker for clinical prognosis and cardiac remodeling in acute heart failure","volume":"43","author":"Lala","year":"2018","journal-title":"Herz"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1179069519836794","DOI":"10.1177\/1179069519836794","article-title":"Galectins in the Pathogenesis of Cerebrovascular Accidents: An Overview","volume":"13","author":"Abel","year":"2019","journal-title":"J. Exp. Neurosci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.devcel.2019.10.025","article-title":"Galectin-3 Coordinates a Cellular System for Lysosomal Repair and Removal","volume":"52","author":"Jia","year":"2020","journal-title":"Dev. Cell"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Clementy, N., Piver, E., Bisson, A., Andre, C., Bernard, A., Pierre, B., Fauchier, L., and Babuty, D. (2018). Galectin-3 in Atrial Fibrillation: Mechanisms and Therapeutic Implications. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19040976"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"40378","DOI":"10.1038\/srep40378","article-title":"Galectin-3 as a marker of interstitial atrial remodelling involved in atrial fibrillation","volume":"7","author":"Lahoz","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1007\/s00109-023-02378-5","article-title":"The role of galectin-3 in atrial fibrillation","volume":"101","author":"Procyk","year":"2023","journal-title":"J. Mol. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e23104","DOI":"10.1002\/jcla.23104","article-title":"Galectin-3 and risk of atrial fibrillation: A systematic review and meta-analysis","volume":"34","author":"Gong","year":"2020","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.clinbiochem.2015.04.021","article-title":"Galectin-3 in atrial fibrillation: Simple bystander, player or both?","volume":"48","author":"Lippi","year":"2015","journal-title":"Clin. Biochem."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.jacc.2006.03.061","article-title":"Utility of amino-terminal pro-brain natriuretic peptide, galectin-3, and apelin for the evaluation of patients with acute heart failure","volume":"48","author":"Januzzi","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00392-010-0125-y","article-title":"Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: Data from the DEAL-HF study","volume":"99","author":"Lok","year":"2010","journal-title":"Clin. Res. Cardiol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1093\/eurheartj\/ehs077","article-title":"Galectin-3 predicts response to statin therapy in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)","volume":"33","author":"Gullestad","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_89","first-page":"530","article-title":"Relationship between Brain Natriuretic Peptide and Recurrence of Atrial Fibrillation after Successful Electrical Cardioversion: An Updated Meta-Analysis","volume":"32","author":"Xu","year":"2017","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"101132","DOI":"10.1016\/j.ijcha.2022.101132","article-title":"Atrial Fibrillation, thromboembolic risk, and the potential role of the natriuretic peptides, a focus on BNP and NT-proBNP\u2014A narrative review","volume":"43","author":"Kerr","year":"2022","journal-title":"IJC Heart Vasc."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"euaf256","DOI":"10.1093\/europace\/euaf256","article-title":"Prevalence and severity of atrial cardiomyopathy in patients with recently diagnosed atrial fibrillation and stroke risk factors and its association with early rhythm control: A secondary analysis of EAST-AFNET 4","volume":"27","author":"Goette","year":"2025","journal-title":"Europace"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Fonseca, A.C., and Coelho, P. (2021). Update on Biomarkers Associated to Cardioembolic Stroke: A Narrative Review. Life, 11.","DOI":"10.3390\/life11050448"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1161\/CIRCULATIONAHA.116.022802","article-title":"RE-LY and ARISTOTLE Investigators. Performance and Validation of a Novel Biomarker-Based Stroke Risk Score for Atrial Fibrillation","volume":"134","author":"Oldgren","year":"2016","journal-title":"Circulation"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1515\/cclm-2024-1090","article-title":"Advancements and challenges in high-sensitivity cardiac troponin assays: Diagnostic, pathophysiological, and clinical perspectives","volume":"63","author":"Clerico","year":"2025","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1161\/CIRCULATIONAHA.111.038729","article-title":"Cardiac biomarkers are associated with an increased risk of stroke and death in patients with atrial fibrillation: A Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) substudy","volume":"125","author":"Hijazi","year":"2012","journal-title":"Circulation"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1038\/s41569-026-01266-y","article-title":"Understanding atrial failure: From diagnosis to clinical implications","volume":"23","author":"Alexander","year":"2026","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1126\/science.1077771","article-title":"KCNQ1 gain-of-function mutation in familial atrial fibrillation","volume":"299","author":"Chen","year":"2003","journal-title":"Science"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1161\/CIRCGENETICS.112.963520","article-title":"Autosomal recessive atrial dilated cardiomyopathy with standstill evolution associated with mutation of Natriuretic Peptide Precursor A","volume":"6","author":"Disertori","year":"2013","journal-title":"Circ. Cardiovasc. Genet."},{"key":"ref_99","first-page":"1203","article-title":"Lone Atrial Fibrillation: Risk Factors, Triggers and Ablation Techniques","volume":"8","author":"Vroomen","year":"2015","journal-title":"J. Atr. Fibrillation"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1161\/CIRCEP.123.003750","article-title":"Genetic Atrial Cardiomyopathies: Common Features, Specific Differences, and Broader Relevance to Understanding Atrial Cardiomyopathy","volume":"16","author":"Marcoux","year":"2023","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1161\/CIRCRESAHA.120.316575","article-title":"Genetics of atrial fibrillation in 2020: GWAS, genome sequencing, polygenic risk, and beyond","volume":"127","author":"Roselli","year":"2020","journal-title":"Circ. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1001\/jamacardio.2021.3370","article-title":"Early-onset atrial fibrillation and the prevalence of rare variants in cardiomyopathy and arrhythmia genes","volume":"6","author":"Yoneda","year":"2021","journal-title":"JAMA Cardiol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"e001667","DOI":"10.1161\/CIRCGENETICS.116.001667","article-title":"Fifteen genetic loci associated with the electrocardiographic P wave","volume":"10","author":"Christophersen","year":"2017","journal-title":"Circ. Cardiovasc. Genet."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"4523","DOI":"10.1093\/eurheartj\/ehab466","article-title":"Genome-wide association study identifies 18 novel loci associated with left atrial volume and function","volume":"42","author":"Ahlberg","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"104429","DOI":"10.1016\/j.ejmg.2022.104429","article-title":"Genetic findings in patients with primary fibrotic atrial cardiomyopathy","volume":"65","author":"Zhu","year":"2022","journal-title":"Eur. J. Med. Genet."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e007030","DOI":"10.1161\/JAHA.117.007030","article-title":"Dysfunction of Myosin Light-Chain 4 (MYL4) Leads to Heritable Atrial Cardiomyopathy with Electrical, Contractile, and Structural Components: Evidence from Genetically-Engineered Rats","volume":"6","author":"Peng","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1161\/01.STR.0000119381.52589.AB","article-title":"Atrial natriuretic peptide gene polymorphisms and risk of ischemic stroke in humans","volume":"35","author":"Rubattu","year":"2004","journal-title":"Stroke"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e037490","DOI":"10.1161\/JAHA.124.037490","article-title":"Genetic Determinants of Left Atrial Function Are Associated with Stroke","volume":"13","author":"Vad","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1161\/01.RES.70.5.1035","article-title":"Hemodynamic performance and myosin light chain-1 expression of the hypertrophied left ventricle in aortic valve disease before and after valve replacement","volume":"70","author":"Brunner","year":"1992","journal-title":"Circ. Res."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0167-5273(92)90302-J","article-title":"Increased expression of atrial myosin light chain 1 in the overloaded human left ventricle: Possible expression of fetal type myocytes","volume":"36","author":"Nakao","year":"1992","journal-title":"Int. J. Cardiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1093\/cvr\/cvaf255","article-title":"Advances in single-cell transcriptomics: Unraveling the pathogenesis of calcific aortic valve disease","volume":"121","author":"Qin","year":"2025","journal-title":"Cardiovasc. Res."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1016\/j.jacc.2014.01.023","article-title":"Lone atrial fibrillation: Does it exist?","volume":"63","author":"Wyse","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/HCO.0000000000000610","article-title":"Genetics of atrial cardiomyopathy","volume":"34","author":"Fatkin","year":"2019","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"e003179","DOI":"10.1161\/CIRCGEN.120.003179","article-title":"Role of Common Genetic Variation in Lone Atrial Fibrillation","volume":"14","author":"Lazarte","year":"2021","journal-title":"Circ. Genom. Precis. Med."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.hrthm.2024.02.006","article-title":"Polygenic risk scores in atrial fibrillation: Associations and clinical utility in disease prediction","volume":"21","author":"Gibson","year":"2024","journal-title":"Heart Rhythm."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"100785","DOI":"10.1016\/j.lanepe.2023.100785","article-title":"Atrial fibrillation: Pathophysiology, genetic and epigenetic mechanisms","volume":"37","author":"Vinciguerra","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"e12661","DOI":"10.1111\/anec.12661","article-title":"Genetic variants on chromosomes 7p31 and 12p12 are associated with abnormal atrial electrical activation in patients with early-onset lone atrial fibrillation","volume":"24","author":"Seifert","year":"2019","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"11303","DOI":"10.1038\/ncomms11303","article-title":"A mutation in the atrial-specific myosin light chain gene (MYL4) causes familial atrial fibrillation","volume":"7","author":"Orr","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1161\/CIRCULATIONAHA.119.044268","article-title":"Metastable Atrial State Underlies the Primary Genetic Substrate for MYL4 Mutation-Associated Atrial Fibrillation","volume":"141","author":"Ghazizadeh","year":"2020","journal-title":"Circulation"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1038\/s41588-018-0133-9","article-title":"Multi-ethnic genome-wide association study for atrial fibrillation","volume":"50","author":"Roselli","year":"2018","journal-title":"Nat. Genet."},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Zhang, J., Huang, X., Wang, X., Gao, Y., Liu, L., Li, Z., Chen, X., Zeng, J., Ye, Z., and Li, G. (2020). Identification of potential crucial genes in atrial fibrillation: A bioinformatic analysis. BMC Med. Genom., 13.","DOI":"10.1186\/s12920-020-00754-5"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"euaf042","DOI":"10.1093\/europace\/euaf042","article-title":"Identification of a new genetic locus associated with atrial fibrillation in the Taiwanese population by genome-wide and transcriptome-wide association studies","volume":"27","author":"Lee","year":"2025","journal-title":"Europace"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"3111","DOI":"10.1093\/eurheartj\/ehae298","article-title":"Genetic testing in early-onset atrial fibrillation","volume":"45","author":"Kany","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1016\/j.jacep.2025.03.039","article-title":"MYL4 Identifies Intramural Anatomy of Purkinje Fibers in Human Hearts","volume":"11","author":"Hillestad","year":"2025","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"12681","DOI":"10.1038\/s41598-019-49191-0","article-title":"Human cardiac myosin light chain 4 (MYL4) mosaic expression patterns vary by sex","volume":"9","author":"Wang","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"4316","DOI":"10.1038\/s41467-018-06618-y","article-title":"Rare truncating variants in the sarcomeric protein titin associate with familial and early-onset atrial fibrillation","volume":"9","author":"Ahlberg","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1001\/jama.2018.18179","article-title":"DiscovEHR study and the NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium. Association Between Titin Loss-of-Function Variants and Early-Onset Atrial Fibrillation","volume":"320","author":"Choi","year":"2018","journal-title":"JAMA"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1161\/CIRCRESAHA.119.315686","article-title":"Monogenic and Polygenic Contributions to Atrial Fibrillation Risk: Results from a National Biobank","volume":"126","author":"Choi","year":"2020","journal-title":"Circ. Res."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1001\/jamacardio.2025.0460","article-title":"Cardiomyopathy-Associated Gene Variants in Atrial Fibrillation","volume":"10","author":"Wijdeveld","year":"2025","journal-title":"JAMA Cardiol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/eurheartj\/ehw379","article-title":"A frameshift deletion in the sarcomere gene MYL4 causes early-onset familial atrial fibrillation","volume":"38","author":"Gudbjartsson","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jacep.2018.07.016","article-title":"Atrial Arrhythmias and Extensive Left Atrial Fibrosis as the Initial Presentation of MYH7 Gene Mutation","volume":"4","author":"Zhang","year":"2018","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/pace.14077","article-title":"A novel homozygous SCN5A variant detected in sick sinus syndrome","volume":"44","author":"Alkorashy","year":"2021","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.jacep.2020.05.031","article-title":"Genetic Susceptibility to Atrial Fibrillation Is Associated with Atrial Electrical Remodeling and Adverse Post-Ablation Outcome","volume":"6","author":"Wong","year":"2020","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1161\/CIRCGEN.119.002874","article-title":"Genetic Determinants of Electrocardiographic P-Wave Duration and Relation to Atrial Fibrillation","volume":"13","author":"Weng","year":"2020","journal-title":"Circ. Genom. Precis. Med."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"e013180","DOI":"10.1161\/CIRCEP.124.013180","article-title":"Mechanisms Underlying Sinus Node Dysfunction in a Rat Model of Genetic Atrial Cardiomyopathy","volume":"18","author":"Marcoux","year":"2025","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1253\/circj.CJ-19-0415","article-title":"Rs4968309 in Myosin Light Chain 4 (MYL4) Associated with Atrial Fibrillation Onset and Predicts Clinical Outcomes After Catheter Ablation in Atrial Fibrillation Patients Without Structural Heart Disease","volume":"83","author":"Zhong","year":"2019","journal-title":"Circ. J."},{"key":"ref_137","doi-asserted-by":"crossref","unstructured":"Xu, X., Yu, Z., Ai, N., Liufu, S., Liu, X., Chen, B., Li, X., Jiang, J., Zhang, Y., and Ma, H. (2023). Molecular Mechanism of MYL4 Regulation of Skeletal Muscle Development in Pigs. Genes, 14.","DOI":"10.3390\/genes14061267"},{"key":"ref_138","doi-asserted-by":"crossref","unstructured":"Ye, Y., Wu, G., Wang, H., Duan, M., Shang, P., and Chamba, Y. (2024). The Role of the MYL4 Gene in Porcine Muscle Development and Its Molecular Regulatory Mechanisms. Animals, 14.","DOI":"10.3390\/ani14091370"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1536\/ihj.22-560","article-title":"Correlation between Serum Myosin Light Chain 4 Levels and Recurrence after Radiofrequency Ablation in Patients with Atrial Fibrillation","volume":"64","author":"Yu","year":"2023","journal-title":"Int. Heart J."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"e2314920120","DOI":"10.1073\/pnas.2314920120","article-title":"Myosin-binding protein H-like regulates myosin-binding protein distribution and function in atrial cardiomyocytes","volume":"120","author":"Barefield","year":"2023","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"e202413630","DOI":"10.1085\/jgp.202413630","article-title":"Myosin-binding protein H-like nonsense variants exhibit impaired sarcomere incorporation and alter contractility","volume":"158","author":"Fritzmann","year":"2026","journal-title":"J. Gen. Physiol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1161\/CIRCULATIONAHA.117.028585","article-title":"Experimental Modeling Supports a Role for MyBP-HL as a Novel Myofilament Component in Arrhythmia and Dilated Cardiomyopathy","volume":"136","author":"Barefield","year":"2017","journal-title":"Circulation"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"e051222211571","DOI":"10.2174\/1573403X19666221205100148","article-title":"Prediction of Recurrence of Atrial Fibrillation Post-ablation Based on Atrial Fibrosis Seen on Late Gadolinium Enhancement MRI: A Metaanalysis","volume":"19","author":"Regmi","year":"2023","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1007\/s00415-023-11693-3","article-title":"Atrial cardiomyopathy and incident ischemic stroke risk: A systematic review and meta-analysis","volume":"270","author":"Guo","year":"2023","journal-title":"J. Neurol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"17049","DOI":"10.1038\/s41598-024-61304-y","article-title":"Association between atrial cardiopathy and stroke severity in acute ischemic stroke","volume":"14","author":"Zhang","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1001\/jama.2022.8831","article-title":"Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients with Persistent Atrial Fibrillation: The DECAAF II Randomized Clinical Trial","volume":"327","author":"Marrouche","year":"2022","journal-title":"JAMA"},{"key":"ref_147","doi-asserted-by":"crossref","unstructured":"Karakasis, P., Theofilis, P., Milaras, N., Vlachakis, P.K., Patoulias, D., Karamitsos, T., Antoniadis, A.P., and Fragakis, N. (2025). Epigenetic Drivers of Atrial Fibrillation: Mechanisms, Biomarkers, and Therapeutic Targets. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26115253"},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1177\/23969873241276358","article-title":"Atrial cardiopathy biomarkers and atrial fibrillation in the ARCADIA trial","volume":"10","author":"Kamel","year":"2025","journal-title":"Eur. Stroke J."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"331","DOI":"10.3390\/pathophysiology31030024","article-title":"Diagnostic Utility of N-Terminal Pro-B-Type Natriuretic Peptide in Identifying Atrial Fibrillation Post-Cryptogenic Stroke: A Systematic Review and Meta-Analysis","volume":"31","author":"Patel","year":"2024","journal-title":"Pathophysiology"},{"key":"ref_150","doi-asserted-by":"crossref","unstructured":"Mangia, M., D\u2019Andrea, E., Cecchetto, A., Beccari, R., Mele, D., and Nistri, S. (2024). Current and Clinically Relevant Echocardiographic Parameters to Analyze Left Atrial Function. J. Cardiovasc. Dev. Dis., 11.","DOI":"10.3390\/jcdd11080241"},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"Karakasis, P., Theofilis, P., Vlachakis, P.K., Ktenopoulos, N., Patoulias, D., Antoniadis, A.P., and Fragakis, N. (2025). Atrial Cardiomyopathy in Atrial Fibrillation: Mechanistic Pathways and Emerging Treatment Concepts. J. Clin. Med., 14.","DOI":"10.3390\/jcm14093250"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.jacc.2017.07.758","article-title":"Left Atrial Fibrosis and Risk of Cerebrovascular and Cardiovascular Events in Patients with Atrial Fibrillation","volume":"70","author":"King","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.jacep.2017.07.004","article-title":"Assessment of Left Atrial Fibrosis by Late Gadolinium Enhancement Magnetic Resonance Imaging: Methodology and Clinical Implications","volume":"3","author":"Siebermair","year":"2017","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_154","first-page":"180","article-title":"Use of delayed-enhancement magnetic resonance imaging for fibrosis detection in the atria: A review","volume":"19","author":"Pontecorboli","year":"2017","journal-title":"Europace"},{"key":"ref_155","first-page":"101078","article-title":"The role of interventional cardiac magnetic resonance (iCMR) in a typical atrial flutter ablation: The shortest path may not always be the fastest","volume":"41","author":"Bijvoet","year":"2022","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_156","doi-asserted-by":"crossref","unstructured":"Jabbour, J.P., Palombi, M., Bonanni, M., Matteucci, A., Arcari, L., Pierucci, N., La Fazia, V.M., Lavalle, C., and Mariani, M.V. (2025). The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review. J. Cardiovasc. Dev. Dis., 12.","DOI":"10.3390\/jcdd12040114"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1001\/jama.2014.3","article-title":"Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: The DECAAF study","volume":"311","author":"Marrouche","year":"2014","journal-title":"JAMA"},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/jce.14957","article-title":"DECAAF II Investigators. Efficacy of LGE-MRI-guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: The DECAAF II trial: Study design","volume":"32","author":"Marrouche","year":"2021","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"euad199","DOI":"10.1093\/europace\/euad199","article-title":"Effect of fibrosis regionality on atrial fibrillation recurrence: Insights from DECAAF II","volume":"25","author":"Assaf","year":"2023","journal-title":"Europace"},{"key":"ref_160","doi-asserted-by":"crossref","unstructured":"Guichard, J.B., Guasch, E., Roche, F., Da Costa, A., and Mont, L. (2022). Premature atrial contractions: A predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.971691"},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1001\/jama.2023.27188","article-title":"ARCADIA Investigators. Apixaban to Prevent Recurrence After Cryptogenic Stroke in Patients with Atrial Cardiopathy: The ARCADIA Randomized Clinical Trial","volume":"331","author":"Kamel","year":"2024","journal-title":"JAMA"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ejim.2023.10.023","article-title":"Atrial cardiomyopathy: An entity of emerging interest in the clinical setting","volume":"118","author":"Boriani","year":"2023","journal-title":"Eur. J. Intern. Med."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1080\/14796678.2025.2548159","article-title":"Atrial cardiomyopathy: Current clinical perspectives and future insights","volume":"21","author":"Daise","year":"2025","journal-title":"Future Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6317\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:16:28Z","timestamp":1787112988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,15]]},"references-count":163,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15166317"],"URL":"https:\/\/doi.org\/10.3390\/jcm15166317","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,15]]}}}