Abstract
Atrial fibrillation (AF) is a common arrhythmia that has major morbidity
and mortality. Hypoxia plays an important role in AF initiation and
maintenance. Hypoxia inducible factor (HIF), the master regulator of
oxygen homeostasis in cells, plays a fundamental role in the regulation
of multiple chemokines and cytokines that are involved in different
physiological and pathophysiological pathways. HIF is also involved in
the pathophysiology of AF induction and propogation mostly through
structural remodeling such as fibrosis, however some of the cytokines
discussed have even been implicated in electrical remodeling of the
atria. In this article, we highlight the association between HIF and
some of its related cytokines with AF. Additionally, we provide an
overview of the potential diagnostic benefits of using the mentioned
cytokines as AF biomarkers. Research discussed in this review suggests
that the expression of these cytokines may correlate with patients who
are at an increased risk of devleoping AF. Furthermore, cytokines that
are elevated in patients with AF can assist clinicians in the diagnosis
of suspect paroxysmal AF patients. Interestingly, some of the cytokines
have been elevated specifically when AF is associated with a
hypercoaguable state, suggeting that they could be helpful in the
clinician’s and patient’s decision to begin anticoagulation. Finally,
more recent research has demonstrated the promise of targeting these
cytokines for the treatment of AF. While still in its early stages,
tools such as neutralizing antibodies have proved to be efficacious in
targetting the HIF pathway and treating or preventing AF.