Evidence map›Paper›PMID 40428200›Full record

ReviewDiagnostics (Basel, Switzerland)2025

Atrial Cardiomyopathy in Atrial Fibrillation: A Multimodal Diagnostic Framework.

Paschalis Karakasis, Panayotis K Vlachakis, Panagiotis Theofilis, Nikolaos Ktenopoulos, Dimitrios Patoulias, Barbara Fyntanidou, Antonios P Antoniadis, Nikolaos Fragakis

Abstract readReview
In one paragraph

Review in Diagnostics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Rare TruncatingGenes · 2026
    Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Inflammation and Resolution in Obesity-Related Cardiovascular Disease.International journal of molecular sciences · 2026
    Review
  10. Metabolic Syndrome and Atrial Cardiomyopathy on the Risk of Stroke Mortality in the General Population.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026
    Article
  11. Discovery ofDiagnostics (Basel, Switzerland) · 2025
    Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Review
  17. Review
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Paschalis KarakasisSecond Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.ORCID 0000-0002-3561-5713
Panayotis K VlachakisFirst Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0003-0736-4942
Panagiotis TheofilisFirst Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0001-9260-6306
Nikolaos KtenopoulosFirst Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0002-0995-7015
Dimitrios PatouliasSecond Propedeutic Department of Internal Medicine, Faculty of Medicine, School of Health Sciences Aristotle, University of Thessaloniki, 54642 Thessaloniki, Greece.ORCID 0000-0002-6899-684X
Barbara FyntanidouEmergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.ORCID 0000-0003-0019-0134
Antonios P AntoniadisSecond Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.ORCID 0000-0002-6604-5581
Nikolaos FragakisSecond Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.ORCID 0000-0002-7158-4950

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) is increasingly recognized as the clinical manifestation of an underlying atrial disease process rather than a purely electrical disorder. This evolving paradigm has given rise to the concept of atrial cardiomyopathy (AtCM), encompassing structural, electrical, contractile, and molecular remodeling of the atrial myocardium that contributes to AF initiation, maintenance, and progression. Although consensus definitions of AtCM now exist, its integration into clinical practice remains limited, with AF management still largely guided by arrhythmic patterns rather than substrate characterization. This review synthesizes current diagnostic strategies for AtCM within the context of AF, emphasizing a multimodal approach. We outline advances in cardiac imaging-including echocardiography, cardiac magnetic resonance, and computed tomography-for detailed assessment of atrial morphology, function, and fibrosis. Electroanatomic mapping is discussed as a key invasive tool for substrate localization, while electrocardiographic indices such as P-wave morphology and dispersion serve as accessible surrogates of electrical remodeling. In parallel, we examine the role of circulating biomarkers and emerging genomic, transcriptomic, and epigenomic markers in refining disease phenotyping. Despite promising progress, significant challenges remain. Standardization of imaging protocols, validation of biomarker thresholds, and integration of artificial intelligence tools are needed to enhance clinical utility. A diagnostic framework informed by atrial substrate assessment may support more tailored therapeutic decision-making in AF. Future research should prioritize the harmonization of diagnostic criteria and explore how substrate profiling in AF may refine risk stratification and improve clinical outcomes.

Indexed as

atrial cardiomyopathyatrial fibrillationatrial substratebiomarkerscardiac imagingelectroanatomic mappingelectrocardiography

Identifiers

PMID40428200
PMCPMC12110179

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.