• Shuguang Qin, Maxime Boidin, Benjamin J R Buckley, LipGregory Y HGYHhttps://orcid.org/0000-0002-7566-1626Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and University of Liverpool, Liverpool, UK., and ThijssenDick H JDHJhttps://orcid.org/0000-0002-7707-5567Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and University of Liverpool, Liverpool, UK.Research Institute for Sport and Exercise Sciences, Liverpool John Moores Univ.
• Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and University of Liverpool, Liverpool, UK.
• Eur. J. Clin. Invest. 2021 May 1; 51 (5): e13477.

AbstractAtrial fibrillation (AF) is the most common arrhythmia and is associated with worsened morbidity and mortality. The prevalence of AF is estimated to increase with an ageing population resulting in an ever-increasing burden on the healthcare system. Despite improvements in AF treatment, several questions remain unanswered in relation to the development and progression of AF. In this review, we discuss the evidence supporting the presence of vascular dysfunction in the development of AF, but also as a final common pathway explaining why AF constitutes a markedly increased risk of cardiovascular morbidity and mortality. Specifically, we summarise the work performed in humans related to the impact of AF on vascular structure and function, and whether measures of vascular function predict AF progression and the development of cardiovascular events. Subsequently, we discuss the potential mechanisms linking AF to the development of vascular dysfunction. Finally, we propose future perspectives of vascular health and AF, advocating a strong focus on regular exercise training as a safe and effective strategy to improve vascular function and, hence, reduce the risk for development and progression of AF and its associated risk for cardiovascular events.© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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